A controlled study on edema in elderly inpatients

The clinical background relating to edema in elderly inpatients was investigated, in terms of various items in elderly (aged greater than or equal to 65) cases with edema (n = 96) and without edema (controls, n = 95). Both groups were matched for sex, age, and underlying diseases. As compared with the control patients, the patients with edema had longer hospital stays with more disabled status, and showed less activity of daily living (ADL). The rates of bed-restricted patients, dementia patients, and patients with decubitus, muscle atrophy, or incontinence were found to be significantly higher in the patients with edema. The measurement of biochemical parameters revealed that the patients with edema had significantly lower levels of serum albumin, Na, Cl, creatinine, and uric acid, in contrast to higher levels of C-reactive protein. According to the classification of the assumed causes of edema, we divided the patients with edema into five groups; group 1 (n = 33): edema associated with immobilization, group 2 (n = 18): edema due to heart failure, group 3 (n = 15): edema on paretic limbs, group 4 (n = 6): edema due to hypoproteinemia, group 5 (n = 5): edema associated with liver cirrhosis. Both group 1 and group 4 patients had lower levels of hemoglobin and albumin, whereas group 3 patients had higher scores of ADL, higher blood pressure, and higher levels of hemoglobin and albumin. These results suggest that immobilization and restriction in bed, as well as malnutrition, were important factors in causing edema in elderly inpatients.     

血清中胰岛素样生长因子-1水平与脑卒中后痴呆关系的研究

目的研究血清胰岛素样生长因子-1(IGF-1)水平与脑卒中后痴呆(post-stroke dementia,PSD)的关系。方法同期选择脑卒中患者129例作为脑卒中组,其他疾病患者76例为对照组,健康老年人41例为正常组。6个月后将脑卒中组患者按其是否符合痴呆诊断标准又分为PSD组(65例)和非PSD组(64例),发病时及6个月后测血IGF-1及认知功能量表测定。结果脑卒中组IGF-1水平比对照组低,差异无显著性意义(t=-1.88,P=0.06),与正常组比较,则差异有显著性意义(t=-2.79,P=0.006);PSD组IGF-1水平比其他3组均低,4组间组内比较,差异有显著性意义(F=3.43,P=0.013);发病6个月后,PSD组IGF-1保持较低水平;logistic回归方程发现与PSD相关的危险因素包括年龄、收缩压I、GF-1及冠心病、高血压。相关分析发现血IGF-1水平与一般认知功能水平相关,其中空间结构能力、注意、短时记忆与瞬间记忆受影响比较明显(P<0.05)。结论脑卒中发病时低IGF-1水平者,其发生PSD的可能性大;血IGF-1水平与认知功能存在一定的相关性。     

Bone mineral density in patients with Parkinson's Disease

BACKGROUND AND AIMS: This study assesses bone mineral density (BMD) in the lumbar spine, proximal femur and hand, and examines the relationship between BMD and disease duration, Hoehn and Yahr staging in Turkish elderly patients with Parkinson's disease (PD). DESIGN: Twenty-four PD patients and 31 age- and sex-matched controls took part in the study. The BMD in the lumbar spine (L2-L4), femoral neck, Ward's triangle, trochanter and bilateral hands were evaluated by dual X-ray absorptiometry (DXA). RESULTS: There was no significant difference in right hand BMD (rHBMD), L2-L4 spinal BMD, and right proximal femur BMD between patients and controls. However, in female patients hand BMD and right femoral neck BMD were significantly lower than in female controls (p<0.05). Male patients had no significant difference in BMD measurements in any sites compared with controls. Patients' Hoehn and Yahr index and disease duration were negatively correlated with BMD in all sites except L2-L4. CONCLUSIONS: We emphasize the increased risk for osteoporosis in elderly female patients with PD, which is more prominent in proximal femur and hand measurements. Elderly female patients should be carefully examined and screened for osteoporosis to prevent bone loss and associated disability.     

老年患者行经皮腔内肺动脉成形术的短期效果

目的 探索经皮腔内肺动脉成形术(PTPA)对老年慢性血栓栓塞性肺动脉高压(CTEPH)患者的短期有效性和安全性.方法 回顾分析复旦大学附属中山医院2017年12月-2019年12月接受PTPA治疗的CTEPH患者,根据年龄分为非老年组(n=24)和老年组(n=13).比较2组基线和随访时的心功能、6 min步行距离(6...     

