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康复干预对气道高反应性患者肺功能的影响 总被引:2,自引:1,他引:1
目的探讨康复干预对轻、中度气道高反应性患者肺功能的影响。 方法轻、中度气道高反应性患者60例,随机分为对照组30例和观察组30例,对照组采用常规药物治疗,观察组在常规药物治疗的基础上增加呼吸功能训练、适宜的有氧运动训练和心理指导等。应用肺功能仪检测2组患者治疗前和治疗2,4,8周后的用力肺活量(FVC)、第一秒用力呼气量(FEV1.0)、用力呼气50%流速(FEF50)、用力呼气中期流速(MMEF)。 结果治疗2,4,8周后,观察组的FVC实测值占预计值的百分比(FVC%)、FEV1.0实测值占预计值的百分比(FEV1.0%)、FEF50实测值占预计值的百分比(FEF50%)、MMEF实测值占预计值的百分比(MMEF%)均明显高于对照组(P<0.05)。 结论对气道高反应性患者采用呼吸功能训练等措施早期干预,可明显改善肺功能,延缓或防止发展成为慢性阻塞性肺疾病(COPD)。 相似文献
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目的 建立健康青年人仰卧位肺通气功能的正常预计值,并探讨其预计值方程式.方法 使用JAEGER MasterScreen组合式肺通气功能仪,对73名(男37名、女36名)19~25岁健康青年,分别取坐位及仰卧位检测肺通气功能.选择下列4项肺通气功能指标:(1)用力肺活量(Fvc);(2)1秒用力呼气容积(FEV1);(3)最大呼气中段流量(MMEF);(4)最高呼气流量(PEF).具体检测方法参考美国胸科协会标准.采用SPSS 11.5统计学软件进行统计学分析.比较坐位与仰卧位检测值的差异,并对仰卧位各实测指标作多元逐步线性回归,得出预计值方程式.结果 健康青年仰卧位肺通气功能4项指标与坐位相比存在明显差异.初步建立了仰卧位肺通气功能各指标的预计值方程式,其中FVC(男性、女性),FEV1(男性、女性)及MMEF(女)方程有意义,例如:FVC(男)=0.014×年龄+0.077×身高+0.018×体质量-10.625(F=12.695,r =0.732).结论 健康青年肺通气功能实测值坐位与仰卧位相比存在明显差异;建议在仰卧位检测肺通气功能时使用仰卧位的肺通气功能预计值;初步计算出仰卧位FVC(男性、女性),FEV1(男性、女性)及MMEF(女)的预计值方程式. 相似文献
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目的研究烟龄(年)、烟量(年支)、戒烟时间(年)与慢性阻塞性肺疾病(COPD)患者肺通气功能指标『FEV1%、FEV1/FVC(%)、PEF%、FEF25%、FEF50%、MMEF%]的关系。方法测定156例稳定期COPD患者的肺功能[FEV1%、FEV1/FVC(%)、PEF%、FEF25%、FEF50%、MMEF%],根据气道阻塞程度分为ⅡA、ⅡB、Ⅲ级COPD。结果各组间的PEF%、FEF;%、FEF。%、MMEF%等肺通气功能指标的比较差异均有统计学意义(P〈0.05)。FEV1%、FEV1/FVC(%)、FEF25%、FEF50%、MMEF%等肺通气功能指标与烟量及烟龄存在负相关,与戒烟时间存在正相关;在控制年龄、烟量等因素后,FEV1%、FEV1/FVC(%)、FEF25%、FEF50%、MMEF%等肺通气功能的指标与戒烟时间存在正相关,而与烟龄存在负相关。结论戒烟可减缓COPD患者肺功能的恶化。 相似文献
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目的:研究轻中度青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者肺功能特征。方法:选取68例AIS患者作为AIS组,20例健康青少年作为正常对照组,采用肺功能仪测定研究对象用力肺活量(FVC)、FVC预计值(FVC pred)、FVC占预计值百分数(FVC pred%)、第1秒用力呼气量(FEV1)、FEV1预计值(FEV1 pred)、FEV1占预计值百分数(FEV1 pred%)、FEV1占FVC百分数(FEV1/FVC%)。结果:AIS组FEV1 pred%、FEV1/FVC%分别为(85.60±11.60)、(88.40±6.84),对照组分别为(93.20±9.39)、(91.00±3.13),AIS组FEV1 pred%、FEV1/FVC%均低于正常对照组,差异有显著性意义。不同侧凸类型、不同性别AIS患者FVC pred%、FEV1 pred%、FEV1/FVC%差异无显著性意义。患者年龄与FVC、FVC pred、FEV1、FEV1 pred正相关,患者Cobb角与肺功能指标无关。结论:轻、中度AIS患者存在肺功能障碍,患者肺功能与年龄正相关,与侧凸类型、性别、Cobb角没有相关性。 相似文献
