喘可治治疗支气管哮喘

我们使用喘可治 (珠海健心医药有限公司生产 )治疗支气管哮喘 14例 ,年龄 9～ 65岁 ,平均病程 8.1±4 .2年 ,均在常规抗感染和吸氧下肌注喘可治 ,每日 1- 2次 ,每次 2 ml,疗程 18～ 30天 ,并观察治疗前后肝肾功能、心电图、用力肺活量 (FVC)、一秒钟用力呼气量 (FEV1)和 2 5 %、5 0 %肺活量时最大呼气流量 (V2 5、V50 )。结果 14例患者显效、有效各 6例 ,无效 2例 ,有效率 85 .7%。FEV1、V2 5、V50 治疗后与治疗前比较有显著性差异 ,FVC治疗前后比较无显著性差异 ,未观察到肝肾功能损害和心脏毒性反应。喘可治主要成分为巴戟天等 ,既…     

孟鲁司特治疗支气管哮喘急性发作的临床疗效观察

目的了解孟鲁司特治疗支气管哮喘急性发作的临床效果。方法将支气管哮喘急性发作患者76例随机分为两组,实验组39例,对照组37例;对照组常规吸入β^2受体激动剂、糖皮质激素吸入或静点、二羟丙茶碱口服或静点。实验组在相同对照组治疗基础上,加用LT调节剂孟鲁司特10mg,一次／日,口服。治疗前和治疗后第2天、第4天分别观察症状、体征及动脉血PaO2变化。结果治疗前两组患者均为支气管哮喘急性发作,动脉血PaO2平均值比较差异无统计学意义;治疗后第2天、第4天,两组症状、体征缓解率比较,动脉血PaO2值,两组比较差异有统计学意义。结论LT调节剂孟鲁司特治疗支气管哮喘急性发作具辅助疗效,可加速缓解哮喘症状、缩短住院日期。     

支气管哮喘急性发作的治疗

由危险因素诱发支气管哮喘（简称哮喘）患者出现哮喘急性发作（asthmaattack），又称急性哮喘（acuteasthma）或哮喘持续状态（statusasthmatics）。澳大利亚、加拿大和西班牙哮喘急性发作占急诊成人患者的1％-12％。1995年美国急诊哮喘患者达150万，其中20％～30％患者住院治疗。     

26例急性支气管哮喘护理体会

2002年10月～2004年10月，我院共收治哮喘急性发作患者26例。现将护理体会报告如下。     

院前急救支气管哮喘急性发作134例临床分析

目的 探讨院前急救对支气管哮喘急性发作的抢救价值.方法 对2007年1月-2009年12月我院院前急救的134例支气管哮喘急性发作患者进行回顾性分析.结果 经急救处理病情明显好转,拒绝去医院进一步治疗21例(15.7%);病情好转送医院作进一步治疗47例(35.1%);病情无明显改善,紧急送医院抢救66例(49.2%).所有患者均平安送至医院.结论 支气管哮喘急性发为院前急救中的常见病种,病情变化快,采取及时有效的院前急救措施具有积极意义.     

柴麻止哮胶囊配合西药治疗老年支气管哮喘急性发作期的临床研究

目前我国老年性哮喘的发病率约3%～10%,呈逐年上升的趋势,仅次于儿童哮喘[1].目前临床上老年支气管哮喘急性发作期常用西药治疗,但老年患者对西药的耐受性较差,不良反应较多,治疗效果不十分理想.本文拟探讨柴麻止哮胶囊配合西药治疗老年支气管哮喘的疗效.     

支气管哮喘急性发作期并发症60例临床分析

我院自2004～2006年收治支气管哮喘病60例，出现并发症者36例，占60％；有2种以上的并发症状12例，占20％；因并发症死亡的2例，占总数的3％。年龄在47～62岁。     

支气管哮喘急性发作期20例陪伴护理体会

支气管哮喘简称哮喘,是一种嗜酸粒细胞、肥大细胞和T淋巴细胞等多种炎症细胞参与的气道慢性炎症性疾病。慢性炎症引起易感者对各种激发因子具有气道高反应性和导致不同程度的广泛可逆性气道阻塞症状。临床主要表现为反复发作性的喘息、呼气性呼吸困难、胸闷或咳嗽等,常子夜间和（或）清晨发作、加重。严重者被迫采取坐位或呈端坐呼吸,干咳或咯大量白色泡沫痰,甚至出现紫绀等。     

