COPD合并肺结核患者TNF-α和IFN-γ与sIL-2R及CRP的表达

目的 分析慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、可溶性白细胞介素-2受体(sIL-2R)、C-反应蛋白(CRP)的表达。方法 选取2016年3月-2019年3月重庆市梁平区人民医院呼吸与危重症医学科收治的COPD急性期合并PTB活动期(A组)、COPD急性期合并PTB恢复期(B组)、COPD稳定期合并PTB活动期(C组)、COPD稳定期合并PTB恢复期(D组)、单纯COPD稳定期组、单纯PTB恢复期组、单纯COPD急性期组、单纯PTB活动期组患者各25例及同期25名常规体检者作为对照组,比较各组血清TNF-α、IFN-γ、sIL-2R、CRP水平,并对数据进行统计分析。结果 各病例组TNF-α、IFN-γ、sIL-2R、CRP均高于对照组(P<0.05);单纯COPD稳定期组、单纯COPD急性期组、单纯PTB恢复期组、单纯PTB活动期组、D组、B组、C组、A组血清TNF-α、IFN-γ、sIL-2R、CRP依次升高(P<0.05);病情好转者血清TNF-α、IFN-γ、sIL-2R、CRP均较治疗前降低(P<0.05);TNF-α、IFN-γ、sIL-2R、CRP预测病情恶化AUC为0.706、0.718、0.768、0.807。结论 PTB合并COPD患者血清TNF-α、IFN-γ、sIL-2R、CRP明显异常,TNF-α、IFN-γ、sIL-2R、CRP均与疾病严重程度有关,对病情恶化具有较高预测价值。     

肺结核合并不同肺部疾病住院患者血浆D-二聚体和纤维蛋白原检测的临床意义

目的研究单纯肺结核(PTB)及其合并其他不同肺部疾病住院患者血浆D-二聚体(D-D)和纤维蛋白原(FIB)水平,探讨其临床意义。方法以2016年1-6月研究期间住院PTB患者为对象,检测分析单纯PTB患者、PTB合并肺炎、PTB合并结核性胸膜炎、PTB合并慢性阻塞性肺疾病(COPD)患者和40例健康对照者的血浆D-D和FIB水平的差异。结果分别有75例单纯PTB患者、57例PTB合并肺炎、38例PTB合并结核性胸膜炎、30例PTB合并慢性阻塞性肺疾病(COPD)患者和40例健康对照者纳入分析。各研究组的血浆D-D和FIB水平差异均有统计学意义(血浆D-D:H=57.118,P=0.000。血浆FIB:F=13.986,P=0.001)。血浆中D-D水平取大于0.5 mg/L为阳性,其中D-D水平阳性率以PTB合并结核性胸膜炎组最高(65.79%),PTB合并COPD次之(59.67%),PTB合并肺炎组为56.67%,单纯PTB为44%,健康对照未检出阳性;血浆中FIB水平取大于4 g/L为阳性,FIB水平阳性率以PTB合并肺炎组阳性率最高(54.39%),PTB合并结核性胸膜炎次之(47.37%),PTB合并COPD组为33.33%,单纯PTB为30.67%,健康对照检出阳性1例。结论单纯PTB及其合并结核性胸膜炎、合并肺炎、合并慢性阻塞性肺疾病(COPD)住院患者,其血浆D-D和FIB水平升高。监测结核病患者及其合并不同肺部疾患的血浆D-D和FIB水平,对预防血栓并发症有重要临床意义。     

COPD合并肺部感染患者血清炎性因子表达及呼吸功能变化

目的探讨慢性阻塞性肺疾病(COPD)合并肺部感染患者的血清炎性因子表达及呼吸功能变化。方法选取2016年4月至2018年12月我院收治的64例COPD合并肺部感染患者作为观察组,另选取同期60例COPD患者作为对照组,检测两组患者的血清炎性因子(TNF-α、IL-6、IL-8、TGF-β)水平和呼吸功能相关指标。结果观察组的TNF-α、IL-6、IL-8、TGF-β、RAW、Fres水平均显著高于对照组,FEV1.0、MVV、MMF、Cdyn水平显著低于对照组,差异均有统计学意义(P<0.05)。结论COPD合并肺部感染患者的炎性因子水平更高,呼吸功能更差,可能会增加不良事件发生风险,因此临床治疗COPD患者时应警惕出现肺部感染。     

慢性牙周炎合并慢性阻塞性肺疾病患者血清IL-6、IL-8水平变化

目的:探讨慢性牙周炎合并慢性阻塞性肺疾病(COPD)患者的血清中炎症因子水平变化。方法:选择2018年9月至2019年9月温州市中医院收治的单纯慢性牙周炎患者51例为B组,单纯COPD患者56例为C组,COPD合并慢性牙周炎患者54例为D组,同期选取本院健康体检者49例为A组。检测研究对象的牙周状况、肺功能、炎症因子[...     

