高血压、吸烟与年龄相关白内障关联性研究

目的：探讨高血压、吸烟与年龄相关白内障（ARC）的关系。方法：采用以医院为基础的病例对照研究方法,病例组为2009年10月至2011年3月施行白内障摘除术,年龄45～85岁的260例患者;对照组为与病例同期入住相同医院的260例罹患其他疾病的患者,病例与对照采取1∶1匹配。应用自行设计的健康状况调查表进行调查,调查内容主要包括一般人口学特征、生活方式（吸烟）以及个人疾病既往史等。同时还对研究对象的血压进行测量。采用多因素Logistic回归模型估计高血压、吸烟与ARC关联的比值比（OR）及其相应的95%CI。结果：调整年龄、性别因素后,高血压与ARC呈正相关（OR=1.533,95%CI：1.057～2.223,P=0.024）。高血压病程≥20年者发生ARC的危险性显著增加（OR=2.418,95%CI：1.065～5.491,P=0.035）。与从不吸烟者相比,吸烟≥30支/d者发生ARC的OR为2.120（95%CI：1.039～4.326,P=0.039）。吸烟量越大,发生ARC的危险性越高。吸烟≥30年者发生ARC的危险性比不吸烟者增加51.2%（OR=1.512,95%CI：1.006～2.272,P=0.047）。与现行吸烟者相比,戒烟≥10年的研究对象发生ARC的危险性显著降低（OR=0.437,95%CI：0.195～0.980,P=0.041）。结论：高血压、吸烟是ARC发生的重要危险因素,控制高血压、尽早戒烟可有助于延缓ARC的发生发展。     

膳食宏量营养素摄入量与年龄相关白内障危险性分析

目的探讨中老年人膳食宏量摄入量与年龄相关白内障(ARC)危险性之间的关系。方法选取2009年9月—2011年3月45～85岁的白内障患者360例为病例组,对照组为同期入院的360例非白内障患者。采用标准调查表对研究对象进行调查,内容包括人口学特征、生活方式以及既往疾病史等,同时采用一份有效的半定量化食物频率调查表(FFQ),获取研究对象膳食营养素的摄入情况。应用多因素Logistic回归分析估计各种宏量营养素摄入量与3种类型白内障关联的比值比(OR)及其相应的95%可信区间(CI)。结果调整多种潜在性混杂因素后,总碳水化合物摄入量与皮质性白内障呈正相关,与摄入量为最低四分位数的患者相比,摄入量为最高四分位数的患者发生皮质性白内障的OR=2.471〔95%CI(1.348,6.043),P=0.027〕。蛋白质摄入量增加对后囊膜下白内障(PSC)具有预防作用〔OR=0.528,95%CI(0.148,0.869),P=0.023〕。总脂肪摄入量与任一类型白内障均无相关性,但多不饱和脂肪酸摄入量为最高四分位数者发生核性白内障的危险性是最低四分位数者的2.7倍〔OR=2.742,95%CI(1.790,4.200),P=0.033〕。结论大量摄入碳水化合物和多不饱和脂肪酸可分别使发生皮质性和核性白内障的危险性升高,而蛋白质,尤其是动物蛋白摄入量增加能够预防PSC,调整中老年人群膳食习惯可能有助于预防ARC。     

中青年体质指数、腰围及腰臀比与脑卒中发生的相关性研究

目的探讨中青年人肥胖的不同指标,如体质指数(BMI)、腰围(WC)及腰臀比(WHR)与脑卒中发生的关系。方法采用以医院为基础的病例对照研究。病例组由280例脑卒中(缺血性脑卒中和出血性脑卒中)患者组成,对照组为患其他与脑卒中无关的疾病同期入住和病例组相同医院的280例患者。采用标准调查表对研究对象进行调查,收集研究对象的人口学特征、生活方式、个体疾病史、脑卒中家族遗传史以及实验室检查等资料,同时对身高、体质量、WC、臀围进行测量,并计算BMI及WHR。采用多元Logistic回归分析对研究对象的BMI、WC及WHR与脑卒中的比值比(OR)及其95%可信区间(CI)进行估计。结果 280例脑卒中患者中出血性76例,缺血性204例。与正常BMI者相比较,调整年龄、性别后的分析结果显示,超重或肥胖的病例发生缺血性脑卒中的危险性明显高于对照组〔超重者:OR=2.03,95%CI(1.26,2.91),P<0.05;肥胖者:OR=1.88,95%CI(1.32,2.39),P<0.05〕。与BMI最低四分位数相比,BMI最高四分位数的病例发生缺血性脑卒中的危险性增加了18%〔OR=1.18,95%CI(1.06,3.54),P<0.01〕。WC最高四分位数的病例发生出血性和缺血性脑卒中的危险性分别是WC最低四分位数的1.80和1.96倍〔OR=1.80,95%CI(1.03,3.16)和OR=1.96,95%CI(1.37,3.78),P<0.01〕。与WHR最低四分位数比较,WHR最高四分位数的病例发生出血性及缺血性脑卒中的危险性分别增加了98%和126%〔OR=1.98,95%CI(1.41,3.59),P<0.01和OR=2.26,95%CI(1.34,2.79),P<0.01〕。结论 BMI增高是发生脑卒中的一个重要危险因素,WC增加可使发生缺血性脑卒中的危险性显著升高,而WHR与发生出血性及缺血性脑卒中的危险性呈正相关。维持正常体质量可能是脑卒中发病的保护因素。     

