血清25-羟维生素D3、IL-33与支气管哮喘病情程度及肺功能的相关性研究

目的研究血清25-(OH)D3、IL-33与支气管哮喘病情程度及肺功能的相关性。方法选取64例支气管哮喘患者作为研究对象(哮喘组),同期选取70例健康体检者作为健康组。比较健康组与哮喘组25-(OH)D3及IL-33水平,分析25-(OH)D3、IL-33与哮喘患者肺功能指标的相关性。结果哮喘组25-(OH)D3水平显著低于健康组,IL-33水平显著高于健康组(P0.05);在哮喘组中,轻度患者25-(OH)D3、FVC、FEV1、FEV1%pre及PEF水平均明显高于中度和重度患者,IL-33水平明显低于中度和重度患者(P0.05);25-(OH)D3与肺功能指标呈正相关,IL-33与肺功能指标呈负相关(P0.05)。结论支气管哮喘患者的血清25-(OH)D3与肺功能指标呈正相关,IL-33与肺功能指标呈负相关,通过检测患者血清25-(OH)D3及IL-33水平可有效评估其肺功能指标及病情程度。     

五禽戏锻炼对出院过渡期慢性阻塞性肺疾病患者肺功能及运动耐量的影响

目的:观察五禽戏锻炼对出院过渡期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者肺功能及运动耐量的临床改善效果.方法:选择2015年1至12月在佛山市南海区第四人民医院治疗随访的COPD患者,随机分为五禽戏组和对照组,对照组给予常规的随访管理及运动锻炼,五禽戏组在此基础上实施五禽戏锻炼,锻炼共持续3个月,比较两组干预前后的肺功能及运动耐量.结果:干预后五禽戏组的第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/forced vital capacity,FEV1/FVC)、第1秒用力呼气容积占预计值百分比(FEV1％pred)依次为1.55 L,55.31％和55.08％,明显高于干预前的1.33 L,40.17％和43.03％及干预后对照组的1.25 L,43.55％和44.61％,差异均具有统计学意义(P＜0.05);在运动耐量方面,干预后五禽戏组的6 min步行距离(6min walk distance,6MWD)、达到无氧阈(anaerobic threshold,AT)时的运动时间及最大摄氧量依次为417.56 m,418.25 s及19.53 mL/(min.kg),明显高于干预前的332.67 m,337.14 s和15.53 mL/(min.kg)及干预后对照组的350.78 m,328.03 s和14.44 mL/(min.kg),差异均具有统计学意义(P＜0.05);同时结果还显示,对照组在FEV1/FVC及6MWD的改善差异也具有统计学意义(P＜0.05).结论:实施五禽戏锻炼有利于改善出院过渡期COPD患者的运动耐量及肺功能状态,对于提升其康复效果具有积极的推动作用.     

维生素D水平与成人哮喘及非哮喘的相关性研究

目的 评估哮喘及非哮喘者的血清维生素D水平及其与肺功能、嗜酸性粒细胞计数的相关性。方法 选取我院2015年9月1日~2016年1月20日收治的85例哮喘患者以及73例健康体检者作为研究对象。根据皮肤过敏试验结果将哮喘患者分为过敏哮喘组56例和非过敏性哮喘组29例,对比两亚组间维生素D水平的差异性;采外周血测量嗜酸性粒细胞计数,用肺功能仪测量肺功能,包括肺活量（FVC）、第1秒最大呼气量（FEV1）、第1秒最大呼气率（FEV1/FVC）,分析过敏哮喘组和非过敏性哮喘组维生素D水平与肺功能、嗜酸性粒细胞计数的相关性。结果 哮喘患者的维生素D水平为（14.36±0.57）ng/ml,低于健康体检组的（22.13±0.84）ng/ml,统计学意义显著（P＜0.01）。过敏哮喘组和非过敏哮喘组的维生素D水平比较,差异无统计学意义（P＞0.05）。低水平维生素D患哮喘的风险增加1.2倍（优势比:1.194,95%可信区间:1.194~1.286,P＜0.01）。维生素D水平与肺功能和嗜酸性粒细胞计数水平无显著相关性。结论 哮喘患者的维生素D水平低于正常人群,维生素D的缺乏与哮喘的发生密切相关;维生素D水平与肺功能、嗜酸性粒细胞计数没有相关性。     