卒中后抑郁患者海马磁共振氢质子波谱分析

目的 探讨卒中后抑郁患者海马氢质子磁共振波谱（1H-MRS）的特点.方法 以32例卒中后抑郁患者为研究组,30例脑卒中患者为病例对照组,30名正常人为正常对照组.三组在入组24 h内采用多体素1 H-MRS检测双侧海马N-乙酰基天门冬氨酸（NAA）、胆碱复合物（Cho）与肌酸复合物（Cr）,完成NAA/Cr值和Cho/Cr值的计算.结果 研究组左右侧海马NAA/Cr值均低于病例对照组和正常对照组,P均＜0.05;研究组左侧海马Cho/Cr值均高于病例对照组和正常对照组,P均＜0.05;右侧海马Cho/Cr值高于正常对照组（P＜0.05）,但与病例对照组比较,P＞0.05.重度抑郁组左右侧海马NAA/Cr值均低于轻度抑郁组,P均＜0.05;不同抑郁程度的双侧海马Cho/Cr值比较,P均＞0.05;研究组双侧海马NAA/Cr值与HAMD评分呈负相关（P均＜0.05）,而双侧海马Cho/Cr值与HAMD评分不存在相关关系（P＞0.05）.三组左右两侧海马各研究指标比较,P均＞0.05.结论 海马神经元代谢的异常可能是卒中后抑郁的神经生物学基础;卒中后抑郁患者、脑卒中患者和正常人脑部NAA、Cho可能并不存在侧化现象.     

血清miR-92a-1-5p及miR-92a-2-5p表达水平与老年卒中后抑郁的关系

目的 分析血清微小核糖核酸-92a-1-5p ( miR-92a-1-5p)、 miR-92a-2-5p 表达水平与老年卒中后抑郁的关系.方法 选取2018年2月至2020年10月胶州中心医院收治的129例老年卒中患者为研究组,另选取110名同期健康体检者为对照组,均检测血清miR-92a-1-5p、miR-92a-2...     

乙哌立松联合肩宁汤治疗脑卒中后肩手综合征Ⅰ期患者临床疗效观察

目的 观察乙哌立松联合肩宁汤(自拟方)治疗脑卒中后肩手综合征(SHS)Ⅰ期患者的疗效.方法 选取2018年1月至2020年7月在我院住院治疗的脑卒中后SHS Ⅰ期患者100例,随机分为对照组和研究组,每组50例.对照组患者给予乙哌立松治疗,研究组患者给予乙哌立松联合肩宁汤治疗,14 d为1疗程,共治疗2个疗程.比较两组...     

A novel robot device in rehabilitation of post-stroke hemiplegic upper limbs

BACKGROUND AND AIMS: In this pilot study, we introduce the "NeReBot", a novel robotic device designed and programmed for clinical neurological applications. The aim of the study was to test whether additional sensorimotor training of paralyzed or paretic upper limbs, delivered by NeReBot, enhanced motor and functional outcome in stroke patients. METHODS: Twenty patients with post-stroke hemiparesis or hemiplegia received standard poststroke multidisciplinary rehabilitation, and were randomly assigned either to exposure to the robotic device without training or to additional sensorimotor robotic training (about 4 h/week) for 4 weeks. Robot training consisted of peripheral manipulation of the shoulder and elbow of the impaired limb, correlated with visual stimuli. RESULTS: At hospital discharge, impairment and disability had declined in all patients, but the group with robot training showed higher gains on motor impairment and functional recovery, which were maintained at the 3-month follow-up. No adverse events resulted from robot-assisted therapy. CONCLUSIONS: According to our results, NeReBot therapy may efficaciously complement standard post-stroke multidisciplinary rehabilitation and offer novel therapeutic strategies for neurological rehabilitation.     