急性心肌梗死患者院前延迟影响因素的系统评价及防控对策

目的 探讨急性心肌梗死患者院前延迟的影响因素,并明确应对策略,旨在缩短院前延迟时间。 方法 经Pubmed、Embase等十大数据库检索相关文献,用NOS量表评价纳入文献19篇,均为流行病调查研究,以Rev Man 5.3软件进行统计分析。 结果 通过Meta分析将影响因素归纳为3大类。①社会因素:年龄[OR=1.090,95%CI(1.060～1.130),P＜0.001]、性别[OR=1.180,95%CI(1.050～1.330),P=0.006]、文化水平[OR=1.410,95%CI(1.190～1.670),P＜0.001]、居住地区[OR=1.350,95%CI(0.990～1.840),P=0.060];②临床因素:糖尿病史[OR=1.380,95%CI(1.220～1.560),P＜0.001]、心绞痛史[OR=1.370,95%CI=1.050～1.770,P=0.020]、心肌梗死史[OR=1.080,95%CI(0.640～1.830),P=0.760]、PCI史[OR=0.760,95%CI(0.670～0.860),P＜0.001];③其他因素: 夜间发病[OR=1.630,95%CI(1.340～1.970),P＜0.001]、就诊方式[OR=0.640,95%CI(0.570～0.710),P＜0.001]、未将症状归因于心脏[OR=3.100,95%CI(1.620～5.940),P＜0.001]。 结论 高龄、女性、糖尿病史、心绞痛史、夜间发病、未将症状归因于心脏是其危险因素,高学历、PCI史、EMS就诊是其保护因素,居住地区、心肌梗死史与急性心肌梗死患者院前延迟无关。采取切实有效地干预措施,能够缩短院前延迟时间,降低患者院外死亡率。      

查尔森合并症指数对老年慢性阻塞性肺疾病患者预后的评估价值

目的探讨查尔森合并症指数(CCI)评估老年慢性阻塞性肺疾病(简称慢阻肺)预后的价值。方法回顾性分析2010年1月至2015年1月首都医科大学宣武医院呼吸科住院的350例大于65岁的慢阻肺患者的临床资料。采集年龄、体重指数(BMI)、合并症、第1秒用力呼气容积占预计值百分比(FEV1%pred)、入院前1年慢阻肺急性加重次数和出院时转归。计算CCI分值,分析慢阻肺急性加重及住院死亡的相关因素。结果慢阻肺急性加重次数≥2次/年患者177例,慢阻肺急性加重次数2次/年患者173例。经多因素Logistic回归分析,CCI[OR=1.559,95%CI(1.309,1.856),P=0.000]及FEV1%pred[OR=0.979,95%CI(0.964,0.994),P=0.006]是慢阻肺急性加重的独立危险因素。住院死亡率为10.3%(36/314)。经多因素Logistic回归分析,CCI[OR=1.894,95%CI(1.422,2.523),P=0.000],年龄[OR=1.153,95%CI(1.063,1.251),P=0.001],FEV1%pred[OR=0.916,95%CI(0.878,0.955),P=0.000],BMI[OR=0.849,95%CI(0.749,0.962),P=0.011],慢阻肺急性加重≥2次/年[OR=6.340,95%CI(1.469,27.366),P=0.013]是慢阻肺患者死亡的独立危险因素。结论 CCI是慢阻肺急性加重及死亡的独立危险因素,对评估慢阻肺预后有一定价值。     

