鲑鱼降钙素对特发性肺间质纤维化患者骨密度的影响

目的 探讨鲑鱼降钙素对特发性肺间质纤维化患者骨密度的影响。方法 24例特发性肺间质纤维化患者随机分为两组，观察组给予鲑鱼降钙素肌肉注射及钙尔奇－D口服。对照组仅给予等剂量钙尔奇－D口服，治疗前后测定骨密度及骨代谢指标。结果 观察组患者腰椎骨密度较治疗前明显提高（P＜0．05），对照组腰椎骨密度下降明显（P＜0．05）。两组间比较各部位骨密度治疗前后变化均有显著性差异（P＜0．01）。治疗后BGP观察组较对照组增高（P＜0．05），TRAP观察组较对照组明显减低（P＜0．01）。结论 鲑鱼降钙素联合钙尔奇－D可显著改善特发性肺间质纤维化患者的骨质疏松。     

泰素、卡铂联合放射治疗老年人非小细胞肺癌的临床研究

目的：评价泰素、卡铂联合常规分割放疗治疗老年非小细胞肺癌的疗效及耐受性。方法：PC方案给予泰素150mg/m^2、卡铂300mg/m^2静脉注射，间隔28天为1周期，重复2-4个周期后给予常规分割放射治疗（2Gy/次，5次/周），照射野包括肺部原发灶和纵隔淋巴引流区，总剂量为60-70Gy。结果：52例患者均完成2个周期以上化疗及放疗，完全缓解6例、部分缓解26例，总有效率61.5%。化疗的毒副作用主要为骨髓抑制。放射治疗的毒性反应主要为放射性食道炎、放射性肺炎及放射性皮炎。结论：泰素、卡铂联合常规分割放疗治疗老年非小细胞肺癌近期疗效、耐受性好，局部控制率高，有望取得较好的无期疗效。     

长期吸氧加双水平气道正压通气对重叠综合征患者心肺功能及生存质量的影响

目的 探讨长期吸氧＋双水平气道正压通气（BiPAP)对重叠综合征患心肺功能及生存质量的影响。方法 23例能适应BiPAP的重叠综合征患作为治疗组，24例单纯吸氧治疗的患作为对照组。治疗前及2年后测超声心动图，肺功能，吸入空气时动脉血气及生存质量（QOL）评分。结果 治疗组肺动脉压较治疗前下降，对照组则恶化。治疗组最大吸气压力，最大呼气压力，血氧分压，二氧化碳分压及治疗后QOL得到明显改善，而对照组恶化。结论 长期吸氧＋BiPAP治疗较单纯氧疗更能有效改善重叠综合征患缺氧及二氧化碳溜留，改善患心肺功能和生存质量。     

咳嗽变异型哮喘患者血清总IgE及白细胞介素-4、γ-肿瘤坏死因子的水平变化研究

目的探讨外周血中血清总IgE及白细胞介素-4（IL-4）、γ-肿瘤坏死因子（TNF-γ）在咳嗽变异型哮喘（CAV）患者发病过程中的相关性。方法研究对象分3组,各20例,分别为单纯CAV患者、CAV合并过敏疾病组和正常成人对照组。采用放射免疫技术、ELISA方法分别测定各组血清总IgE、IL-4、TNF-γ水平。结果单纯CAV患者血清总IgE水平明显高于正常对照组[（160．9±16．7）U／ml,（71．2±13．2）U／ml],CAV合并过敏性疾病组患者的血清总IgE水平明显高于单纯CAV患者,分别为（371．3±18．5）U／ml和（160．9±16．7）U／ml。单纯CAV患者血清IL-4水平明显高于正常对照组[（26．4±4．6）pg／ml,（17．3±5．1）pg／ml],CAV合并过敏性疾病组患者的血清总IL-4水平明显高于单纯CAV患者,分别为（35．7±6．9）pg／ml,（26．4±4．6）pg／ml。单纯CAV患者血清TNF-γ水平明显低于正常对照组[（46．3±2．5）pg／ml,（55．3±3．2）pg／ml],CAV合并过敏性疾病组患者的血清总TNF一1水平明显低于单纯CAV患者,分别为（28．64-2．6）pg／ml和（46．3±2．5）pg／ml。结论CAV患者同支气管哮喘患者一样,存在着Th1／Th2淋巴细胞亚群失衡,变应性鼻炎等过敏性疾病是诱发、加重CAV的重要原因。     

Significance of fractional exhaled nitric oxide combined with serum procalcitonin and C-reactive protein in evaluation of elderly asthma

