慢性阻塞性肺疾病患者FEV_（1．0）的昼夜变化及阿托品对其影响

慢性阻塞性肺疾病患者ＦＥＶ＿（１．０）的昼夜变化及阿托品对其影响湖南省人民医院刘志光，张家春，沈谦受，文懿云为研究慢性阻塞性肺疾病（ＣＯＰＤ）患者肺通气功能昼夜变化规律及迷走神经张力对其影响。我们在２４ｈ内定期测定了１７例ＣＯＰＤ患者一秒钟用力呼气容...     

慢性阻塞性肺疾病患者的康复指导

慢性阻塞性肺疾病（ＣＯＰＤ）是一组包括慢性支气管炎、阻塞性肺气肿等的慢性肺部疾病,是我国中老年人的常见病,病程长,进行性加重,目前尚无法治愈,致残率和病死率很高。因此,加强对ＣＯＰＤ患者的康复指导对延缓ＣＯＰＤ的发展,提高患者的生活质量具有重要意义。...     

慢性阻塞性肺疾病的康复护理

慢性阻塞性肺疾病的康复护理孟祥荣１牛卫东２慢性阻塞性肺疾病（ｃｈｒｏｎｉｃｏｂｓｔｒｕｃｔｉｖｅｐｕｌｍｏｎａｒｙｄｉｓｅａｓｅ，ＣＯＰＤ）是严重危害人类健康的常见病、多发病。目前在治疗上还没有特效方法，我们在临床中采用综合医疗措施对３０例ＣＯＰＤ患...     

老年慢性阻塞性肺疾病的社区康复

老年慢性阻塞性肺疾病的社区康复上海市曹家渡医院卫志华慢性阻塞性肺疾病（ｃｈｒｏｎｉｃｏｂｓｔｒｕｃｔｉｖｅｐｕｌｍｏｎａｒｙｄｉｓｅａｓｅ，ＣＯＰＤ）是危害人类健康的常见病、多发病，尤其是随着人口老化，ＣＯＰＤ作为影响老年人健康的重要因素更为突出，国...     

饮食补充对慢性阻塞性肺疾病的影响

饮食补充对慢性阻塞性肺疾病的影响周满祥王柯黄顺根慢性阻塞性肺疾病（ＣＯＰＤ）患者常伴营养不良，并由此给患者带来不利影响。国内、外研究证明：营养支持可降低感染和呼吸衰竭的发生率，降低死亡率［１］。为减少此类患者发病，我们对１１例ＣＯＰＤ患者给予饮食补...     

呼吸电刺激训练对慢性阻塞性肺疾病康复治疗的观察

呼吸电刺激训练对慢性阻塞性肺疾病康复治疗的观察广州市红十字会医院张鸣生，张辛，李煜庭，胡妙贞，黄长抗慢性阻塞性肺疾病（Ｃｈｒｏｎｉｃｏｂｓｔｒｕｃｔｉｖｅｐｕｌｍｏｎａｒｙｄｉｓｅａｓｅ，ＣＯＰＤ）患者肺功能明显下降，严重影响病人的工作和生活，在ＣＯ...     

COPD病人的营养支持与肺康复

慢性阻塞性肺疾病（ＣＯＰＤ）是一种严重危害人类健康的常见病，在各种死因中居第四位。最新的研究结果显示，提高ＣＯＰＤ病人的生活质量应从营养支持和肺康复入手。重点论述了ＣＯＰＤ病人体重下降的机理、危害、营养支持的意义，以及肺康复的方法。     

测定慢性阻塞性肺疾病患者HCT、MCV、MCH、MCHC的临床意义

测定慢性阻塞性肺疾病患者ＨＣＴ、ＭＣＶ、ＭＣＨ、ＭＣＨＣ的临床意义郑爱菊，田炜宁对我院４９例慢性阻塞性肺疾病（ＣＯＰＤ）患者红细胞压积（ＨＣＴ）、红细胞平均体积（ＭＣＶ）、红细胞平均血红蛋白（ＭＣＨ）和红细胞平均血红蛋白浓度（ＭＣＨＣ）测定结果报告如...     

