舒利迭对支气管扩张伴气流受限的临床疗效

目的观察舒利迭对支气管扩张伴气流受限患者的临床疗效。方法将我院经肺功能检测的45例伴气流受限患者随机分为两组：对照组22例给予支气管扩张常规治疗,体位引流,促进痰液排出,如出现急性加重,予以抗炎、祛痰、止血治疗及对症支持治疗;治疗组23例在常规治疗基础上给予舒利迭300μg每日吸入2次,每次1吸,共3个月。于给药第1天、3个月末分别检测患者肺功能（包括第1秒用力呼气量、用力肺活量、呼出气一氧化氮、BODE指数）。结果治疗组患者治疗后肺功能较治疗前改善（P〈0.05）;呼出气一氧化氮、BODE指数较治疗前降低（P均〈0.05）。结论长期规律使用舒利迭能改善伴气流受限支气管扩张患者的肺功能,改善BODE指数,进而改善患者运动耐量及生活质量。     

沙美特罗氟替卡松治疗支气管扩张伴气流受限患者的临床效果观察

目的观察沙美特罗氟替卡松治疗支气管扩张伴气流受限患者的临床效果。方法选取支气管扩张伴气流受限患者51例,随机分为治疗组26例和对照组25例。两组患者均采用常规治疗,治疗组在常规治疗基础上给予长期规律吸入沙美特罗氟替卡松。分别测定两组治疗前、治疗4个月后临床症状指标、肺功能、痰中中性粒细胞百分比,并进行比较分析。结果两组患者治疗前临床症状指标、肺功能、痰中中性粒细胞百分比各项指标比较差异均无统计学意义(P0.05)。治疗组治疗后临床症状指标、肺功能指标较治疗前明显改善(P0.05),痰中中性粒细胞百分比比治疗前明显降低(P0.05);对照组各项指标改善不明显(P0.05);两组治疗后比较差异有统计学意义(P0.05)。结论沙美特罗氟替卡松治疗支气管扩张伴气流受限患者,可改善临床症状及肺功能,降低痰中中性粒细胞百分比。     

舒利迭治疗支气管哮喘30例临床疗效分析

目的观察舒利迭（沙美特罗氟替卡松粉吸入剂）治疗支气管哮喘的临床疗效。方法30例确诊为支气管哮喘轻、中度发作的患者予舒利迭50ug／100ug吸／次，每日两次，经准纳器吸入，共用4周．观察吸入前后临床症状变化，药物反应及肺功能（FEV1.0（第一秒用力呼气容积），FVC（用力呼气肺活量），PEFR（用力呼气峰流速）]。结果舒利迭治疗支气管哮喘症状计分及肺功能较治疗前明显改善（P〈0．01）。结论吸入舒利迭治疗支气管哮喘有较好的临床疗效。     

舒利迭治疗支气管哮喘的临床观察

目的观察舒利迭（沙美特罗／丙酸氟替卡松）吸入剂治疗支气管哮喘的疗效。方法86例确诊为支气管哮喘的患者给予舒利迭（50／100ug或50／250ug）,1吸／次,每日两次,经准纳器吸入,共用12周,观察治疗前后临床症状变化、药物不良反应、血清ET-1和IL-10水平以及肺功能（第一秒用力呼气容积、呼气峰流量）等变化情况。结果舒利迭治疗支气管哮喘良好以上控制率达到79．1％,治疗后血清ET-1水平（37．9±7．5）ng／L明显低于治疗前（76．2±8．1）ng／L,而血清IL-10水平（16．2±5．7）pg／ml则明显高于治疗前（11．3±3．8）pg／ml,肺功能较治疗前明显改善,FEV1和PEF分别由治疗前的1．82±0．42L、269±31L／min提高到3．09±0．59L、418±56L／min,具有统计学意义（P〈0．01）。结论舒利迭是治疗支气管哮喘较理想的药物,值得推广使用。     