不同PEEP水平对AECOPD伴肺动脉高压患者O2UC、血清炎性因子及脑血流灌注状态的影响对比

目的:探讨不同呼气末正压通气(Positive end expiratory pressure,PEEP)水平对慢性阻塞性肺疾病急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)伴肺动脉高压患者的影响.方法:选取2020年6月至2022年5月期间我院收治的103例AECOPD伴肺动脉高压患者作为研究对象,所有患者按照随机数字表法分为常规组(n=51)和高水平组(n=52).常规组采用常规PEEP,高水平组采用高水平PEEP,两组患者均持续治疗3 d.观察两组氧利用率、血清炎性因子、脑血流灌注以及肺功能.结果:治疗3 d后,高水平组氧利用率(Ratio of oxygen utilization,O2UC)高于常规组(P<0.05);高水平组超敏C-反应蛋白(High sensitivity C-reactive protein,hs-CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白-细胞介素-6(Interleukin-6,IL-6)以及降钙素原(Procalcitonin,PCT)水平低于常规组(P<0.05);高水平组阻力指数(Resistance Index,RI)、搏动指数(Pulsatility index,PI)和平均血流速度(Mean velocity,Vm)和常规组无明显差异(P>0.05);高水平组肺用力肺活量占预计值百分比(Percentage of forced vital capacity to the expected value,FVC％pred)、第一秒用力呼气容积占预计值百分比(Percentage of forced expiratory volume in the first second to the expected value,FEV1％pred)、第一秒用力呼气容积占用力肺活量百分比(Percentage of forced expiratory volume in the first second to forced vital capacity,FEV1/FVC)均高于常规组(P<0.05).结论:相比较于常规PEEP,将高水平PEEP用于AECOPD伴肺动脉高压患者中可提高氧利用率,促进肺功能恢复,减轻机体炎症反应,且不影响脑血流灌注.     

支气管哮喘患儿CXCL5和IL-29水平及意义

目的:探讨支气管哮喘患儿血清CXCL5和IL-29水平及意义。方法:选取2016年1月至2019年1月212例支气管患儿作为哮喘组,并依据疾病的严重程度分为间歇组（n=50）、轻度组（n=51）、中度组（n=49）、重度组（n=46）,选择同期参加体检的50例健康儿童作为对照组,采用酶联免疫吸附法检测血清CXCL5和IL-29水平,肺功能仪检测肺功能,包括第1秒用力呼气量（Forced expiratory volume in 1 second,FEV 1）、用力肺活量（Forcedvitalcapacity,FVC）和FEV1/FVC,并进行统计学分析。结果:哮喘组患儿血清CXCL5和IL-29水平明显高于对照组（P<0.05）,并随患儿哮喘严重程度的加重逐渐增加,且与FEV1、FVC、FEV1/FVC等肺功能指标呈现负相关（P<0.05）,而CXCL5与IL-29呈现明显的正相关（P<0.05）。结论:CXCL5和IL-29参与了支气管哮喘的发生和进展,促进了机体的炎症反应,可以作为评估哮喘诊断和严重程度的指标。     