COPD应用超声雾化吸入与氧气雾化吸入过程的观察

对６０例慢性阻塞性肺疾病（ＣＯＰＤ）应用超声雾化吸入与氧气雾化吸入进行对比观察，经ｘ２检验，Ｐ＜０．０１．根据ＣＯＰＤ患者治疗原则，ＣＯＰＤ患者适合使用氧气雾化吸入器，能达到稀释痰液、排痰消炎之目的     

长期氧气治疗

慢性阻塞性肺疾病（ＣＯＰＤ）和哮喘急性发作期治疗的主要措施之一是充足的供氧,长期氧气治疗（ＬＴＯＴ）能影响ＣＯＰＤ的预后。因此,在家中进行吸氧治疗的病人不断增多,长期或短期使用均可。 ＣＯＰＤ是慢性阻塞性肺炎、肺气肿和某些慢性哮喘的总称,具有气流阻塞数月不能改善的特征,阻塞可通过测定一秒钟用力呼气容积（ＦＥＶ１）和用力肺活量（ＦＶＣ）判断。ＣＯＰＤ可分为轻度、中度和重度三级。重度ＣＯＰＤ病人可能逐渐进展成慢性呼吸衰竭（慢呼衰）。而未经治疗的慢呼衰则可导致重要脏器供氧不足的病理改变,例如红细胞增多…     

Diagnostics and treatment of cardiac insufficiency in patients with chronic pulmonary obstruction

The data on the prevalence of chronic obstructive pulmonary disease (COPD), its possible complications and outcomes are presented with reference to current concepts of this pathology and personal experience of the author with diagnostics and treatment of cardiac insufficiency in patients with COPD. A rationale for the use of selected pharmaceutical products and their combinations for the treatment of COPD is proposed.     

"Ineffective breathing pattern" care for COPD patients

Chronic obstructive pulmonary disease (COPD) is a long-term, chronic respiratory disease from which patients never fully recover. COPD patients usually face abnormal aeration caused by the disease. Patients that are unable to breathe and aspirate adequately and maintain lung appropriate expansion and contraction are considered to have ineffective breathing patterns. This causes physical, psychological and behavioral changes in COPD patients and impacts their emotional condition, daily activities and quality of life. Nurses who care for COPD patients with ineffective breathing patters can improve breathing muscle functions, improve respiration and keep the airway clean. In this paper, the author reviews and integrates relevant findings on this subject from the empirical literature in order to assist clinical nurses responsible for the care of COPD patients.     

慢性阻塞性肺疾病患者疲劳相关因素及非药物干预的研究进展

疲劳是慢性阻塞性肺疾病(COPD)患者的常见症状。作者总结了近年来国内外对COPD患者疲劳相关因素及非药物干预的研究进展,将造成疲劳的相关因素归纳为躯体、心理、社会人口学及环境等,指出心理及认知干预、生活行为干预、运动干预、中西医综合干预等多种非药物干预方法可有效改善COPD患者的疲劳状况,但将其转化应用于临床仍面临着一定的挑战。该研究为临床进一步认识疲劳、管理疲劳提供了参考依据。     

Assessing the impact of health policies on COPD

COPD is a leading but under-recognized cause of morbidity and mortality worldwide. It is currently the fourth leading cause of death in the world, and the fifth commonest cause of death in England and Wales, accounting for nearly 28,000 deaths each year. Methods: the author analyses systematically the national policies around chronic obstructive pulmonary disease such as the long term smoking cessation and NICE and BTS recommendations on COPD. Finding/conclusion: the analysis of current national policies on chronic obstructive pulmonary disease leads to a discussion to justify the need for a National Service Framework on this chronic disease. The current and future impact on local implementation is also analysed.     

Best evidence topic report. Intravenous magnesium in chronic obstructive pulmonary disease

A short cut review was carried out to establish whether the addition of intravenous magnesium to standard treatments improved outcome in patients with exacerbations of COPD. Altogether 465 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.     

慢性阻塞性肺疾病伴高血压病的临床特征和危险因素分析

目的评估未治疗的初诊慢性阻塞性肺疾病(COPD)伴高血压病患者的患病率、临床特征及危险因素。方法采用横断面人群筛查方法抽样受试者,最终纳入初诊COPD患者569例,并分为COPD伴高血压病组249例,COPD不伴高血压病组320例。观察2组呼吸道症状、生活质量评分、血液指标;分析初诊COPD伴高血压病的高危因素。结果COPD伴高血压病组平均年龄、男性占比、身体质量指数(BMI)、吸烟指数高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组合并糖尿病和心血管疾病比率均高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组改良呼吸困难指数(mMRC)和慢性阻塞性肺疾病评估测试(CAT)评分均高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组白细胞总数、中性粒细胞计数、嗜酸性粒细胞计数、单核细胞计数均高于COPD不伴高血压病组,差异有统计学意义(P<0.05)。COPD伴高血压病组静脉空腹血糖、甘油三酯、尿酸、血肌酐水平均高于COPD不伴高血压病组,高密度脂蛋白胆固醇水平低于COPD不伴高血压病组,差异有统计学意义(P<0.05)。高龄、肥胖、空腹血糖升高、单核细胞绝对值升高是COPD伴高血压病的独立危险因素。结论高龄、肥胖、单核细胞计数增高、高血糖的COPD患者更容易合并高血压病,其生活质量较差。全面评估监测COPD患者的代谢状况,控制危险因素,减少合并症的发生具有重要意义。     