酚妥拉明治疗支气管扩张伴咯血12例临床观察

近年来，我院采用酚妥拉明治疗支气管扩张伴咯血患者12例，取得了满意的疗效。现报告如下。     

支气管肺泡灌洗治疗支气管扩张合并感染临床疗效观察

目的探讨支气管肺泡灌洗治疗支气管扩张合并感染的临床效果。方法选取支气管扩张合并感染患者52例作为研究对象,采用随机数字表法随机分为观察组和对照组,每组26例。对照组患者进行常规治疗,配合用体位性的引流排出痰液;观察组患者在常规治疗的基础上采用支气管肺泡灌洗法进行治疗。结果观察组患者治疗总有效率(96.2%)显著高于对照组患者(89.2%),两组比较差异有统计学意义(P0.05);观察组患者的Pa O2,Pa O2/FO2以及致病菌清除率显著高于对照组患者,两组比较差异有统计学意义(P0.05);两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论支气管肺泡灌洗治疗支气管扩张合并感染的临床效果较好,值得在临床上推广使用。     

舒利迭治疗成人支气管哮喘的临床观察

目的观察舒利迭治疗支气管哮喘的疗效。方法对37例确诊的支气管哮喘的患者吸入舒利迭前后的临床疗效及试验指标进行观察对比。观察指标包括肺功能（PEFam、FEV1）检查和支气管激发试验（PD20-FEV1）。结果舒利迭治疗支气管哮喘的总有效率为87．1％，治疗后PEFam值第一周开始增加，第六周明显增加，PD20-FEV1于6周后也明显增加。结论吸入舒利迭治疗哮喘临床疗效良好，能改善肺通气功能，降低气道高反应性，改善生命质量，安全无副作用。     

支气管镜灌洗治疗支气管扩张伴感染病人的疗效观察

目的讨论经支气管镜灌洗治疗对支气管扩张反复感染病人疗效观察。方法选择2013年3月至2014年05月入住我院的35例支气管扩张反复发作肺部感染病人,随机分为灌洗组和对照组,对照组采用静脉抗菌、祛痰、止咳等常规治疗,灌洗组在上述治疗的基础上,通过电子支气管镜行镜下灌洗,并向病变部位注入阿米卡星治疗。观察治疗有效率,住院期间抗生素DDD值,住院天数,1月内再住院率方面的比较。结果灌洗组治愈9例,好转6例,有效率为94%;对照组治愈6例,好转8例,有效率为74%.两组差异有统计学意义(PO.05);抗生素DDD值具有显著性差异(P0.05);1月内再住院例数减少;住院天数与对照组相比无明显差异。无气胸及严重气道内出血等并发症。结论支气管肺泡灌洗治疗支气管扩张感染病人的过程中,其疗效确切且效果显著,对于患者具有十分重要的临床治疗价值。     

小剂量罗红霉素治疗支气管扩张的疗效观察

目的观察口服小剂量罗红霉素对支气管扩张长期治疗的临床疗效。方法选择40例确诊为支气管扩张患者,随机分为治疗组和对照组各20例,治疗组口服罗红霉素＋沐舒坦,对照组仅予口服沐舒坦治疗,疗程均为6个月。观察患者治疗前后咳嗽、咳痰情况及治疗期间病情加重次数等变化。结果两组临床症状改善率：治疗组80％,对照组30％,治疗组明显高于对照组（P〈0．01）;治疗期间人均再感染次数：治疗组0．5次／人,对照组1．5次／人（P〈0．05）;两组患者24h痰量减少量：治疗组约为29．75±10．05ml／d,对照组约为7．24±13．82ml／d,两组比较差异显著（P〈0．001）;治疗组细菌总清除率为67％,治疗前后痰菌显著减少（P〈0．05）,对照组无变化。结论长期口服小剂量罗红霉素可使支气管扩张症患者症状减轻,痰量减少并可预防其急性加重。     