基于B、T淋巴细胞衰减因子探讨膝骨关节炎患者肺功能变化的机制及相关性分析

目的 通过观察膝骨关节炎(knee osteoarthritis,KOA)患者肺功能参数、B、T淋巴细胞衰减因子(B and T lymphocyte attenuator,BTLA)及血清细胞因子的变化情况,探讨KOA患者肺功能变化的可能分子机制.方法 选取2011年10月-2012年7月安徽中医学院第一附属医院风湿病科收治的住院、门诊患者47例.应用肺功能仪检测患者肺功能指标；流式细胞术检测BTLA；ELISA法检测白介素(interleukin,IL)-1β、IL-10、基质金属蛋白酶9(matrix metalloproteinase-9,MMP-9)、基质金属蛋白酶组织抑制物-1(tissue inhibitor of matrix metalloprotease-1,TIMP-1)；魏氏法测定血沉(erythrocyte sedimentation rate,ESR)；日立7060型全自动生化分析仪进行测定超敏C反应蛋白(high-sensitivityC-reactive protein,hs-CRP).结果 (1)与正常组比较,KOA患者用力肺活量(forced vital capacity,FVC)、一秒用力呼气容积(forced expiratory volume in 1 second,FEV1)、FEV1/FVC、用力最大呼气流量(peak expiratory flow,PEF)、最大呼气中段流量(maximal mid-expiratory flow,MEF25-75)、用力呼气50％流量(Maximal mid-expiratory flow velocity in pulmonary vital capacity 50％,MEF50)、用力呼气25％流量(maximal mid-expiratory flow velocity in pulmonary vital capacity 25％,MEF25)、CD3+ BTLA+T细胞、CD4+BTLA+T细胞、IL-10、TIMP1明显降低,IL-1β、MMP9明显升高.(2)相关性分析显示,FVC与Lequesne MG、症状分级量化总分、病程、MMP9呈负相关,与CD3+ BTLA+T细胞、IL-10、TIMP1呈正相关；FEV1与CD3+ BTLA+T细胞、CD4+BTLA+T细胞、TIMP1呈正相关,与病程呈负相关；MEF50与CD3+ BTLA+T细胞、CD4+ BTLA+T细胞呈正相关.结论 KOA患者在发生关节软骨病变的同时,伴有肺功能的下降.其机制可能与BTLA表达水平下降,IL-1β、MMP9明显升高,IL-10、TIMP1明显降低,诱发异常免疫应答,从而介导气道损伤,导致KOA患者肺功能下降有关.     

孟鲁司特钠片联合沙丁胺醇气雾剂对哮喘-慢性阻塞性肺疾病重叠综合征患者肺功能和血清炎性介质的影响

目的:分析孟鲁司特钠片联合沙丁胺醇气雾剂对哮喘-慢性阻塞性肺疾病重叠综合征(Asthma-chronic obstructive pulmonary disease overlap syndrome,ACOS)患者肺功能和血清炎性介质的影响.方法:将本院在2019年6月至2020年6月期间收治的110例哮喘-慢性阻塞性肺疾病重叠综合征患者,按随机数字法分为对照组和观察组,每组55例.对照组接受沙丁胺醇气雾剂治疗,观察组接受孟鲁司特钠片联合沙丁胺醇气雾剂治疗,对比两组治疗效果、肺功能指标及血清炎性介质的变化.结果:治疗后,观察组治疗有效率高于对照组(92.73％>72.72％,p<0.05);观察组和对照组用力肺活量(Forced vital capacity,FVC)、第一秒用力呼吸量(First second forced breathing,FEV1)及FEV1/FVC的比值较治疗前均有所升高,且观察组指标显著高于对照组(p<0.05);观察组和对照组血清白介素-6,血清降钙素原和肺表面活性蛋白-D较治疗前均有所下降,且观察组指标显著低于对照组(p<0.05).结论:孟鲁司特钠片联合沙丁胺醇气雾剂治疗哮喘-慢性阻塞性肺疾病重叠综合征效果显著,可改善患者肺功能指标,降低患者体内炎症因子水平,值得临床推广应用.     