H型高血压与脑出血患者血肿扩大及转归的相关性

【】目的 探讨H型高血压与脑出血早期血肿扩大及3个月时临床转归和死亡的关系。方法 纳入原发性脑出血患者298例,记录其一般资料,在起病6h内及24h行CT扫描,同时检测同型半胱氨酸、血糖、胆固醇、纤维蛋白原等及美国国立卫生研究院卒中量表(National Institute of Health stroke scale ,NIHSS)评分。随访3个月,记录期改良Bathel(MBI) 量评分及死亡例数。结果 血浆Hcy水平升高[优势比(odds ratio,OR)0.356,95%可信区间(confidcnce interval,CI)0.131～0.826;P= 0.021 ]和收缩压增高OR1.021,95% CI 1.002～1.028;P= 0.045)是原发性脑出血患者血肿扩大的独立危险因素。血浆Hcy升高(OR 1.031,95%CI 1.021～1.278;P= 0.035)和收缩压增高(OR 1.141,95%CI 1.011～1.072;P= 0.034)是临床转归不良的独立危险因素。收缩压增高(OR 1.023,95%CI 1.007～1.051;P= 0.021)、血糖高(OR 1.382 ,95%CI 1.221～1.673;P= 0.004)、Hcy水平增高(OR 1.521,95%CI 1.025～8.096 ;P= 0.023)3个月内死亡的独立危险因素。结论 H型高血压是原发性脑出血早期血肿扩大及3个月时临床转归和死亡的独立预测因素。     

卒中相关性肺炎与卒中后急性期高血压的关系研究

目的 探讨卒中相关性肺炎(SAP)和卒中后急性期高血压之间的关系.方法 选取2010-2011年入住我院的急性缺血性脑卒中患者134例,根据有无SAP分为SAP组(40例)、无SAP组(94例).同时又根据急性期血压值将其分为3组:血压正常或轻度高血压者(对照组)65例,中度高血压者(中度组)44例,重度高血压者(重度组)25例.所有患者入院后常规行血常规、生化检查及12导联心电图、X线胸片、经胸超声心动图、颅脑磁共振检查,以脉冲血氧定量法和饮水试验检查吞咽障碍.记录患者的合并症情况,包括既往脑卒中史、缺血性心脏病史、慢性充血性心力衰竭史、糖尿病史和高血压史.采用单因素分析和多因素Logistic回归分析SAP的危险因素.结果 SAP组收缩压(SBP)、白细胞计数(WBC)、C反应蛋白(CRP)水平、Glasgow昏迷量表(GCS)评分及吞咽障碍发生率与无SAP组比较,差异均有统计学意义(P＜0.05).对照组、中度组、重度组的WBC、GCS评分及吞咽障碍、SAP发生率比较,差异均有统计学意义(P＜0.05),其中中、重度组GCS评分及吞咽障碍、SAP发生率与对照组比较,差异均有统计学意义(P＜0.05),重度组WBC与对照组比较,差异有统计学意义(P＜0.05).多因素非条件Logistic回归分析结果发现WBC[OR=1.325,95%CI(1.073,1.811),P=0.024]、血清CRP[OR=1.356,95%CI(1.082,1.914),P=0.021]、GCS评分[OR=0.842,95%CI(0.563,0.924),P=0.015]、吞咽障碍[OR=1.735,95%CI(1.154,2.761),P=0.007]和高血压状态[OR=2.185,95%CI(1.321,4.368),P=0.003]进入回归方程.其中重度组SAP风险与对照组比较,差异有统计学意义(P＜0.05),其调整OR=2.747,95%CI(1.161,7.452).结论 缺血性脑卒中后急性期重度高血压是SAP的独立危险因素,这对于防治SAP有重要意义,同时也为卒中后急性期高血压的治疗时机和药物选择提供了一定的理论依据.     