Bronchial asthma is a common chronic airway inflammatory disease. Asthma is associated with high mortality, especially in the elderly patients. Repeated exacerbations cause disease progression. Therefore, identifying the onset of acute elderly asthma as soon as possible and giving the effective treatment is crucial to improve the prognosis. This study was to investigate the significance of fractional exhaled nitric oxide (FeNO) combined with serum procalcitonin (PCT) and C-reactive protein (CRP) in the evaluation of elderly asthma. A total of 120 elderly patients with an acute attack of asthma from July, 2010 to May, 2012 were studied. On presentation, FeNO, serum PCT and CRP concentrations were measured and sputum culture was also performed. The elderly patients were re-evaluated when they had returned to their stable clinical state. The elderly patients were classified into two groups: positive bacterial culture group (A) and negative bacterial culture group (B). The results showed that: (1) In patients with an acute exacerbation of asthma, 48 (40%) patients had positive sputum bacterial culture and 72 (60%) had negative sputum bacterial culture. (2) The levels of FeNO in patients with acute exacerbation of asthma were significantly higher than in those with no acute exacerbation state (63.8±24.6 vs. 19±6.5 ppb, P<0.05). There was no significant difference in FeNO between group A and group B (P>0.05). (3) The levels of PCT and CRP in group A patients with an acute exacerbation of asthma were significantly higher (P<0.05) than in group B (for PCT: 27.46±9.32 vs. 7.85±3.52 ng/mL; for CRP: 51.25±11.46 vs. 17.11±5.87 mg/L, respectively). When they had returned to stable clinical state, the levels of PCT and CRP in group A were decreased significantly (P<0.05), and those in group B had no significant change (P>0.05) when compared with the exacerbation group. There were no significant differences in the levels of PCT and CRP between the two groups in non-acute exacerbation state (P>0.05). These results suggest that the increase in FeNO indicates the acute exacerbation of asthma, and the elevation of serum PCT and CRP levels may be associated with bacterial infection.     

鲑鱼降钙素对特发性肺间质纤维化患者骨密度的影响

目的　探讨鲑鱼降钙素对特发性肺间质纤维化患者骨密度的影响。方法　 2 4例特发性肺间质纤维化患者随机分为两组 ,观察组给予鲑鱼降钙素肌肉注射及钙尔奇 -D口服。对照组仅给予等剂量钙尔奇 -D口服 ,治疗前后测定骨密度及骨代谢指标。结果　观察组患者腰椎骨密度较治疗前明显提高 (P <0 0 5 ) ,对照组腰椎骨密度下降明显 (P <0 0 5 )。两组间比较各部位骨密度治疗前后变化均有显著性差异 (P <0 0 1)。治疗后BGP观察组较对照组增高 (P <0 0 5 ) ,TRAP观察组较对照组明显减低 (P <0 0 1)。结论　鲑鱼降钙素联合钙尔奇 -D可显著改善特发性肺间质纤维化患者的骨质疏松     

毒素清治疗老年人细菌性肺炎的临床观察

目的：评价毒素清治疗老年人细菌性肺炎的临床疗效及其可能的机理。方法：按照随机对照原则，治疗组在西医常规治疗的基础上，加用毒素清口服液治疗，对照组单用西医常规治疗，并检测两组患者治疗前后外周血白细胞介素2（IL－2）和肿瘤坏死因子－α（TNF－α）的变化。结果：总有效率治疗组为93．9％，对照组为83．9％，两组比较差异有显著性（P＜0．05）。两组治疗后主症积分、次症积分、总积分均明显降低，且治疗组积分降低更明显。老年患者外周血IL－2水平显著低于健康老年人组，TNF－α水平显著高于健康老年人组；治疗后治疗组TNF－α水平降低，而IL－2水平上升并接近健康老年人水平。对照组上述两项治疗前后均无明显变化。结论：毒素清治疗老年人细菌性肺炎具有明显疗效，其作用机理可能与通过提高IL－2水平,改善机体免疫功能，降低过度分泌的TNF－α等炎性细胞因子水平有关。     

老年胃溃疡及萎缩性胃炎患者的肺功能测定

有资料表明老年人慢性胃炎及胃溃疡患者慢性肺部疾病发生率较正常人高［１］，为进一步探讨其发生机理，了解老年人慢性胃炎及胃溃疡患者的肺功能状态，我们于１９９０年１０月至１９９７年１０月，测定６０位老年人萎缩性胃炎及６０例胃溃疡患者的肺功能，并于同期与６０...     

喘乐宁经BiPAP吸入治疗老年慢性呼吸功能衰竭急性加重46例疗效观察

目的探讨老年慢性呼吸衰竭急性加重时的无创伤通气疗法。方法随机将住院患者分为A、B两组。A组单独采用BiPAP经面罩辅助压力支持通气，B组除进行辅助压力支持通气外，同时利用氧气做动力，利用射流式雾化器吸入喘乐宁。结果两组均可使动脉血气分析、肺功能及临床症状得到明显改善，但B组改善程度更为明显(P＜0.05、P＜0.01)，改善时间提前，维持时间长，且无心悸，手颤等不良反应。结论喘乐宁经BiPAP吸入完全，可明显改善通气功能，早期应用可减少气管插管及切开的机会。     

经纤维支气管镜针吸术对纵隔淋巴结肿大及支气管腔外肺肿瘤的诊断意义

目的 探讨经纤维支气管镜(纤支镜)行纵隔淋巴结及叶、段支气管腔外肺肿瘤针吸活检的诊断价值。方法103例在纤支镜检查过程中，对经CT检查的84例纵隔淋巴结肿大和19例叶、段支气管腔外新生物而管腔结构基本正常的患者行针吸术和刷检。结果针吸阳性诊断率为75．73％；刷检阳性诊断率为8．74％；针吸与刷检联合诊断阳性率为77．67％；24．27％的患者穿刺点有少许出血。结论经纤支镜针吸术是一种简便、安全、阳性诊断率高的检查技术。