沙丁胺醇、丙酸倍氯米松和溴化异丙托品联合雾化吸入治疗慢性阻塞性肺疾病急性加重

目的 探讨沙丁胺醇、丙酸倍氯米松和溴化异丙托品三者联合雾化吸入对慢性阻塞性肺疾病急性加重(AECOPD)患者肺功能及动脉血气的影响.方法 以本院2011年1月至2014年1月收治的AECOPD患者108例为研究对象,随机数字表分为对照组(n=54)和联合治疗组(n=54).对照组采用常规治疗,联合治疗组加用沙丁胺醇、丙酸倍氯米松和溴化异丙托品雾化吸入治疗.治疗前及治疗后第7天进行两组患者动脉血气分析,记录动脉血pH值、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2);并测定肺功能,记录第1秒用力呼气容积(FEV1)、FEV1占预计值％(FEV1％pred)和用力肺活量(FVC).结果 血气分析显示,治疗前两组患者动脉血pH值、PaO2和PaCO2差异均无统计学意义(均P＞0.05).治疗后两组患者动脉血pH值、PaO2和PaCO2均较治疗前显著改善(均P＜0.05).与对照组比较,治疗后联合治疗组患者PaO2明显增加[(79.5±9.4) mmHg比(64.0±7.7) mmHg,P＜0.05;1mmHg=0.133 kPa],PaCO2明显降低[(49.3±11.5)mmHg比(61.0±12.2)mmHg,P＜0.05].治疗后两组患者动脉血pH值差异无统计学意义(P＞0.05).治疗前两组患者FEV1、FEV1 ％pred、FVC差异均无统计学意义(均P＞0.05).治疗后两组患者FEV1、FEV1％pred、FVC均较治疗前有显著改善(均P＜0.05).与对照组比较,治疗后联合治疗组患者FEV1、FEV1％ pred、FVC均显著升高[(1.35±0.14)L比(1.18±0.11)L,(61.15±9.51)％比(54.55±8.71)％,(2.49±0.16)L比(2.19±0.17)L,均P＜0.05].结论 沙丁胺醇、丙酸倍氯米松和溴化异丙托品三者联合雾化吸入治疗AECOPD疗效较好.     

风湿病患者肺功能降低与BTLA阳性细胞及调节性T细胞的数量减少有关

目的探讨B、T淋巴细胞衰减因子(BTLA)、调节性T细胞(Treg)与风湿病患者肺功能降低的关系。方法选取482例风湿病患者,包括类风湿性关节炎(RA)198例,强直性脊柱炎(AS)114例、干燥综合征(SS)102例、骨关节炎(OA)68例,应用肺功能仪检测患者肺功能水平,采用流式细胞术检测患者外周血B、T淋巴细胞衰减因子(BTLA)和调节性T细胞(Treg)表达。结果与正常组比较,风湿病患者肺功能降低,外周血BTLA、Treg表达降低;与风湿病BTLA、Treg正常组比较,BTLA、Treg异常组肺功能参数第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)、50%肺活量位的最大呼气流量(FEF50)、FEF75降低(P0.05或P0.01);相关分析显示,肺功能参数用力肺活量(FVC)、最大通气量(MVV)、FEV1、FEF25、FEF50分别与BTLA、Treg呈正相关,FVC、FEV1、FEF50、FEF75分别与IgA、IgM呈负相关(P0.05或P0.01)。结论风湿病患者肺功能降低可能与BTLA、Treg表达降低,促使T细胞、B细胞过度异常活化有关。     

全程多学科合作管理模式对老年哮喘急性期患者心理状态、肺功能及生活质量的影响

目的:探讨多学科协作管理模式对老年哮喘急性期患者心理状态、肺功能及生活质量的影响。方法:选取2018年4月至2020年4月在某院接受治疗的老年哮喘患者90例。依据干预方法的不同将入选患者分为观察组和对照组,每组45例。对照组采用常规干预模式,观察组采用多学科协作干预模式。分别于干预前后采用焦虑自评量表(self-report anxiety scale, SAS)和抑郁自评量表(self-report depression scale, SDS)对患者焦虑抑郁状况评分;采用肺功能仪测量肺功能指标,包括1秒用力呼气容积占预计值百分比(forced expiratory volume in one second expressed as percent predicted, FEV1%)以及FEV1/用力肺活量(forced vital capacity, FVC);采用哮喘生命质量调查问卷(asthma quality of life questionnaire, AQLQ)对患者生活质量评分。结果:干预2个月后,对照组SAS与SDS评分与干预前比较均显著下降(t=19.464,16.639;P0.01),观察组SAS与SDS评分与干预前比较均显著下降(t=23.776,21.840;P0.01),且观察组SAS与SDS评分均显著低于对照组(t=-5.651,-6.139,-6.099;P0.01)。干预2个月后,对照组FEV1%与FEV1/FVC与干预前比较均显著增高(t=-6.519,-7.287;P0.05),观察组FEV1%与FEV1/FVC与干预前比较均显著增高(t=-10.361,-10.575;P0.01),且观察组FEV1%与FEV1/FVC均显著高于对照组(t=3.408,3.730;P0.01)。干预2个月后,对照组AQLQ各维度评分及总分与干预前比较均显著增高(t=8.095,6.819,8.243,8.641,13.062;P0.05),观察组AQLQ各维度评分及总分与干预前比较均显著增高(t=8.095,6.819,8.243,8.478,16.662;P0.01),且观察组AQLQ各维度评分及总分均显著高于对照组(t=3.269,4.828,2.592,3.292,5.197;P0.05)。结论:多学科协作模式可以有效降低老年哮喘急性期患者焦虑、抑郁负面情绪,改善肺功能,提高生活质量。     

Correlation between nasal symptoms and asthma severity in patients with atopic and nonatopic asthma.