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目的探讨超声探测脐区皮下脂肪厚度与肺功能的关系。方法体检健康者312例,超声探测其脐上1 cm处皮下脂肪厚度,并根据其厚度分为5组,A组72例,厚度≤5.0 mm;B组95例,厚度5.1~10.0 mm;C组65例,厚度10.1~15.0 mm;D组42例,厚度为15.1~20.0 mm;E组38例,厚度≥20.1mm。测量用力肺活量(FVC)、第1秒用力呼气容积(FEV1.0)、1秒率(FEV1.0/FVC)、最大自主通气量实测值(MVV实测值)、最大自主通气量预计值(MVV预计值)及最大自主通气量实测值/预计值(MVV实测值/预计值)。结果 1男性B组为优势组。与B组比较,D组FVC、FEV1.0、FEV1.0/FVC及MVV实测值均减低,E组FVC、FEV1.0、FEV1.0/FVC、MVV实测值及MVV实测值/预计值均减低(均P0.05)。E组MVV自身实测值/预测值70%呈低肺功能状态。2女性A组、B组及C组肺功能较好,但无明显肺功能优势组。与A组、B组及C组比较,D组FEV1.0、FEV1.0/FVC减低,E组FVC、FEV1.0、FEV1.0/FVC、MVV实测值及MVV实测值/预计值减低(均P0.05)。D组、E组MVV自身实测值/预计值70%,呈低肺功能状态。结论男女性脐区脂肪不同厚度均与肺功能有关,有效控制腹部脂肪厚度及腰围对肺功能有利。 相似文献
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目的探讨矽肺病人各期肺功能损害程度与性质,并找出相关的危险因素。方法本文随机选取在阜新市矿业集团工作矿工353名,其中矽肺患者183名、无矽肺的矿工170名。对所有研究对象进行问卷调查,测定指标包括:MVV、FVC、FEV1、FEV1/FVC,FVC、FEV1、MVV用实测值/预计值×100%表示,FEV1/FVC用实测值表示。参考各指标结果对肺功能障碍进行分型并进行方差分析,对相关的危险因素进行非条件性Logistic回归分析。结果①各期矽肺患者肺功能损害差异有显著性,早期以FEV1、FVC的降低为主,随着期别增加,肺功能损害越发严重,两者呈正相关。②与肺功能障碍有关的危险因素有吸烟、接尘的时间和浓度、患有矽肺相关并发症等。③矽肺病人肺功能障碍早期以阻塞型和混合型通气障碍为主,限制型通气障碍随级别增高而增加。结论长期接触高浓度的生产性粉尘对肺功能的损害作用明显,而且损害的程度随着病期的进展而加重,长期吸烟、患有呼吸系统疾病等因素会加重这种损害,因此肺功能的检查对矽肺全面诊断、病情演变的动态观察及劳动能力鉴定等有着重要的参考价值。 相似文献
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目的 分析深呼气末CT扫描肺气肿阈值-856HU、-910HU及-950HU以下低密度衰减区占全肺体积百分比(LAA%-950、LAA%-910、LAA%-856)对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)严重程度的影响,并探讨定量指标与肺功能相关性。方法 收集104例COPD患者深呼气CT扫描数据与临床肺功能数据,根据GOLD指南将数据分为4组。将4组扫描原始数据导入“数字肺”检测及分析平台,计算出呼气相全肺平均肺密度(MLDex)、深呼气末阈值低于-856HU、-910HU及-950HU以下低密度衰减区占全肺体积百分比(LAA%-950、LAA%-910、LAA%-856)。肺功能指标包括:用力肺活量实测值(FVC)、用力肺活量实测值占预计值百分比率(FVC%)、第一秒用力呼气容积实测值占预计值百分率(FEV1%)、FEV1与用力肺活量比值(FEV1/FVC)、肺一氧化碳弥散量实测值占预计值百分率(DLCO%)、单位肺体积一氧化碳弥散量(DLCO/VA)及残气量与肺总量比值(RV/TLC)。采用单因素方差分析或Kruskal-Wallis H检验比较4组间肺功能及CT定量参数的差异。应用Pearson相关分析或Spearman秩相关分析CT定量参数与肺功能相关性。进行多元逐步回归分析确定LAA%-950、LAA%-910、LAA%-856与MLDex关系。结果 4组间CT定量参数:LAA%-910、LAA%-950、MLDex差异具有统计学意义(P<0.01),LAA%-856差异无统计学意义(P=0.265)。LAA%-910与FVC、FEV1/FVC、FEV1%、FVC%、DLCO%及DLCO/VA均呈负相关,与RV/TLV正相关。MLDex与LAA%-856、LAA%-910、LAA%-950均呈负相关。多元逐步回归分析:LAA%-910、LAA%-950与MLDex回归方程R2值0.917,p <0.01。结论 呼气相CT扫描定量指标LAA%-910能够准确评估COPD严重程度并且与肺功能具有良好相关。 相似文献
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张健杰 《中国组织工程研究与临床康复》2005,9(1):22-23