Validity of the Leg-O-Meter, an instrument to measure leg circumference

The objective of this study was to validate the Leg-O-Meter measure against the clinical assessment of edema made by physicians using data from a 1-year follow-up study of unselected patients with chronic venous disease of the leg (CVDL). The Leg-O-Meter consists of a tape measure fixed to a stand attached to a small board on which the patient is in standing position. Its reliability has been shown to be above 97%. Data from the Venous Insufficiency Epidemiologic and Economic Study (VEINES) were used: 1,521 patients from France, Belgium, Italy, and Quebec (Canada) who spontaneously consulted a physician between 1994 and 1995 with a complaint resulting from venous problems of the legs were included. Baseline variables included leg circumference measurements using the Leg-O-Meter; physicians were also asked to diagnose edema and report it as present or absent on each leg. Clinical edema and leg circumferences were assessed again 3 to 6 months after the baseline visit and 12 months after baseline. The tape measure of the Leg-O-Meter was fixed at 13 cm from the floor. The first and last assessments were used to evaluate the variation in edema during the follow-up period. Clinical variation in edema status was assessed as follows: improved, if edema was diagnosed at baseline but not at the final visit; unchanged, if edema was diagnosed at both visits; and worsened, if there was no diagnosis of edema at baseline but a diagnosis of edema was made at the final visit. Variation in measured edema was classified as improved if there was a decrease in leg circumference of more than 1 cm between baseline and final evaluation; unchanged, if the difference in leg circumference was between plus or minus 1 cm between the 2 assessments; and worsened, if there was an increase in leg circumference greater than 1 cm between the 2 assessments. Data-driven cut-off points were also used: 1.3 cm and 1.5 cm. Sensitivity and specificity of the Leg-O-Meter using physician diagnosis as "gold standard" were calculated. In addition, receiver operating characteristics (ROC) curves were calculated by using the 3 different leg circumference cut-off points in order to determine the accuracy of the Leg-O-Meter to detect changes in edema. The overall accuracy of the Leg-O-Meter was 0.84 (standard error (se) = 0.06). Accuracy was greater when 1.5 cm was used as a cut-point. The Leg-O-Meter is an objective, reliable, and standardized instrument to assess patients over time. A change of 1.5 cm between 2 measurements gives a valid estimate of improvement or worsening of edema, when compared to physicians' diagnosis. The Leg-O-Meter is also sensitive to any changes in leg circumferences, which is an advantage over the clinical evaluation of edema.     

Blood pressure control with cilnidipine treatment in Japanese post-stroke hypertensive patients: The CA-ATTEND study

Blood pressure control is important in post-stroke hypertensive patients and antihypertensive treatment is recommended for such patients. Ca-channel blockers are recommended as the medications of choice for the treatment of post-stroke patients. Here, we report the results of a large-scale prospective post-marketing surveillance study of post-stroke hypertensive patients (n = 2667, male 60.4%, 69.0 ± 10.9 years) treated with cilnidipine, with regard to blood pressure control and adverse reactions. Cilnidipine treatment caused a decrease in both clinic and home blood pressures 2 months after the beginning of treatment, and the decreased blood pressure was maintained until the end of 12 months’ observation. The proportion of patients in whom clinic blood pressure was well controlled (<140/90 mmHg) increased from 21.5% to 65.3% in cilnidipine treatment, with no differences in effectiveness among the various clinical subtypes of stroke. In total, 346 adverse events occurred, with an overall incidence of 8.9% (238 of 2667 patients). In the elderly group, specifically, a fall and a hip fracture each occurred in 1 (0.1%) patient. These results indicate that cilnidipine was effective in treating uncontrolled blood pressure and was well tolerated in Japanese post-stroke hypertensive patients in a real-world clinical setting.     

Prevention of edema in long flights with Pycnogenol.

The aim of this study was to evaluate the prevention of edema during long-haul flights with an oral, anti-edema and antithrombotic agent (Pycnogenol, Horphag, Research Management SA, Geneva, Switzerland) in asymptomatic subjects. The assessment of edema was performed by evaluating an analogue scale, the rate of ankle swelling by strain-gauge derived rate of ankle swelling (RAS), and by assessing the ankle circumference variation. The study included 211 subjects; 169 completed the study (88 in the control group and 81 in the Pycnogenol group). There were no important differences between the two groups (comparable for age, gender, weight, body mass index, and pattern distribution). The edema score, the RAS, and the circumference at inclusion were also comparable. After the flight in those treated with Pycnogenol, the edema score was increased only by 17.9% (vs. an increase of 58.3% in the control group) (p<0.05). The RAS, evaluated in 22 subjects in the Pycnogenol group (age 44.5; SD 8) and in 23 in the control group (age 45; SD 9) was increased on average by 91% in the control group and 36% in the Pycnogenol group (p<0.05). The variation on circumference at the ankle was 6% in the Pycnogenol group (11% in the control group; p<0.05). These results indicate a positive effect of Pycnogenol on edema during long flights when considering subjective and objective data. No unwanted effects were observed.     