BACKGROUND: The association between allergic rhinitis and asthma has been well recognized, and it has been postulated that rhinitis may worsen asthma. OBJECTIVE: To investigate the severity of asthma among patients with atopic and nonatopic asthma with and without nasal symptoms. METHODS: Atopic asthmatic patients and nonatopic asthmatic patients were identified from the records of a university-based asthma clinic. A comparison of demographic clinical features was made within and between these 2 asthmatic groups, dichotomized according to the presence or absence of rhinitis. RESULTS: A total of 178 patients were classified as having atopic asthma and 218 as having nonatopic asthma. The atopic asthmatic patients with nasal symptoms compared with those without had a higher mean forced expiratory volume in 1 second (FEV1), a higher forced vital capacity (FVC), and a higher FEV1/FVC ratio, used fewer oral steroids, and had fewer hospitalizations. The nonatopic asthmatic patients with nasal symptoms compared with those without used more inhaled steroids (and they were also more likely to have nasal polyps on examination). Atopic, relative to nonatopic, asthmatic patients were younger, had a longer duration of asthma, had a higher FEV1/FVC ratio, and took fewer oral steroids. CONCLUSION: Contrary to current hypotheses, in this study the severity of asthma among atopic asthmatic patients was less in those with nasal symptoms. Conversely, among the nonatopic asthmatic patients, asthma was more severe among those with nasal symptoms than those without nasal symptoms.     

The relationship between serum 25 hydroxy vitamin d levels and asthma in children

Purpose

Asthma and other allergic disorders have increased over the past decades in nearly all nations. Many studies have suggested the role of vitamin D deficiency in both T-helper1 and T-helper2 diseases; however, the association between vitamin D, allergy, and asthma remains uncertain. In this study, the associations of 25-hydroxy vitamin D3 levels with asthma and with the severity of asthma were evaluated.

Methods

This cross-sectional study was conducted on 50 asthmatic children and 50 healthy controls aged 6-18 years. Serum 25-hydroxy vitamin D3 levels were determined and compared between the two groups. The relationship between serum vitamin D levels and pulmonary function test outcomes and eosinophil counts were examined in asthmatic patients.

Results

Univariate analysis of the relationship between asthma and vitamin D showed that decreased vitamin D levels were associated with significantly increased odds of asthmatic state (P=0.002). In a multivariate analysis after adjustment for age, body mass index, and sex, the relationship between vitamin D and asthma increased. In asthmatic patients, 25-hydroxy vitamin D levels had direct and significant correlations with both predicted FEV1 (R²=0.318; P=0.024) and FEV1/FVC (R²=0.315; P=0.026). There were no associations between vitamin D level and eosinophil counts, duration of disease, and the number of hospitalization or unscheduled visits in the previous year (P>0.05).

Conclusions

These results showed that serum 25-hydroxy vitamin D levels were inversely associated with asthma, and there was a direct and significant relationship between vitamin D levels and pulmonary function test outcomes in asthmatic children. An interventional study in asthmatic patients with low serum vitamin D concentration may establish a causal relationship between asthma and vitamin D.     

Vitamin D Insufficiency and Asthma Severity in Adults From Costa Rica

Purpose

Non-classical actions of vitamin D as a cytokine are related to the immunopathology of asthma. Few studies have examined vitamin D levels and asthma severity in adults. The aim of this research was to assess the relationship between vitamin D levels, atopy markers, pulmonary function, and asthma severity.

Methods

We analyzed 25-hydroxyvitamin D levels in serum collected from 121 asthmatic adults from Costa Rica to investigate the association between vitamin D levels (categorized as sufficient, ≥30 ng/mL, or insufficient, <30 ng/mL), allergic rhinitis, total IgE and peripheral blood eosinophils (as markers of atopy), asthma severity, baseline forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC). Univariate and multivariate analyses were performed to assess these relationships.