舒利迭治疗哮喘疗效观察

目的对舒利迭治疗哮喘的临床效果进行比较分析。方法选取64例在我院就诊的确诊为哮喘的患者,将其分为A、B两组,每组平均32例。A组患者采用西替利嗪进行治疗;B组患者采用舒利迭进行治疗。对两组患者的临床治疗效果、并发症和不良反应情况进行比较分析。结果 B组患者的临床治疗效果与A组患者比较,明显有效,差异有统计学意义（P〈0.05）。结论采用舒利迭对患有哮喘的患者进行治疗的临床效果十分明显,且药物不会引起特殊的并发症和不良反应,可以作为治疗该病的首选用药。     

舒利迭改善COPD合并尘肺病患者肺功能研究

目的研究舒利迭对COPD合并尘肺病患者肺功能影响的机制。方法选择我院肺功能Ⅱ～Ⅲ组稳定期COPD合并尘肺病和COPD患者各28例,给予舒利迭吸入治疗4周,检测治疗前后两组FEV1、FVC、FEV1%和FEV1/FVC等指标,比较两组肺功能改善程度。结果两组治疗后FEV1、FVC、FEV1%和FEV1/FVC均较治疗前显著提高(P<0.05)。治疗后COPD合并尘肺病组的FEV1%低于COPD组(P<0.05);两组FEV1/FVC差异无显著性(P>0.05)。结论舒利迭吸入治疗能显著改善COPD患者和COPD合并尘肺患者的肺功能,但合并尘肺病使舒利迭对COPD患者的疗效减弱。     

酚妥拉明联合垂体后叶素治疗支气管扩张并大咯血简

目的 观察支气管扩张并大咯血应用酚妥拉明联合垂体后叶素治疗的临床疗效.方法 选取我院2009年5月~2013年2月收治的90例支气管扩张并大咯血患者作为研究对象,按照随机数字表法随机分为治疗组30例与对照组60例,分别给予酚妥拉明＋垂体后叶素和垂体后叶素治疗,比较两组患者临床疗效.结果 治疗组治疗总有效率高于对照组,但无明显差异（2=2.265,P〉0.05）,治疗组显效率显著高于对照组（=11.054,P〈0.01）,具有统计学差异.治疗组治疗2h完全止血6例,4 h完全止血15例,8 h完全止血8例,8 h后止血率为96.7%;对照组治疗2 h完全止血9例,4 h完全止血18例,8 h完全止血23例,8 h后止血率为83.3%.治疗组8 h止血率显著高于对照组（2=8.236,P〈0.01）.结论 酚妥拉明联合垂体后叶素治疗支气管扩张并大咯血止血效果佳,但应用过程中应注意相关不良反应情况,做好各项监测工作.     

慢性阻塞性肺疾病合并支气管扩张患者的临床特点分析

目的分析慢性阻塞性肺疾病(简称慢阻肺)合并支气管扩张患者的临床特征,提高对该病的认识和诊断水平。方法选择我院2011~2013年间住院的112例慢阻肺患者为研究对象,分为慢阻肺合并支气管扩张组(n=48)和慢阻肺组(n=64),比较两组患者的临床特征、胸部高分辨率CT(HRCT)、肺功能、血气分析表现,随访6个月记录两组患者的急性加重次数。结果慢阻肺合并支气管扩张组BMI低于慢阻肺组;日常咳脓性痰者比例、入院前一年的住院次数均明显高于慢阻肺组(P值分别0.01与0.05)。慢阻肺合并支气管扩张组患者FEV1%pred、FEV1/FVC、FVC%pred、DLCO%pred降低较单纯慢阻肺组更为显著(P0.05)。慢阻肺合并支气管扩张组6个月内平均每人发生急性加重次数(1.47±0.85次);高于慢阻肺组患者(1.06±0.54次),两者比较差异有统计学意义(P0.05)。结论慢阻肺患者中合并支气管扩张者较为常见,合并支气管扩张的慢阻肺患者肺功能下降更为明显,发生急性加重的风险增加。     