肺结核并发呼吸机相关性肺炎的危险因素和预防措施

目的探讨肺结核(PTB)并发呼吸机相关性肺炎(VAP)的相关危险因素和预防措施。方法选取2016年3月至2020年2月本院收治的PTB并发VAP患者113例作为观察组,另选同期单纯PTB患者80例作为对照组。采取自制《PTB并发VAP调查分析量表》统计两组患者人口学和临床体征资料,分析PTB并发VAP危险因素。结果两组年龄、长期吸烟史、糖尿病、机械通气时间、空洞型PTB、病变累及肺野数、咯血症状、PTB复治、长期使用广谱抗生素、长期使用糖皮质激素、血红蛋白、血清白蛋白、气管切开比较差异均有统计学意义(均P0.05)。Logistic回归分析显示,空洞型PTB、长期使用广谱抗生素、血清白蛋白38.94 g/L、气管切开是PTB并发VAP的独立危险因素(均P0.05)。结论 PTB并发VAP与多种因素有关,临床应针对危险因素采取防控措施,改善患者预后。     

COPD急性加重期合并感染患者血清细胞因子和肺功能指标变化

目的 探讨慢性阻塞性肺疾病(COPD)急性加重期合并感染患者血清细胞因子和肺功能指标变化情况.方法 选取2018年2月至2019年4月本院收治的COPD急性加重期合并肺部感染患者52例为合并感染组,COPD急性加重期未感染患者52例为非合并感染组.分别于治疗前、治疗3d后抽取两组患者空腹外周静脉血4ml,检测白细胞计数...     

老年COPD合并肺部细菌性感染外周血STING、 TBK1、STAT6表达

目的 探讨老年慢性阻塞性肺疾病(COPD)合并肺部细菌性感染外周血干扰素基因刺激因子(STING)、TANK结合激酶1(TBK1)、信号转导和转录激活因子6(STAT6)的表达。方法 选取2019年2月-2021年2月聊城大学医院诊治的96例老年COPD合并肺部细菌性感染患者为感染组，同期96例老年COPD未合并肺部细菌性感染患者为非感染组，实时荧光聚合酶链式反应(PCR)检测外周血STING、STAT6、TBK1表达及其诊断COPD合并肺部细菌性感染的临床价值。结果 感染组外周血STING、TBK1、STAT6表达分别为(25.21±4.69)、(7.06±3.02)、(2.68±0.85)均高于非感染组(P<0.05);重度感染组患者外周血STING、TBK1、STAT6表达均高于轻中度感染组(P<0.05);受试者工作特征(ROC)曲线分析显示，STING、TBK1、STAT6联合预测COPD合并肺部细菌性感染的曲线下面积为0.902,敏感度为89.66%,特异度为74.63%。结论 老年COPD合并肺部细菌性感染患者外周血STING、TBK1、STAT6表达升高，三...     

COPD急性加重期患者血清降钙素原与超敏C反应蛋白水平检测临床意义

目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平变化情况。方法选取2016年2月—2017年9月收治COPD急性加重期患者60例作为A组,选取同期诊治COPD稳定期患者50例作为B组,选取同期体检中心体检健康自愿者50名作为C组,比较三组WBC、PCT、hs-CRP水平。结果 A组WBC、PCT、hs-CRP水平低于B组、C组,B组WBC、PCT、hs-CRP水平低于C组,差异有统计学意义(均P0.05)。出院时,A组WBC、PCT、hs-CRP水平均低于入院时,差异有统计学意义(均P0.05)。结论 COPD急性加重期患者WBC、PCT、hs-CRP水平均可反应性升高,经积极治疗控制病情稳定后其水平可降低,临床中可检测WBC、PCT、hs-CRP水平反映COPD患者疾病严重程度。     