喘可治注射液治疗支气管哮喘急性发作期患者临床观察

目的观察喘可治注射液治疗支气管哮喘急性发作期患者的临床效果。方法选取2013年6月至2014年10月我院收治的支气管哮喘急性发作期患者91例作为观察对象,按照随机数字表法将其分为对照组(45例)和观察组(46例)。对照组患者给予常规治疗,包括止咳化痰、解痉平喘、抗感染、对症治疗等,同时给予异丙托溴铵治疗,观察组患者在对照组患者治疗的基础上加用喘可治注射液治疗,比较两组患者的临床治疗效果及肺功能改善情况。结果治疗4周,观察组患者的治疗总有效率为97.8%,对照组为75.6%,两组比较差异有统计学意义(P0.01);观察组患者的临床疗效显著优于对照组(P0.05)。治疗前,两组患者FEV1、PEF比较差异无统计学意义(P0.05);治疗后,观察组的FEV1、PEF明显改善(P0.05),且显著优于对照组(P0.05)。结论在常规治疗的基础上,加用喘可治注射液治疗支气管哮喘急性发作期患者临床效果确切,可显著改善患者肺功能,值得推广使用。     

心电图表现为酷似心肌梗死的支气管哮喘急性发作1例

患者女性,64岁。因腹胀、恶心、呕吐、停止肛门排气、排便2d入院。既往有慢性支气管炎病史。体检:T37℃,P80次/min,BP125/80mmHg。胸廓对称,双肺呼吸音减低,未闻及干湿性罗音。心界不大,律齐、心率均80次/min。各瓣膜听诊区未闻及病理性杂音。腹软、肝脾肋下未及。脐周明显压痛,反跳痛不明显,未及包块,肠鸣音亢进,叩诊无移动性杂音,麦氏点有压痛。腹透示:肠梗阻。实验室检查血WBC7.9×10/L,N0.60。心电图(附图略)示:窦性心律,正常心电图。X线胸片示:慢性支气管炎、阻塞性肺气肿。临床诊断:①肠梗阻;②慢性支气管炎,阻塞性肺气肿。患者…     

Salivary oxidative stress in children during acute asthmatic attack and during remission

BACKGROUND: Patients with asthma generate an increased amount of reactive oxygen species from peripheral blood cells, which may contribute to its pathogenesis. Saliva analysis is non-invasive and friendly to children. We undertook this study to analyze the salivary oxidative profile and composition in children with asthma during attack and remission, and to compare them with the levels of salivary antioxidants of healthy control children. METHODS: School age (range 6-18 years) children referred to the emergency room for acute asthma were included. Clinical score was assessed, spirometry performed, and saliva samples were collected and analyzed. All measurements were repeated during remission of asthma attack (2-4 weeks after attack). Salivary analysis was performed blindly during asthma attack and the results were compared to those obtained during remission, and to those of the control group. RESULTS: Statistically significant decreases in levels of salivary peroxidase enzyme activity were observed in asthmatic children during attack compared with healthy controls, with partial recovery during remission of attack. Similarly decreased levels of calcium concentrations were observed in asthmatic children, accompanied by increased phosphate levels. CONCLUSIONS: Children with acute asthma attacks exhibit a decrease in the activity of the most important salivary antioxidant enzyme-peroxidase, which is accompanied by other salivary composition alterations. Hence, acute asthma is manifested by salivary changes. This implies systemic oxidative stress in asthma, which may be reflected in salivary analysis.     

匹多莫德辅助治疗儿童慢性扁桃体炎急性发作疗效观察

目的观察匹多莫德在儿童慢性扁桃体炎急性发作治疗中的临床疗效~([1])。方法于2011年3月至2012年3月门诊或住院诊断慢性扁桃体炎急性发作资料完整的5~12岁患儿中,随机选取应用匹多莫德口服液的42例为观察组;未应用的48例为对照组。两组均采用常规抗感染、对症支持等治疗,观察组在常规治疗基础上加用匹多莫德口服液治疗。比较两组治疗的总有效率、症状、体征变化时间及随访治疗1年后急性发作次数,再住院率等。结果观察组总有效率为95.23%,对照组总有效率为75.0%,两组比较P0.05;观察组发热、扁桃体肿大消退时间均短于对照组;再次急性发作及因扁桃体炎再次就诊次数明显少于对照组。结论在儿童慢性扁桃体炎急性发作治疗过程中加用匹多莫德治疗后,临床取得显著效果,值得推广应用。     

Benefit of serological determination of ECP levels during asthmatic attack in children

Objective. – The determination of the serological levels of ECP (biological marker of bronchial eosinophil inflammation) may predict objectively the asthmatic severity and activity in children.Methods. – Comparison of ECP levels in 80 non-atopic asthmatic children to levels in 25 healthy control children. Patients were studied during the attack and 2 weeks later. The asthma attack severity was determined according to a pre-existing score. The measurement of ECP was performed by the immunofluorescence technique (Phamacia CAP-system). This measurement was correlated to the clinical and radiological investigation as well as other variables such as blood oxygen saturation, peak expiratory rate and eosinophil count.Results. – The ECP level of all asthmatics was significantly higher during the attack (12.7 ± 8.82 μg/L) when compared to the control group (2.9 ± 0.72 μg/L) (P < 0.001). Two weeks after resolution of the exacerbation, ECP levels significantly decreased (5.48 ± 2.34 μg/L) (P < 0.001). The ECP levels were highest in patients with severe attacks (18.45 ± 10.66 μg/L) (P < 0.001). There was no statistical difference between mild (9.75 ± 7.25 μg/L) and moderate attacks (4.53 ± 1.17 μg/L). At the 2-week follow-up, the ECP levels in patients who had mild or moderate attacks were comparable to control levels but was persistently elevated in the severe attack subgroup (7.65 ± 2.94 μg/L) (P < 0.001). No significant correlation was found between serum ECP levels and blood oxygen saturation, peak expiratory rate or eosinophil count.Conclusion. – A statistically significant correlation was found between serum ECP levels and the severity of the attack in asthmatic children. It could be useful in quantifying bronchial inflammation. This result can further allow us to institute an adequate anti-inflammatory treatment.     