Alteration in systemic markers of oxidative and antioxidative status in Tunisian patients with asthma: relationships with clinical severity and airflow limitation

Objective: This study aims to determine the systemic oxidant-antioxidant status in Tunisian patients with asthma. Methods: We evaluated the levels of malondialdehyde (MDA) as thiobarbituric acid complexes, total protein carbonyls (PCs) and advanced oxidation protein products (AOPP). The levels of total thiols, protein sulfhydryls, glutathione (GSH), together with hydrogen peroxide, ascorbic acid, iron and total antioxidant status (TAS) were colorimetrically estimated. Glutathione peroxidase (GSH-Px), catalase (CAT) and superoxide dismutase (SOD) activities were assessed in plasma and erythrocytes by spectrophotometry. We also determined the levels of nitric oxide (NO) and peroxynitrite in plasma from asthmatic patients and healthy controls. The volume of fractionated exhaled NO (Fe_NO) was evaluated by the Medisoft HypAir method. Estimation of DNA damage was determined using the comet assay. Results: Asthmatic patients showed increased levels of MDA in comparison to healthy controls (p?<?0.001), while no significant difference was found in protein carbonyls (p?=?0.79) and AOPP (p?=?0.98). Patients with asthma also had significantly lower levels of total thiols (355.9?±?15.72 versus 667.9?±?22.65, p?<?0.001), protein sulfhydryls (333.99?±?16.41 versus 591.95?±?24.28, p?<?0.001) and glutathione (p?<?0.001). They also showed decreased GSH-Px activity (p?<?0.001), whereas no significant differences in measurements of catalase and SOD enzyme activities were observed between the two groups (respectively, p?=?0.06 and p?=?0.55). In addition, ascorbic acid and nitric oxide levels were decreased in asthmatics in comparison to controls (p?<?0.01). Conclusions: Our findings highlight that oxidative stress and defective anti-oxidative status are major alterations in Tunisian patients with asthma.     

Survival on long-term oxygen therapy in chronic airflow limitation: from evidence to outcomes in the routine clinical setting

Abstract
Background : Two previous randomized controlled trials (RCT) demonstrated that the administration of long-term oxygen therapy (LTOT) improved survival in selected patients with hypoxic chronic obstructive pulmonary disease (COPD) or chronic airflow limitation (CAL).
Aims : The aim of the present study was to investigate whether the survival of CAL patients prescribed LTOT at Flinders Medical Centre (FMC) was gender and age related, and equivalent to that of the previous RCT.
Methods : A list of patients prescribed domiciliary oxygen therapy for CAL at FMC was generated from Respiratory Unit records and hospital financial records for the supply of this therapy. Survival was compared with that reported for the original RCT, and for Swedish and Belgian COPD patients. Factors influencing survival were studied.
Results : Five hundred and five (249 males, 256 females) patients were prescribed LTOT for CAL at FMC during the study period and included in the survival analysis. The patients were elderly with multiple comorbidities. Survival was less than for the control arms of the previous RCT (apart from the Medical Research Council Working Party (MRC) female group) but comparable with recent overseas data. Overall crude survival was 75.1%, 51.3%, 18.9% and 1.1% at 1, 2, 5 and 10 years respectively. Females experienced longer survival than males. Multivariate analysis indicated that age, forced expiratory volume in 1 s, body mass index (BMI) and the number of comorbidities were prognostic indicators for females; BMI was a prognostic indicator for males. A survival advantage existed for females using at least 19 h concentrator oxygen per day.
Conclusions : In routine practice, survival of unselected CAL patients with multiple comorbidities is less than that reported in the original RCT. (Intern Med J 2001; 31: 448–454)     

