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.     

老年糖尿病肺部感染患者空腹血糖变化作为肺部感染致老年多器官功能不全综合征诊断指标的可行性研究

目的探讨老年糖尿病肺部感染患者的空腹血糖变化作为肺部感染致老年多器官功能不全综合征(MODSE)诊断指标的可行性。方法对196例≥65岁的糖尿病肺部感染病例进行回顾性调查,所有病例按肺部感染是否诱发MODSE分为MODSE组(n=89)和非MODSE组(n=107),比较两组患者肺部感染后最高空腹血糖水平的差异。绘制老年糖尿病肺部感染患者最高空腹血糖水平受试者工作特征(ROC)曲线,计算ROC曲线下面积、以及不同空腹血糖水平对MODSE诊断的敏感度和特异度,确定诊断肺部感染致MODSE的最佳空腹血糖阈值。结果 MODSE组最高空腹血糖水平(13.720±4.863)mmol/L显著高于非MODSE组(7.439±3.043)mmol/L(t=10.580,P0.001);老年糖尿病肺部感染患者最高空腹血糖水平ROC曲线下面积为0.900,面积的95%可信区间为0.857~0.943(P0.001),取空腹血糖8.83 mmol/L时,诊断肺部感染致MODSE的敏感度和特异度均较为理想、分别为86.5%和81.3%。结论老年糖尿病肺部感染患者的空腹血糖变化对肺部感染致MODSE具有诊断价值、作为肺部感染致MODSE的诊断指标具有可行性。空腹血糖≥8.83 mmol/L可作为一项诊断指标纳入肺部感染致MODSE的诊断。     

氧自由基损伤在老年轻度认知功能损害发病机制中的作用

目的 了解轻度认知功能损害(MCI)患者血清维生素E(Vit E)、超氧化物歧化酶(SOD)和丙二醛(MDA)的水平,探讨氧自由基损伤在老年轻度认知损害发病机制中的作用。方法 采用1:1配对病例对照设计,应用紫外分光光度法测定了45例老年MCI患者和45例健康老年人血清Vit E、SOD和MDA的含量,并进行分析。结果 老年MCI患者血清Vit E含量及SOD活性显著低于健康老年人(P<0.01),血清MDA含量显著高于健康老年人(P<0.01)。结论 氧自由基损伤参与了MCI的病理生理过程;临床上应给予外源性Vit E以进行早期干预治疗。     

老年人肺部感染并发多器官功能不全综合征的早期预测评分系统研究

目的 建立筛查肺部感染并发老年人多器官功能不全综合征(MODSE)高危人群及其发病的早期预测评分系统.方法 回顾性调查2001年1月至2006年12月因肺部感染在我院住院或住院期间出现肺部感染的驻石家庄地区60岁及以上的军队师以上离退休干部393例的病历资料,根据肺部感染是否诱发MODSE,将所有病例分为MODSE组和非MODSE组,分析年龄、慢性疾病和健康体检有关血检测项目对MODSE发病的影响,从中筛选早期预测MODSE发病的指标,标以一定的分值,建立MODSE早期预测评分系统.结果 年龄、21种慢性疾病和15项血检测项目中经统计学分析结合临床专业知识评价,最终确立了年龄、7种慢性疾病(慢性阻塞性肺疾病、慢性呼吸衰竭、肺间质纤维化、慢性心功能不全、脑血管疾病、糖尿病和慢性肾功能不全)和4项血检测项目(血红蛋白、血白蛋白、血尿素和空腹血糖)作为MODSE早期预测评分系统的评分指标.结论 所建立的MODSE早期预测评分系统评分指标易得、操作简单、易于推广,为筛查肺部感染并发MODSE高危人群及早期预测MODSE发病提供了简易工具.     

苯溴马隆（立加利仙）致过敏反应

苯溴马隆（立加利仙）为促尿酸排泄药,它主要通过抑制肾小管对尿酸的重吸收,从而降低血中尿酸浓度,治疗高尿酸血症有较好效果,一般患者服用苯溴马隆少有不良反应出现。本文介绍了1例口服苯溴马隆后出现过敏反应的情况,提醒临床使用苯溴马隆需注意过敏反应的发生。     

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.     

老年多器官功能不全综合征的预测研究近况

老年多器官功能不全综合征(MODSE)与成年人多器官功能不全综合征(MODS)虽有许多相似点,但其发病基础、致病原因等方面有不同之处。MODSE一旦发生,救治困难,因此研究其预测指标成为热点。归纳起来,目前应用的指标主要有评分系统、炎性介质、甲状腺激素水平、血小板计数等。由于目前对MODSE的预测还没有理想指标,因而也无法早期采取干预措施,提示加强MODSE的预测指标研究势在必行。     

高龄多器官功能衰竭伴发呼吸心搏骤停1例的救治经验

老年多器官功能不全综合征（Multiple Organ Dysfunction Syndrome in the Elderlt，MODSE）是指老年人在器官老化和患有多种慢性疾病的基础上，由某种诱因激发，在短时间内出现2个或2个以上器官序贯或同时发生功能不全或衰竭的临床综合征。MODSE分为器官功能衰竭前期和器官功能衰竭期。MODSE为老年病临床常见的危重症，发病率高，病情凶险，病死率高，是导致老年人死亡的重要原因之一。年龄越大，合并严重慢性疾病越多，     

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.     

老年慢性肾衰并带状疱疹26例临床分析

1995年1月—2007年12月我院收治26例老年慢性肾衰竭合并带状疱疹,现报告如下。 1临床资料 1.1一般资料 本组26例中男18例,女8例,年龄63～87岁,平均76岁;均为慢性肾功能衰竭患者,其中11例为血透患者。