目的:研究脑卒中患者肺通气功能变化,探讨其临床意义。方法:用Pal型肺通气功能测定仪检测了深圳铁路医院1997-01/2002-12收治的47例脑卒中患者肺通气功能情况,包括用力肺活量(FV)C,第1秒用力呼气量FEV1),第1秒用力呼气量占用力肺活量百(分比(FEV1/FVC),峰值流速(PEF),平均呼气中期流速(MMEF),50%呼气最大流速V50)及25%呼气最大流速(V25)。(结果:患者肺通气功能实测值FVC,FEV1,FEV1/FVC分别为(2.80±0.17),(2.02±0.28)L,(68.79±10.23)%,其正常预计值分别为(3.62±0.42),(2.84±0.35)L,(81.61±7.55)%,两组比较差异有显著性意义。肌力0或1级患者组FVC,FEV1,FEV1/FVC分别为(2.25±0.51),(1.65±0.23)L,(65.19±7.25)%,肌力2或3级患者组FVC,FEV1,FEV1/FVC分别为(2.87±0.36),(2.11±0.73)L,(70.06±5.52)%,肌力4级患者组FVC,FEV1,FEV1/FVC分别为(3.05±0.85),(2.45±0.38)L,(85.67±9.43)%,组间比较差异有显著性意义(P均<0.05)。随访18例患者,肌力恢复前FVC,FEV1,FEV1/FVC分别为(2.46±0.21),(1.85±0.23)L,(67.52±12.09)%,肌力恢复后FVC,FEV1,FEV1/FVC分别为(3.62±0.42),(2.23±0.26)L,(78.56±3.42)%两组比较差异有显著性意义。,结论:脑卒中可造成患者肺通气功能损害,肌力下降可能是其主要因素之一,加 相似文献
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目的:探讨介休市煤工尘肺患者肺通气功能的损害情况。方法:对660例男性煤工尘肺患者和300例男性接尘工人进行肺通气功能测量并比较。结果:各期煤工尘肺患者的肺活量(VC)、用力肺活量(FVC)、第1秒用力呼气容积(FEV1.0)、FEV1.0/FVC%、25Voo呼气中期流速(MEF75%)、50%呼气中期流速(MEF50%)、75%呼气中期流速(MEF25%)、最大呼吸中期流速(MMEF)、最大通气量(MVV)均明显低于对照组,差异有统计学意义(P〈0.01),Ⅰ,Ⅱ,Ⅲ期煤工尘肺患者肺通气功能异常率分别为77.78%、88.54%和100.00%,明显高于对照组,差异有统计学意义(P〈0.01);Ⅰ,Ⅱ期煤工尘肺患者肺通气功能损害类型主要为阻塞性和混合性,皿期煤工尘肺患者肺功能损害以混合性为主。结论:各期煤工尘肺患者的肺通气功能损伤明显,尘肺患者肺通气功能随尘肺期别增加而降低。 相似文献
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目的探讨血清转化生长因子β1(TGF-β1)和白细胞介素-17A(IL-17A)水平在煤工尘肺(CWP)中的变化及其与肺功能关系。方法采用双抗体夹心ELISA法检测118例CWP患者(CWP组)、61例具有与CWP组相同接尘条件的健康井下接尘矿工(接尘对照组)及53例井上健康查体人员(正常对照组)血清TGF-β1和IL-17A水平;用肺功能机检测用力肺活量(FVC%)、一秒钟用力呼气量(FEV1%)、用力呼气1秒率(FEV1/FVC%)、最大呼气中期流速(MMEF75/25%)4项肺功能指标。结果与正常对照组比较,CWP组TGF-β1和IL-17A水平明显升高,差异具有统计学意义(P〈0.05和P〈0.01);CWP组IL-17A水平明显高于接尘对照组(P〈0.01),而4项肺功能指标均明显降低,差异具有统计学意义(P〈0.05和P〈0.01)。CWP并发慢性阻塞性肺疾病组TGF-β1水平明显低于单纯CWP组(P〈0.01)。CWP组TGF-β1与FEV1/FVC(%)呈负相关(r=-0.427,P〈0.05)。结论 CWP患者血清TGF-β1水平可能与疾病严重程度有关,并间接反映肺功能;检测IL-17A水平可能对协助诊断CWP有一定参考价值;TGF-β1和IL-17A在CWP发生发展中可能各自发挥其作用。 相似文献
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目的探讨煤工尘肺患者血清中肺表面活性蛋白A(SP—A)和C(SP—C)与肺功能损害的关系,为煤工尘肺标志物的研究提供理论依据。方法选择32例煤工尘肺患者和41例健康体检者作为研究对象,对其血清中SP—A和SP-C进行检测,同时进行呼吸困难分级评定和肺功能检测,测定项目包括通气功能[用力肺活量(FVC),1秒钟用力呼气量(FEV.),最大通气量(MVV)]和弥散功能[一氧化碳弥散量(DLCO)],测定结果以实测值占预计值的百分数表示,1秒钟用力呼气量与用力肺活量比值(FEV。%)为实测值。结果32例煤工尘肺患者呼吸困难分级为Ⅲ级14例,Ⅳ级18例。呼吸功能Ⅳ级煤工尘肺患者的FEV1、MVV和DLCO占预计值的百分比分别为(69.38±15.17)%、(65.89±8.14)%、(69.55±7.96)%,明显低于健康对照组[(96.35±10.24)%、(94.13±10.38)%和(96.51±11.37)%],差异均有统计学意义(P均〈0.05)。