舒利迭吸入治疗哮喘急性发作后55例疗效观察

目的观察舒利迭对支气管哮喘急性发作控制后的治疗效果及安全性。方法55例已控制急性发作的哮喘患者,随机分为舒利迭治疗组、布地奈德气雾剂对照组,治疗后对临床症状、肺功能、药物不良反应等方面进行评价。结果治疗组哮喘症状、肺功能和对照组相比明显改善。结论哮喘急性发作后吸入舒利迭可取得满意的临床效果。     

舒利迭治疗COPD患者的肺功能及凝血状态分析

目的 观察舒利迭对COPD患者的肺功能及血液高凝状态的影响,并探讨其作用机制.方法 32例COPD出院患者主要采用舒利迭吸入治疗,疗程为12周.比较治疗前、后肺功能及纤维蛋白原;血小板;D-二聚体变化.结果 患者治疗前后的肺功能及凝血功能有明显改善.结论 舒利迭治疗COPD的临床疗效满意.能有效改善患者肺功能及凝血状态.     

Trapped gas and airflow limitation in children with cystic fibrosis and asthma

Trapped gas (TG) has been shown to be present in cystic fibrosis (CF) and asthma, but its relationship with airflow limitation (AL) has not been explored. TG was defined as the difference between the functional residual capacity measured by body plethysmography [FRC(BP)] and that measured by helium dilution [FRC(He)] expressed as a percentage of total lung capacity (TLC). We studied 21 children with CF and 15 with asthma who had a similar degree of AL and hyperinflation, however the children with CF had greater amounts of TG compared with asthma [15% +/- 2 (mean +/- 1 SE) vs 8 +/- 2, P less than 0.05]. Mixing efficiency (ME), an index of the distribution of ventilation, was found to be lower in the CF children than in those with asthma (34 +/- 4 vs 54 +/- 4). In CF, TG correlated with forced expiratory flow between 25 and 75% of vital capacity (FEF25-75), ME, RV/TLC, and maximal expiratory flow rates at 25 and 50% of vital capacity (Vmax25 and 50, respectively; r = -0.66, -0.61, 0.72, -0.71, -0.74). ME also correlated with the above measures. In asthma, TG did not correlate with the FEF25-75, ME, RV/TLC, Vmax25, or Vmax50. Furthermore, TG was frequently found in patients with asthma with moderate AL while it was often absent in patients with severe AL. For both CF and asthma, neither the severity of AL nor the magnitude of the TG could be predicted from the increase in Vmax50 with helium (delta V50).(ABSTRACT TRUNCATED AT 250 WORDS)     

An epidemiological study of the effects of statin use on airflow limitation in patients with chronic obstructive pulmonary disease

Background and objective: Chronic obstructive pulmonary disease (COPD) is considered to be a systemic inflammatory disease, and systemic inflammation has been noted as a factor contributing to cardiovascular disease, which is one of the comorbidities associated with COPD. On the other hand, pleiotropic effects, such as the anti‐inflammatory effects of statins, have attracted attention in recent years, and there have been a variety of reports regarding the usefulness of statins for patients with COPD. Methods: We investigated whether the use or non‐use of statins influenced the prevalence of airflow limitation. All outpatients who were over the age of 40 years and who regularly visited a primary health care facility were invited to participate. Each participant underwent spirometry and completed a questionnaire regarding their clinical status, which was used to screen for COPD. A variety of factors that are potentially related to airflow limitation were assessed. Results: Of the 853 patients included in the study, 81 (9.5%) had airflow limitation. The prevalence of airflow limitation was 2.3% among the 89 patients with a history of statin use, which was five times lower than the prevalence of airflow limitation among patients who had not used statins (10.5%). Among the 347 patients with a history of past or current smoking, airflow limitation was not observed in the 30 patients who had used statins. However, by multivariate analysis, statin use was not significantly associated with a lower prevalence of airflow limitation. Conclusions: This is the first cross‐sectional study from Japan that has demonstrated that statin use has a potential impact on airflow limitation in patients with COPD.