体力活动水平与子宫肌瘤发生关系的研究

目的探讨体力活动水平与中老年女性子宫肌瘤发生的关系。方法采用以医院为基础的病例对照研究方法。病例组是由35～62岁的382例子宫肌瘤患者组成,对照组是由同期入住相同医院按年龄进行频数匹配的382例非子宫肌瘤患者组成。采用自行设计的健康状况调查表对两组人群进行调查,内容包括人口学特征、生活方式以及疾病既往史等。同时还采用国际体力活动调查表(IPAQ)对两组人群的体力活动情况进行调查,将每周进行的不同体力活动所花费的时间转换成代谢当量(MET)。应用多因素Logistic回归分析估计不同体力活动与子宫肌瘤关联的比值比(OR)及其相应的95%可信区间(CI)。结果调整了多种潜在性混杂因素后,与总体力活动量≤137.20MET-h/周相比较,总体力活动量为178.11～229.35 MET-h/周发生子宫肌瘤的危险性降低〔OR=0.586,95%CI(0.453,0.946),P=0.002〕。在职业性体力活动中,与体力活动量为最低四分位数相比较,体力活动量为第三个四分位数发生子宫肌瘤的危险性降低〔OR=0.622,95%CI(0.415,0.960),P=0.003〕。而在家务劳动中,体力活动量≥28.81 MET-h/周发生子宫肌瘤的危险性是体力活动量≤8.70 MET-h/周的近1.5倍〔OR=1.492,95%CI(1.006,2.049),P=0.030〕。娱乐性体力活动和交通性运动与发生子宫肌瘤的危险性无关(P>0.05)。但是,高强度体力活动(>6 METs)每周活动时间为≥4.51 h能降低发生子宫肌瘤的危险性〔OR=0.601,95%CI(0.402,0.997),P=0.011〕。结论进行适度的体力活动,可能有助于预防子宫肌瘤。     

环孢素和甲氨蝶呤比较治疗银屑病有效性和安全性的Meta分析

目的系统评价环孢素和甲氨蝶呤比较治疗银屑病的有效性和安全性。方法计算机检索PubMed、The Cochrane Library、Web of Science、CNKI、CBM、VIP、WangFang Data数据库,搜集有关环孢素和甲氨蝶呤比较治疗银屑病的随机对照实验(randomized controlled trial,RCT),由2名评价者共同对所纳入的研究进行质量评价,采用RevMan 5.3软件进行Meta分析。结果共纳入9个RCT,包括635名患者。Meta分析结果显示:两组在临床有效率[OR=1.52,95%CI(0.80,2.91),P=0.20]、复发率[OR=1.05,95%CI(0.58,1.89),P=0.88]方面的差异无统计学意义;环孢素发生肝功能异常[OR=0.17,95%CI(0.09,0.31),P0.00001]、血常规异常[OR=0.20,95%CI(0.09,0.44),P0.0001]的风险显著低于甲氨蝶呤,但增加发生高血压的风险[OR=21.58,95%CI(7.37,63.25),P0.00001]。结论当前证据表明,银屑病采用环孢素与甲氨蝶呤进行治疗均能够达到满意的临床疗效,复发率低;环孢素发生肝功能异常和血常规异常的风险更低,但增加发生高血压的风险。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。     

Notch1表达与乳腺癌及其临床病理特征相关性的系统评价及Meta分析

目的系统评价Notch1表达与乳腺癌及其临床病理特征的相关性。方法计算机检索PubMed、The Cochrane Library、Embase、Web Of Science、中国知网(CNKI)、万方(WanFang Data)、中国生物医学文献数据库、维普(VIP)等数据库,收集国内外自数据库建立起截止至2020年6月18日公开发表的关于Notch1表达与乳腺癌及其临床病理特征相关性的研究。由2位研究者按照纳入与排除标准独立筛选文献、提取数据并进行质量评价后,采用RevMan 5.3及STATA 15.1软件进行Meta分析。结果最终纳入13项病例-对照研究,共包含806例乳腺癌组和390例对照组。Meta分析结果显示,Notch1在乳腺癌组中的表达显著高于对照组[OR=13.11,95%CI(7.73,22.23),P0.00001]。Notch1在乳腺癌有淋巴结转移组表达较无淋巴结转移组高[OR=5.15,95%CI(3.12,8.50),P0.00001],在临床Ⅲ～Ⅳ期组较临床Ⅰ～Ⅱ期组高[OR=0.25,95%CI(0.11,0.58),P=0.001],而在不同年龄[OR=1.02,95%CI(0.66,1.59),P=0.92]、肿瘤大小[OR=1.01,95%CI(0.58,1.76),P=0.96]、组织学分级[OR=0.42,95%CI (0.16,1.14),P=0.09]分组中的表达比较,差异无统计学意义。结论 Notch1高表达可能与乳腺癌的发生、发展有关,是乳腺癌靶向治疗的潜在分子标志物。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.