Results

When the population was stratified by vitamin D status, 91% of asthmatic patients with vitamin D levels below 20 ng/mL (n=36) and 74% of patients with vitamin D levels between 20 and 30 ng/mL (n=73) had severe asthma versus 50% of those with vitamin D sufficiency (n=12; P=0.02). Vitamin D insufficiency was associated with a higher risk of severe asthma (odds ratio [OR], 5.04; 95% Confidence interval [CI], 1.23-20.72; P=0.02). High vitamin D levels were associated with a lower risk of hospitalization or emergency department visit during the last year (OR, 0.90; 95% CI, 0.84-0.98; P=0.04). Although there appeared to be a direct relationship between vitamin D levels and FEV1 (regression coefficient=0.48; r²=0.03), it did not reach statistical significance (P=0.07).

Conclusions

Our findings suggest that vitamin D insufficiency is common among our cohort of asthmatic adults. Lower vitamin D levels are associated with asthma severity.     

The Impact of Smoking on Clinical and Therapeutic Effects in Asthmatics

Smoking is associated with poor symptom control and impaired therapeutic responses in asthma. A total of 843 patients with asthma were recruited. The patients received treatment for 1 yr according to the severity of their asthma. We compared the forced expiratory volume in 1 sec (FEV1), the ratio of FEV1 to forced vital capaity (FVC), atopy, total IgE, emphysema on high-resolution computed tomography (HRCT), the number of near-fatal asthma attacks, and physiological fixed airway obstruction between the smoking and nonsmoking groups. The study population consisted of 159 (18.8%) current smokers, 157 (18.7%) ex-smokers, and 525 (62.5%) nonsmokers. Although the prevalence of atopy was not different between the smoking and nonsmoking groups, the total IgE was higher among the smokers than the nonsmokers. Compared with the nonsmoking group, the smokers had a lower FEV1 % predicted and forced expiratory flow between 25 and 75% of FVC. A greater prevalence of emphysema and a significantly higher number of asthmatic patients with fixed airway obstruction were detected in the smoking versus nonsmoking group. The 37.5% of asthmatic patients who were former or current smokers showed decreased pulmonary function and increased IgE, emphysema on HRCT, and fixed airway obstruction, indicating that smoking can modulate the clinical and therapeutic responses in asthma.     

支气管哮喘患者FeNO的表达及临床意义

目的:探讨不同呼出气一氧化氮(Fractional exhaled nitric oxide,FeNO)水平下支气管哮喘患者痰液、血液、肺功能检测等多个观察指标的表达特点,并分析在气道高反应性中的预测价值.方法:选取2017年1月至2019年5月于我院就诊的120例疑似支气管哮喘患者作为研究对象进行前瞻性分析,根据Fe...     

Immunological parameters and respiratory functions in patients suffering from atopic bronchial asthma after intravenous treatment with salmon calcitonin.

This study reports the effect of salmon calcitonin on airway function and peripheral blood parameters in asthmatic subjects. The premise for the study is that calcitonin is given to asthmatics that require systemic corticosteroids as a way to counter problems with calcium balance and osteoporosis, and that it has an immunosuppressive effect. Salmon calcitonin (100 IU) was administered to 18 patients with atopic bronchial asthma, and the following spirometric parameters were evaluated: forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak respiratory flow rate (PEFR) and forced expiratory flow rates at 25%, 50% and 75% of the forced vital capacity (FEF25%, FEF50% and FEF75%). Calcitonin significantly decreased the levels of FVC and FEV1 by 20 min after starting the infusion. The effect of 500 mg aminophylline, used as a reference drug in this study, was much more profound, with a significant increase in all investigated parameters. Also, the effect of salmon calcitonin on some immune parameters (white blood cell count, number of eosinophils, serum levels of immunoglobulins IgG, IgM and IgA, and serum levels of lymphocytes subpopulations CD3, CD4, CD8 and CD19) was determined in another group of 30 patients suffering from atopic bronchial asthma. Calcitonin at a dose of 100 IU/day subcutaneously for 3 days did not alter the immune parameters studied, thus rendering it safe for such and similar treatment schedules in a variety of medical conditions.     