Severe soft-tissue injury following intravenous infusion of phenytoin. Patient and drug administration risk factors

From April 8, 1982, through June 1984, 11 patients in a single hospital experienced 17 episodes of limb edema and discoloration after the intravenous (IV) administration of phenytoin sodium (Dilantin). One patient required a below-the-elbow amputation; all other patients recovered. No single drug lot was implicated. A case-control study was performed using three controls for each case; controls received IV infusions of phenytoin and were hospitalized close in time to the case patients. Compared with controls, patients with reactions were more often female and elderly and had underlying cardiovascular disease. Affected patients also received phenytoin through an IV catheter smaller than 20 gauge (50% vs 6%), at a rate greater than 25 mg/min (63% vs 19%), and in two or more IV infusions of phenytoin given "IV push" at the same site (81% vs 24%). High-risk patients require careful monitoring and stricter guidelines for the IV administration of phenytoin.     

Swallowing Kinematics and Factors Associated with Laryngeal Penetration and Aspiration in Stroke Survivors with Dysphagia

The purpose of this study was to investigate swallowing kinematics and explore kinematic factors related with penetration-aspiration in patients with post-stroke dysphagia. Videofluoroscopic images of 68 patients with post-stroke dysphagia and 34 sex- and age-matched healthy controls swallowing a thin liquid were quantitatively analyzed using two-dimensional motion digitization. The measurements included the movement distances and velocities of the hyoid and larynx, and the maximal tilt angles and angular velocities of the epiglottis. All velocity variables were significantly decreased in the stroke patients compared to the controls. There was a significant difference in the maximal horizontal displacement of the larynx, but there were no significant differences in other displacements of the larynx, the maximal displacements of the hyoid bone, and the maximum tilt angle of the epiglottis between the two groups. The maximal tilt angle of the epiglottis was lower in the aspiration subgroup than in the no penetration/aspiration and penetration subgroups as well as the controls. The maximal tilt angle from the y axis showed a dichotomous pattern at 90° of the angle, and all 11 patients with an angle <90° showed either penetration or aspiration. In the ROC curve of the angle for prediction of aspiration, the area under the curve was 0.725 (95 % CI 0.557–0.892, P = 0.008). This study suggested that sluggish rather than decreased hyolaryngeal movements during swallowing are a remarkable feature of post-stroke dysphagia. The association of reduced epiglottic movement with the risk of aspiration in patients with post-stroke dysphagia was supported by the quantitative analysis.     

Effect of venous support on edema and leg pain in patients after coronary artery bypass graft surgery.

The purpose of this study was to assess the effect of external venous support on edema and pain in the saphenous graft leg of patients who had coronary artery bypass graft surgery (CABG) 5 days and 1 month after surgery. Fifty-six patients who had CABG surgery were randomly assigned to the experimental (n = 24) or control (n = 32) group. Subjects in the experimental group wore graded compression support hose. Edema was assessed by using ankle, calf, and thigh circumference measurements. Pain was measured on a visual analog scale. Hose were effective in preventing edema during hospitalization, but results at 1 month were inconclusive. There was no difference in leg pain for experimental and control subjects. That a number of patients in the experimental group were unable to complete the study suggests that off-the-shelf, thigh-high support hose may not be useful for individuals with disproportionately large thighs. Further investigation of the long-term effects of support hose is warranted.     

老年阻塞性睡眠呼吸暂停低通气综合征患者血压及心率变异性分析

目的: 探讨老年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血压及心率变异性各指标的关系。方法: 2006年1月~2007年12月在我院就诊,经便携式睡眠分析仪（PSG）诊断为老年OSAHS患者41例作为阳性组,因睡觉打鼾就诊并经PSG整夜检测排除OSAHS的老年患者41例作为对照组,进行动态心电图及动态血压检测,计算血压、心率变异性各指标值。结果: 老年OSAHS患者在体质量指数、腰围、颈围等均明显高于对照组（P<0.05或P<0.01）;心率变异性在时域指标SDNN、SDNNI、rMSSD、PNN50及频域指标的TP、LF、HF、LF/HF上与对照组比较差异均有统计学意义（P<0.05）;白天、夜间及24 h收缩压、舒张压血压变异性与对照组比较差异有统计学意义（P<0.05 或P<0.01）。结论: 老年OSAHS患者心率变异性明显异常,血压变异性明显升高。     