右心房功能参数与慢性阻塞性肺疾病合并肺动脉高压患者预后的相关性

目的探讨右心房功能参数与慢性阻塞性肺疾病(COPD)合并肺动脉高压患者预后的相关性。方法回顾性选取2020年2月至2022年6月新疆医科大学第一附属医院收治的84例采用波生坦联合米力农治疗的COPD合并肺动脉高压患者作为研究对象, 根据治疗效果将其分为有效组(63例)和无效组(21例)。于治疗前采用Philips iE33彩色超声诊断仪对患者的右心功能进行检测, 采用Logistic回归分析影响患者治疗效果的危险因素, 采用受试者工作特征(ROC)曲线分析右心房功能参数对COPD合并肺动脉高压患者不良预后的预测价值。结果有效组主肺动脉内径(MPA)、右心室基底横径(RVd1)、右心室中部横径(RVd2)、右心房左右径(RAd)、右心室游离壁厚度低于无效组[(2.65 ± 0.23)cm比(2.90 ± 0.44)cm、(3.46 ± 0.43)cm比(3.76 ± 0.72)cm、(3.48 ± 0.42)cm比(3.88 ± 0.69)cm、(3.53 ± 0.81)cm比(4.03 ± 1.20)cm、(0.63 ± 0.12)cm比(0.72 ± 0.21)cm], 舒张末期至收...     

凝血功能和动脉血气分析指标在诊断慢性阻塞性肺疾病合并肺栓塞中的价值

目的探讨凝血功能和动脉血气分析在诊断慢性阻塞性肺疾病(COPD)合并肺栓塞中的价值,为临床鉴别肺栓塞提供诊断线索。方法同期收集COPD合并肺栓塞患者35例(A组)、COPD患者35例(B组)和体检健康者35例(C组),比较3组凝血功能和动脉血气分析指标的差异。应用SPSS 11.0软件进行统计学分析。结果与C组比较,A、B两组凝血酶原时间(PT)和活化部分凝血酶原时间(APTT)缩短,血浆凝血酶时间(TT)延长,纤维蛋白原(FIB)增加,肺动脉收缩压(SPAP)升高,动脉血氧分压(PaO_2)下降,差异均有统计学意义(P0.05);与B组比较,A组PT和APTT缩短,FIB增加,SPAP升高,动脉血二氧化碳分压(PaCO_2)下降,差异均有统计学意义(P0.05)。结论凝血功能、PaCO_2和SPAP对诊断COPD合并肺栓塞具有一定的价值,对预防COPD合并肺栓塞发生有一定的作用。     

Phthalate exposure and pulmonary function

Exposure to phthalates is widespread because of their use in plastics, cosmetics, and other consumer products. Phthalate exposure has been associated with adverse respiratory outcomes in children. With urinary phthalate measures, we assessed the association between phthalate exposure and four pulmonary function parameters [forced vital capacity (FVC), forced expiratory volume at 1 sec (FEV1), peak expiratory flow (PEF), and maximum mid-expiratory flow] among the 240 adult Third National Health and Nutrition Examination Survey (NHANES III) participants with urinary phthalate data. Linear regression models controlled for race, age, age squared, standing height, body mass index, cumulative smoking, and current smoking. Monobutyl phthalate (MBP) was significantly associated with decrements in three measures of pulmonary function (FVC, FEV1, PEF) in males but not in females. For a change from the 25th to the 75th percentile in MBP level among men, FEV1 decreased 112 mL (SE = 51, p = 0.03). Monoethyl phthalate (MEP) was associated with lower FVC and FEV1 values in men. Monoethylhexyl phthalate (MEHP), the metabolite of the plasticizer commonly used in medical tubing, was not adversely associated with any of the pulmonary function parameters evaluated. Our results suggest that MBP and MEP, but not MEHP, may influence pulmonary function among adult males.     

