老年多器官功能障碍综合征早期预测评分系统的预测价值

Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.     

老年多器官功能障碍综合征早期预测评分系统的预测价值

Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.     

老年多器官功能障碍综合征早期预测评分系统的预测价值

Objective To evaluate the prediction value of the early prediction score system of multiple organ dysfunction syndrome in the elderly (MODSE). Method A total of 393 patients with pulmonary infection, who were above60 years old, were divided into non MODSE(n =224) and MODSE group(n = 169) and were scored by the early prediction score system of MODSE. Independent-samples t Test was used to analyze the difference of forecast score between MODSE and non MODSE group. Receiver operating characteristic (ROC) curve was drawn,and the area under the curve was calculated. The prediction accuracy of scores for MODSE was assessed using sen-sitivity and specificity, and the optimal forecast point for MODSE was found. Results The score of MODSE group was higber than that of non MODSE[(19.38±12.049) vs. (45.78±20.257), P <0.001]. The area under the ROC curve was 0.889 (P <0.001) ond 95% (0.857～0.920). As the value of forecast score was 27.5, the sensitivity of the early prediction score system of MODSE was 82.8 %, the specificity of the early prediction score system of MODSE was 80.3 %. Conclusions The early prediction score system of MODSE is valuable in predic-tion of MODSE, which may be used to forecast MODSE and find the high risk population of MODSE.     

骨质疏松症的中医病因病机研究

骨质疏松症（Osteoporosis,OP）是一种以骨量减少、骨微结构破坏,导致骨脆性增加,容易发生骨折为特征的全身代谢性骨病。骨质疏松症是老年人的一种常见病,随着人类寿命的延长,社会老龄化进程的加快,骨质疏松症的发生卒呈逐渐上升趋势,已严重危害着老年人的身体健康。     

老年人肺部感染致多器官功能不全综合征的血糖分析

目的观察老年人肺部感染致多器官功能不全综合征(MODSE)患者的血糖变化,分析血糖变化与MODSE发病及其严重程度的相关性。方法对2005年1月至2014年12月在解放军白求恩国际和平医院住院的625例≥65岁的肺部感染患者进行回顾性调查,所有患者按是否有糖尿病分为糖尿病组和非糖尿病组;各组再按肺部感染是否诱发MODSE分为MODSE亚组和非MODSE亚组。分别比较糖尿病组中MODSE亚组与非MODSE亚组、以及非糖尿病组中MODSE亚组与非MODSE亚组的最高空腹血糖水平,采用Spearman等级相关分析血糖与MODSE发病及其严重程度的相关性。结果糖尿病组196例患者并发MODSE 89例,非糖尿病组429例患者并发MODSE 95例,糖尿病组中MODSE亚组和非MODSE亚组患者最高空腹血糖水平分别为(13.720±4.863)、(7.439±3.043)mmol/L,非糖尿病组中MODSE亚组和非MODSE亚组患者最高空腹血糖水平分别为(8.656±2.664)、(5.679±1.332)mmol/L,MODSE亚组最高空腹血糖水平均显著高于非MODSE亚组(P0.001)。老年肺部感染患者的最高空腹血糖水平与MODSE发病及其严重程度呈显著正相关(P0.001)。结论老年人肺部感染致MODSE患者的最高空腹血糖水平明显增高,并且空腹血糖变化与MODSE发病及其严重程度呈显著正相关。     

健康体检血液检测项目预测老年多器官功能不全综合征的价值

目的 探讨老年健康体检血检测项目对老年多器官功能不全综合征(MODSE)的早期预测价值.方法 回顾性分析2001年1月至2006年12月住院的393例老年肺部感染病例,根据肺部感染是否诱发MODSE将所有病例分为MODSE组和非MODSE组,调查各组入院时或入院前的健康体检有关血常规、肝功能、肾功能、血脂、空腹血糖等血检测结果.先做单因素分析,采用独立样本t检验比较两组病例有关血检测项目的 差异,再选择单因素分析中差异有统计学意义的血检测项目作自变量,以MODSE为因变量,作二分类逐步Logistic回归分析,筛选与MODSE发病密切相关的血检测项目.结果 血红蛋白、门冬氨酸氨基转移酶、血白蛋白、血尿素和空腹血糖等5项血检测项目与MODSE发病密切相关.血红蛋白和血白蛋白水平低下,门冬氨酸氨基转移酶、血尿素和空腹血糖水平升高是MODSE发病的危险因素.结论 老年健康体检血检测项目中的血红蛋白、门冬氨酸氨基转移酶、血白蛋白、血尿素、空腹血糖等对筛查MODSE高危人群、早期预测MODSE发病具有一定价值.     

老年糖尿病的胰岛素治疗

近年的研究证实，随着病程的延长，胰岛B细胞功能也呈逐渐下降趋势，早期应用胰岛素，对于控制代谢紊乱，保护和改善胰岛功能，减少并发症的发生发展具有积极作用。因此，胰岛素在老年糖尿病的应用也日趋积极。     

老年糖尿病低血糖症误诊原因与对策

近年来,随着老年糖尿病患病率的上升,口服降糖药物和胰岛素在老年糖尿病患者的广泛应用,与药物有关的老年低血糖症也有所增加.由于许多老年低血糖症临床表现复杂且不具有特异性,容易被误诊.本文就老年糖尿病低血糖症被误诊的原因进行分析,并提出相应的对策,以期引起临床医师的重视,减少或避免老年糖尿病低血糖症的误诊.     

骨质疏松症临床验方用药规律探析

目的:探讨骨质疏松症临床验方用药规律.方法:收集近年来临床报道的对防治骨质疏松症有较好疗效的方剂26首,将方中中药按功效分类,进行单味中药用药次数统计.结果:补虚药用药次数及用药味数占居首位,活血祛瘀药用药次数及用药味数位居其次.结论:补肾健脾药为骨质疏松症临床验方基本组成药物,活血祛瘀药为其主要配伍药物.     

老年恶性肿瘤与继发性血小板增多症

继发性血小板增多症又称反应性血小板增多症,临床可见于各种感染、外伤及恶性肿瘤等疾病,2001-2007年我院收治的27例老年恶性肿瘤继发血小板增多症,现分析报告如下.