尘肺组血清中SP—A、SP—C分别为(4.02±1.22)μg/L和(3.58±0.67)ng/L,健康对照组分别为(2.41±0.68)μg/L和(2.31±0.29)ng/L,差异均有统计学意义(t值分别为6.480和9.290,P值分别为0.001和〈0.001)。血清SP-A与尘肺患者接尘工龄、呼吸困难分级、DLCO相关(r值分别为0.124、0.235、-0.352,P值分别为0.042、0.041、0.025),血清SP-C与接尘工龄、呼吸困难分级、FEV,相关(r值分别为0.117、0.288、-0.238,P值分别为0.015、0.037、0.036)。结论煤工尘肺患者血清中SP—A、SP-C与肺功能损伤密切相关,可作为煤尘致肺损伤的候选标志物。 相似文献
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Acute exposures to hemp dust, in healthy subjects as well as hemp workers with byssinosis, resulted in two different responses. Men with symptoms (chest tightness, coughing, and wheezing) after exposure showed decreases of forced expiratory volumes (FEV(1.0)), flow rates on maximum expiratory flow-volume (MEFV) curves, and of vital capacity (VC), while airway conductance (Gaw: TGV ratio) did not decrease significantly ("flow rate response"). Men without symptoms after exposure showed no changes of VC, FEV(1.0), and MEFV curves, but had a significantly decreased airway conductance ("conductance response"). The flow rate response is attributed to a pharmacological bronchoconstrictor effect of hemp dust on small airways, the conductance response to a mechanical or reflex effect of hemp dust on large airways. Both responses were abolished by a bronchodilator drug. The type of response reflects a difference between individuals and is not related to age, smoking habits, or prior exposure history. Men with normal control function data had either a flow rate or a conductance response. All men with abnormal control data had a flow rate response.Long-term hemp dust exposure causes irreversible obstructive lung disease, in particular among men who respond to acute dust exposure with symptoms and flow rate decreases. The detection of this response, with FEV(1.0) measurements and MEFV curves, is essential in the study of byssinosis. Decreases of airway conductance after dust exposure have no consistent relation to the development of clinical symptoms. The relative value of measurements of maximum expiratory flow rates and of airway conductance in other lung diseases needs to be reassessed. 相似文献