Oxidant-antioxidant status and pulmonary function in welding workers

Welding is a process during which fumes, gases, electromagnetic radiation and noise are emitted as by-products. Metal oxide particles are particularly hazardous components of welding fumes. Welding has been found to be associated with respiratory symptoms and our objective in the present study was to study the effects of welding on pulmonary function and serum oxidant-antioxidant status. Fifty-one welding workers and 31 control subjects were recruited. Face to face interviews were conducted using the respiratory illness questionnaire adapted from the American Thoracic Society with the addition of demographic characteristics, work history and working conditions. Additionally physical examinations and spirometric measurements were performed at workplaces. Thiobarbituric acid reactive substances (TBARS), protein carbonyls, protein sulfhydryls (SH) and erythrocyte reduced glutathione (GSH) levels were measured to evaluate oxidant-antioxidant status in 34 welding workers and in 20 control subjects. No statistically significant differences were observed in age, height, weight, body mass index (BMI), smoking status and annual working durations between welding workers and controls. Coughing, sputting and wheezing were significantly higher in welding workers (p<0.05). When adjusted for age, BMI and smoking status in logistic regression, welding work showed a significant risk for chronic bronchitis (OR: 4.78, 95%CI: 1.30-17.54). Forced expiratory volume in one second (FEV(1))/forced vital capacity (FVC) and four parameters of forced expiratory flow (FEF: FEF(25), FEF(50), FEF(75), FEF(25-75)) levels measured in the welding workers were significantly lower than those in the control group (p<0.05). Serum TBARS and protein carbonyl levels were higher in welding workers than those in controls (p<0.001, p<0.05, respectively). On the other hand, total protein SH groups and GSH levels were significantly lower in welders than those in controls (p<0.05, p<0.001, respectively). Pulmonary function tests and oxidant-antioxidant status were found to be negatively affected in welding workers chronically exposed to welding fumes and gases. Preventive measures should be taken to improve the health status of these workers.     

6200型肺功能仪分析及故障维修

本文对美国Sensor Medics公司生产的6200型肺功能仪的工作原理进行简单分析，重点介绍日常工作中一些常见和特殊故障的解决方法。     

Smoking, pulmonary function, and mortality.

The association of pulmonary function (as percent of predicted forced expiratory volume in 1 second [FEV1]) with total and cause-specific mortality over 15 to 18 years was investigated in a large cohort (5924) of prospectively followed Japanese-American men. Among those who never smoked, pulmonary function was found not to be significantly predictive of total mortality in a multivariate model in which adjustment for variables that might confound the results was made. Among past and current smokers, highly significant associations were found (P < 0.0001). The positive relationship of pulmonary function to mortality in smokers was so strong that it overshadowed these differences in nonsmokers in a model including all smoking groups combined, even after adjusting for smoking. A smoking-pulmonary function interaction term added to this model was statistically significant (P < 0.003). This illustrates the need for attention to the potential for complex interactions between biologic variables when carrying out multivariate statistical analysis. Findings for cardiovascular and noncardiovascular mortality were similar. This analysis indicates that while pulmonary function is associated with subsequent mortality, the relationship is significantly associated with smoking history.     

Major genetic mechanisms in pulmonary function

Regressive models were used to search for possible major gene effects on pulmonary function in two groups of families: one ascertained through patients with chronic obstructive pulmonary disease [COPD defined as forced expiratory volume in one second (FEV1) less than 70% forced vital capacity (FVC)] and the other ascertained through patients with non-pulmonary disorders. There were 85 COPD families with data on 270 individuals and 56 non-pulmonary families with data on 199 individuals. The analysis was done on residuals obtained from a regression of FEV1 on age, sex, race, height, and ascertainment group. Smoking status was incorporated directly as a covariate in the regressive models. Data on probands were excluded in this analysis as a partial correction for ascertainment bias. The best fitting model for the 85 COPD families included a major gene effect with sex specific variances, but no residual familial correlation. The best fitting model for the non-pulmonary families was one with no major gene effect and no residual familial correlation. Cigarette smoking was a significant covariate in both groups of families. Testing for heterogeneity showed a significant difference in the control of pulmonary function among these COPD and non-pulmonary families (X2 = 20.12 on 6 df; p = 0.0026). Major gene effects appear to be limited to these COPD families, while there was no evidence for major gene effects in the non-pulmonary families.     

Indoor air pollution and its effect on pulmonary function of adult non-smoking women: III. Passive smoking and pulmonary function

The association between pulmonary function and exposure to tobacco smoke in the home was investigated in a sample of adult, non-smoking women living in a rural area. The women were all participants in a large longitudinal survey on the natural history and determinants of chronic non-specific lung disease. On cross-sectional analysis, several pulmonary function parameters were found to be significantly associated with exposure to tobacco smoke in the home. There was no association between exposure and pulmonary function decline.