雾化吸入干扰素同沙丁胺醇对重症肺炎患儿的疗效及PCT和CRP水平的影响

目的 研究雾化吸入干扰素同沙丁胺醇对重症肺炎患儿的疗效及降钙素原(PCT)和C反应蛋白(CRP)水平的影响.方法 选择从2016年3月至2017年3月在医院治疗的重症肺炎患儿118例进行研究,分别为对照组和观察组各59例.两组患儿均常规予以吸氧、抗生素和抗病毒治疗、平喘和维持呼吸道通畅,以及相关支持治疗.观察组在此基础上另给予雾化吸入干扰素和沙丁胺醇,对比两组疗效和不良反应,以及治疗前和治疗7d后两组PCT及CRP水平和肺功能指标水平(用力肺活量FVC、第1秒末用力呼气量FEV1及呼气峰流速PEF).结果 观察组的治愈率是45.76％,总有效率是96.61％,均分别较对照组的15.25％,84.75％提高,差异均有统计学意义(均P＜0.05).观察组不良反应的总发生率是13.56％,与对照组的8.47％相比,差异无统计学意义(P＞0.05).治疗后两组的PCT及CRP水平均较治疗前明显降低,且观察组较对照组更低,差异均有统计学意义(均P ＜0.05).治疗后两组的FVC、FEV1及PEF水平均较治疗前明显提高,且观察组较对照组更高,差异均有统计学意义(均P＜0.05).结论 雾化吸入干扰素和沙丁胺醇治疗重症肺炎患儿,具有较好的疗效,且可明显改善患儿的机体炎症状态及肺功能,值得给予推广.     

支气管哮喘患者血清嗜酸细胞阳离子蛋白的变化

探讨检测血清嗜酸细胞阳离子蛋白在支气管哮喘的诊断１病情监测及疗效判断中的价值。方法采用荧光酶免疫法测定了发作期和缓解哮喘患者各２０例,慢性阻塞性肺疾病患者１６例和正常人２０例的血清ＥＣＰ,同时进行了肺功能测定,并对发作期哮喘患者在给予吸入皮质激素治疗３ｍｏ后复测其ＥＣＰ及肺。     

慢性阻塞性肺疾病患者年龄及体质量指数与肺功能的关系

目的：揭示慢性阻塞性肺疾病发作期患者体质量指数（body mass index,BMI）、年龄与肺功能的关系。方法：选择慢性阻塞性肺疾病患者,测量其体质量及身高并检测其肺功能。比较营养不良组（BMI＜18.5）、正常组（18.5≤BMI＜24）、超重组（24≤BMI＜28）、肥胖组（BMI≥28）患者肺功能之间的关系;同时将患者分为老年组（年龄≥65岁）和非老年组（年龄≤64岁）,同样方法比较这两组患者的肺功能状态;检测BMI和年龄与肺功能之间的相关性。结果：营养不良组和正常组、超重组、肥胖组相比,第1秒用力呼气量占预计值的百分比（forced expiratory volume in on second, FEV1%）均存在统计学意义（P＜0.01）;正常组和超重组、肥胖组相比,FEV1%差异无统计学意义（P＞0.05）;超重组和肥胖组相比,差异无统计学意义（P＞0.05）。营养不良组与超重组、肥胖组相比,FEV1/用力肺活量（forced vital capacity, FVC）的比值差异均存在统计学意义（P＜0.01）;正常组和超重组、肥胖组相比,FEV1/FVC的差异有统计学意义（P＜0.05）。FEV1%老年组与非老年组相比,差异有统计学意义（P＞0.05）,而FEV1/FVC老年组与非老年组相比,差异有统计学意义（P＜0.05）;FEV1%和BMI呈正相关（r=0.22, P＜0.01）、FEV1/FVC和BMI呈正相关（r=0.29,P＜0.01）,年龄和FEV1%无显著相关性（r=-0.12,P＞0.05）,而年龄和FEV1/FVC呈负相关（r=-0.17, P＜0.05）。结论：慢性阻塞性肺疾病患者FEV1/FVC与患者的体质量指数和年龄均存在相关性,而体质量指数对FEV1%的影响不及对FEV1/FVC的影响,年龄对FEV1%的影响不大。