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目的:对便携式肺功能测试仪的信度进行评价,分析其在健康受试者肺功能检查中的一致性及可重复性。方法:随机选取30例健康受试者为研究对象,采用便携式肺功能测试仪进行肺功能检查,记录受试者3次用力呼气和用力吸气的用力肺活量(FVC)、呼气峰流速(PEF)、一秒用力呼气量(FEV1)、用力吸气肺活量(FIVC)、吸气峰流速(PIF)、一秒用力呼气量/用力肺活量(FEV1/FVC)、最大呼气压(MEP)、最大吸气压(MIP),并进行测试者间信度和重测信度的检测。结果:测试者间信度方面,FVC、PEF、FEV1、FIVC、PIF、FEV1/FVC、MEP、MIP的组内相关系数(ICC)值为0.80~0.97,具有极好信度;相对信度方面,FVC、PEF、FEV1、FIVC、PIF、FEV1/FVC、MEP、MIP的ICC值为0.86~0.97,具有极好信度;绝对信度方面,各项评估结果参数的SEM、SEM%值分别为0.28~11.15、4.81%~13.15%,MDC、MDC%值分别介于0.37~30.91,13.33%~36.46%;Bland-Altman图形显示无系统性误差,肺功能检差各项结果比较差异均无统计学意义。结论:肺功能测试仪用于健康受试者肺功能检查具有良好的信度。 相似文献
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Fate of grainhandlers with bronchial hyperreactivity 总被引:1,自引:0,他引:1
D A Enarson S Vedal M Chan-Yeung 《Clinical and investigative medicine. Médecine clinique et experimentale》1988,11(3):193-197
Bronchial reactivity to methacholine and to grain dust were determined in a group of grainhandlers whose spirometry was being studied prospectively. Six workers showed specific bronchial responses to grain dust (indicative of occupational asthma), 21 did not show reactivity to grain dust but had bronchial hyperreactivity to methacholine and 40 had neither. Those with hyperreactivity were older, had lower FEV1 at initial examination and were more likely to experience a significant decline in FEV1 over a single working shift. Over 6 years of follow-up, those with hyperreactivity were not more likely to leave work and although they showed a more rapid decline in lung function over the period, because of the small number of individuals studied the difference between those with and without bronchial hyperreactivity was not significant. Among those with hyperreactivity to methacholine, there was a significant positive association between change in FEV1 over a single workshift and change in FEV1 over six years of followup, not seen in those without hyperreactivity to methacholine. Moreover, reactivity to methacholine was a stable observation over 6 years in the majority of studied individuals. We conclude that in the presence of bronchial hyperreactivity to methacholine, change in FEV1 over a single workshift more precisely predicts the trend in FEV1 over time in grainhandlers. 相似文献
16.