Clinical evaluation and significance of measurement of airway hyperresponsiveness in COPD]

Airway hyperresponsiveness (HR) is one of the clinical characteristics of bronchial asthma and COPD. HR of COPD has been known to correlate with progress of pulmonary function in COPD. In order to evaluate the necessity of HR measurement, HR of COPD alone, COPD with asthma, asthma and control subjects was compared. Patients with COPD alone exhibited weak HR, while COPD with asthma represented severe HR, which was the same degree with asthmatics. From these results, we should be cautious in measurement of HR in COPD. Especially patients with FEV1 less than 1 L should be prevented from HR test.     

D-二聚体、纤维蛋白原检测在慢性阻塞性肺疾病合并2型糖尿病患者中的临床意义

目的观察慢性阻塞性肺疾病（COPD）合并2型糖尿病（T2DM）患者血浆D-二聚体（D-D）及纤维蛋白原（FIB）的含量,探讨COPD合并T2DM凝血与纤溶机能的变化。方法选择25例COPD合并T2DM患者、25例单纯COPD患者及25例正常对照组进行血浆D-D及FIB含量的检测。结果 COPD合并T2DM组血浆D-D及FIB含量分别与正常对照组比较,差异均有统计学意义,COPD合并T2DM组血浆D-D及FIB含量均高于单纯COPD组。结论 COPD合并T2DM患者体内可能存在凝血与纤溶平衡失调,通过对血浆D-D及FIB的检测,及时防治疾病的发生发展。     

Tryptase enzyme activity is correlated with severity of chronic obstructive pulmonary disease

Tryptic enzymes, including tryptase, a signature enzyme in mast cells, are involved in the pathogenesis of chronic obstructive pulmonary disease (COPD), a chronic inflammatory airway disease. However, the relationship between tryptase enzyme activity and COPD remains to be investigated. We therefore measured the enzyme activity and immunoreactivity of tryptase in the sputum and plasma of COPD patients in the present study. The results showed that tryptase enzyme activity in the sputum of severe COPD patients (FEV(1)s being recorded at ≤ 30% prediction values) was 3.4 times greater than that in patients with mild COPD (FEV(1)s being recorded at ≥ 80% of predicted values), whereas tryptic activity was 2.0 times higher in the severe COPD patients than in mild COPD patients. Moreover, tryptase enzyme activity, but not tryptic enzyme activity, was significantly elevated in the plasma of severe COPD patients compared with that of mild COPD patients. The level of immunoreactive tryptase was 1.9 times higher in the sputum of the severe COPD patients at admission than that at remission stage. We also employed a rat model of cigarette smoke-induced COPD. After 36 weeks of daily challenges with cigarette smoke, a well-established risk factor of COPD, tryptic and tryptase activities in the bronchoalveolar lavage fluid were elevated 1.5 and 2.6 times, respectively. These results indicate that smoking induces tryptase enzyme activity in the airway. In conclusion, tryptase enzyme activity is markedly increased in sputum and plasma of severe COPD patients. Enhanced tryptase enzyme activity may contribute to the pathogenesis of COPD.     

慢性阻塞性肺疾病合并2型糖尿病患者凝血和纤溶功能的变化

目的探讨慢性阻塞性肺疾病(COPD)合并2型糖尿病(T2DM)患者凝血、纤溶功能的变化。方法分组:正常对照组(40例)、单纯COPD组(40例)、COPD+DM+无并发症组(40例)和COPD+DM+有并发症组(40例)。分别检测各组血浆D-二聚体(D-Dimer)和纤维蛋白原(FIB)的水平。统计分析并比较各组的D-Dimer、FIB水平。结果 COPD+DM+有并发症组的D-Dimer、FIB均高于其他3组,组间比较差异有统计学意义(P<0.01),单纯COPD组的D-Dimer、FIB与COPD+DM+无并发症组的比较差异无统计学意义(P>0.05)。结论 COPD合并T2DM同时出现并发症时会进一步使凝血、纤溶功能失调。在诊断和治疗COPD合并T2DM同时出现并发症的患者时,要充分考虑到这一因素的影响。