BiPAP辅助治疗重症哮喘发作的临床观察

目的 探讨无创通气在重度哮喘患者治疗中的应用价值.方法 通过BiPAP辅助药物治疗重度哮喘发作与单纯药物治疗相比较,观察两组患者治疗前后症状、血气分析结果及气管插管率的差别.结果 治疗组在治疗后24小时患者症状、血气分析结果及插管率方面表现明显优势.结论 BiPAP在辅助治疗重症哮喘方面有较好价值,值得临床推广.     

川芎嗪诱导急性胰腺炎胰腺细胞凋亡及其机制的初步研究

目的研究川芎嗪（tetramethylpyrazine,TMP）对大鼠急性胰腺炎（acutepancreatitis,AP）的治疗作用,并探讨川TMP治疗AP的机理。方法采用腹腔内注射蛙皮素制备急性水肿型胰腺炎（acuteedematouspancreatitis,AEP）模型,腹腔内注射TMP,端口标记法（triphosphate-biotinnick-endlabeling,TUNEL）检测胰腺腺泡细胞凋亡,免疫组化法检测Bax基因表达,同时观察IL-6、TNF-α、CRP、AMY等变化,并进行胰腺组织形态学检查。结果采用蛙皮素腹腔注射造成AEP,发现AEP胰腺存在明显细胞凋亡。TMP可以抑制IL-6、TNF-α、CRP等表达,上调促凋亡基因Bax的表达,诱导AEP胰腺细胞凋亡。结论TMP对AEP有明显疗效,其机制与降低IL-6、TNF-α含量,抑制CRP等表达,上调促凋亡基因Bax表达,促进胰腺细胞凋亡有关。     

Effective pulmonary blood flow in children with acute asthma attack requiring hospitalization

In children with acute obstructive lung disease gas exchange is affected by ventilation-perfusion mismatch and the degree of bronchoconstriction. Standard lung function measurements do not reflect the impairment in gas exchange. Alternatively, the effective pulmonary blood flow (EPBF), that is, the proportion of the cardiac output that is supplying well-ventilated lung units, can give accurate and noninvasive estimates of ventilation-perfusion mismatch. We measured EPBF with the argon freon ?22 rebreathing technique in children with acute severe asthma to assess their response to nebulized salbutamol and to determine whether induced changes in the EPBF could be predicted from baseline measurements. Twenty-four children admitted with an acute asthma attack had spirometry and triplicate EPBF measurements before and after nebulized salbutamol. Eighteen patients had repeated tests 50 days later when fully recovered; 4 patients were taking methylxanthines on at least one occasion. The mean forced expiratory volume in 1 sec (FEV₁) rose from 55% of predicted to 66% after salbutamol and to 83% with recovery. The mean coefficients of variation for EPBF measurements on the three test occasions were 11.3%, 8.2%, and 9%. Except in children on methylxanthines, the EPBF values were reduced during the acute asthma attack (median, 2.53 L/min/m²; range, 1.99–3.60 L/min/m²) compared with paired values obtained after recovery (median, 2.89 L/min/m²; range, 2.2Eb4.04 L/min/m²) (P = 0.009). Salbutamol caused a highly significant increase in EPBF from 2.88 L/min/m² (range, 1.86–3.80) before treatment to 3.34 L/min/m² (range, 2.264.65) immediately afterwards (P = 0.0003). The spirometric indices did not relate to the changes in the EPBF values. However, when the effective stroke volume index was calculated in 11 patients, the changes induced by nebulized salbutamol had a significant inverse relation with the pretreatment FEV, (P = 0.61; P = 0.02). In conclusion, the argon freon-22 rebreathing technique can be used successfully and reproducibly to measure EPBF in children with an acute asthma attack. Except in children taking methylxanthines, EPBF during the acute attack is reduced and rises significantly after salbutamol. EPBF values after recovery were significantly higher than the presalbutamol values during the attack. Spirometric indices do not relate to the EPBF changes but are inversely related to the effective stroke volume changes. Pediatr Pulmonol. 1994; 17:370–377. © 1994 Wiley-Liss, Inc.