Storaas T Irgens A Florvaag E Steinsvåg SK Ardal L Do TV Greiff L Aasen TB 《Clinical physiology and functional imaging》2007,27(5):327-334
BACKGROUND: Bronchial hyperresponsiveness (BHR) is common in bakery workers. The relation between bronchial responsiveness measured with a tidal breathing method and smoking, airway symptoms, IgE-sensitization, nasal indices of inflammation and flour dust exposure have been studied with bronchial responsiveness expressed as a continuous outcome. MATERIAL AND METHODS: Bakery workers (n = 197) were subjected to interviews, questionnaires, allergy tests, workplace dust measurements and bronchial metacholine provocation. Eosinophil cationic protein (ECP) and alpha(2)-macroglobulin were measured in nasal lavage. Bronchial responsiveness was expressed as slope(conc), a measurement based on regressing the per cent reduction in FEV(1) at each provocation step. RESULTS: BHR expressed as slope(conc) was associated with smoking (P = 0.009), asthma symptoms at work (P = 0.001), and occupational IgE sensitization (P = 0.048). After adjusting for baseline lung function the association between BHR and IgE sensitization was no longer present. We demonstrated an association between nasal ECP and BHR (slope(conc) < 3: P = 0.012), but not to alpha(2)-macroglobulin in nasal lavage. No association was seen between BHR and current exposure level of flour dust, number of working years in a bakery or a history of dough-making. CONCLUSION: BHR is related to baseline lung function, work-related asthma symptoms, smoking and nasal eosinophil activity, but not to occupational IgE sensitization and current flour dust exposure when measured with metacholine provocation. The slope(conc) expression seems to be a useful continuous outcome in bronchial responsiveness testing. 相似文献
17.
目的 观察支气管哮喘缓解期肺通气功能情况与正常人有何异同。方法 选择病程小于 3年的老年哮喘缓解期患者 2 1例 (A组 )、青壮年哮喘缓解期患者 2 0例 (B组 ) ,健康青壮年 15例 (C组 ) ,比较三组之间肺通气功能指标。结果 VC %、FEV1/FVC、FEV1% :A组与B组比较差异有显著意义 (P <0 0 5 ) (VC %比较差异无显著意义P >0 0 5 ) ;B组与C组比较差异无显著意义 (P >0 0 5 )。MMF %、V75 %、V5 0 %、V2 5 % :A组与B组比较差异有显著意义 (P <0 0 1) ;B组与C组比较差异有非常显著意义 (P <0 0 0 1)。结论 支气管哮喘缓解期小气道通气功能仍不正常 ,存在气流受限 ,需维持缓解期治疗 ,定期复查肺功能。 相似文献
18.
Piirilä P Kivisaari L Huuskonen O Kaleva S Sovijärvi A Vehmas T 《Clinical physiology and functional imaging》2009,29(1):1-9
Introduction: Disorders of pulmonary tissue and pleura are visualized by findings in high‐resolution computed tomography (HRCT), and the impairment caused by these findings is assessed by pulmonary function tests. Our aim was to determine how some commonly used spirometric variables are related to certain HRCT signs, in order to find out which HRCT signs are associated with restrictive and which with obstructive ventilatory impairment. Methods: Altogether 590 asbestos‐exposed workers, 95% of whom were smokers or ex‐smokers, were studied with HRCT; 19 pathological signs were scored. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, forced expiratory flow at 50% of FVC (MEF50) and total lung capacity (TLC) were measured, and their relationship with HRCT signs was examined with bivariate correlations and multiple regression analysis. Results: FVC and TLC were negatively correlated with fibrosis score, parenchymal bands, extent of pleural thickenings and positively with widened retrosternal space. FEV1/FVC ratio was negatively correlated with emphysema types and widened retrosternal space and positively with parenchymal bands and subpleural nodules. Thickened bronchial walls did not separate between restrictive and obstructive ventilatory function. Conclusions: HRCT signs showed distinctive patterns in restrictive and obstructive ventilatory impairment. These results can be used to help to analyse the lung function of patients simultaneously exposed to asbestos and smoking, when this relationship requires elucidation. In addition, the results may be helpful in explaining some radiological findings. 相似文献
19.
目的 探讨微小核糖核酸(microRNA,miRNA/miR)-146在支气管扩张伴支气管哮喘患者血清中的表达及对肺功能的影响.方法 选取邢台市第三医院2017年1月~2020年8月收治的156例支气管扩张伴支气管哮喘患者作为研究对象,并以同期150例健康体检者作为对照组.采用实时定量聚合酶链式反应(real-time... 相似文献