The LONFLIT4-Venoruton Study: a randomized trial--prophylaxis of flight-edema in venous patients

The aim of this independent study was to evaluate the protective effects, on the development of flight edema, of Venoruton. The study included patients with venous disease traveling in economy in long-haul flights (9 hours). Edema is a relevant aspect of long-haul flights affecting both patients with venous disease and normal subjects. Microcirculatory variations during flights cause a microangiopathy and biochemical and coagulation alterations. This condition may be defined as flight microangiopathy. A group of 203 subjects with chronic venous disease (uncomplicated varicose veins) at low-medium risk for DVT were contacted; 43 subjects were excluded for several nonmedical, travel-related problems or inconvenient evaluation time; the remaining 160 were randomized, after informed consent, into 2 groups to evaluate 2 prophylaxes in 7-8-hour, long-haul flights: The treatment group received Venoruton (hydroxyethyl rutosides) 1 g twice daily for 3 days (2 days before the flight and the day of the flight). The control group received comparable placebo. The edema score was based on the edema tester, ankle circumference, volume measurements, subjective swelling, and discomfort score. Items 1, 4, and 5 are based on an analogue scale line (1 to 10) directly defined by the subjects before and after the flights. Of the 160 included subjects 139 completed the study. Dropouts (21) were due to poor compliance, traveling, and/or connection problems (11 in the control group, 10 in the treatment group). Age and sex distribution were comparable in the 2 groups as were risk factors distributions. The level of edema at inclusion was comparable in the 2 groups of subjects. After the flight there was an average score of 7.2 (sd 2) in the control group, while in the Venoruton group the score was on average 3.2. (sd 1.1) (p < 0.05), 2.25 times lower than in the control group (p < 0.05). In the control group 89% of the subjects had an evident increase in ankle circumference and volume, which was clearly visible at inspection and associated with discomfort. In the Venoruton group edema was clearly present in 12% of subjects (associated with discomfort between 5 and 7 on the analogue scale line) and it was mild-moderate, not associated with symptoms (pain, discomfort between 2 and 4 on the analogue scale line). Therefore, the control of flight edema with Venoruton was clear both considering parametric data (circumference and volume) and nonparametric (analogue scale lines) measurements. The combined evaluation of the edema score is significantly favorable for patients treated with Venoruton. No deep vein thrombosis or superficial vein thrombosis was observed in this study.     

高龄老年患者择期冠脉介入治疗的长期预后

目的随访高龄老年患者择期经皮冠状动脉介入治疗(PCI)术后的长期临床事件,与普通老年患者比较,探讨其预后的影响因素。对象与方法将年龄≥80岁定义为高龄老年,年龄在60～79岁定义为普通老年,选择冠脉择期PCI术史的患者,详细记录PCI前冠脉造影结果,血运重建策略,支架植入数目,随访其长期主要心血管事件和非心血管临床事件。结果两组患者临床特征,除高龄老年组高血压的比例(76.85%)有高于普通老年组(67.08%)的趋势(P=0.061)以外,二组性别构成,糖尿病,高脂血症,不稳定心绞痛,吸烟史,慢性肾功能不全情况没有显著差异,二组造影结果冠脉病变部位没有显著差异,在病变支数上,高龄老年组的单支病变要少于普通老年组,(12.96%vs.24.31%,P=0.013),双支病变(31.48%vs.29.85%,P=0.749)及三支病变上(55.56%vs.45.85%,P=0.081)差异没有显著性。在冠脉策略选择上,高龄老年组完全血运重建较少(43.01%vs.59.30%,P=0.005)。随访结果,包括全因死亡(21.29%vs.6.15%,P0.001),心血管死亡(16.67%vs.4.01%,P0.001),心衰住院(6.56%vs.2.77%P0.001),心绞痛住院(33.33%vs.18.15%,P0.001),所有心血管原因住院(50.93%vs.27.08%,P0.001)的差异具有统计学意义。结论高龄老年冠心病患者长期主要心脏不良事件发生率较普通冠心病患者高,年龄是其独立的危险因素,高血压病也提示长期预后不良。     

IL-10单核苷酸多态性与溃疡性结肠炎的相关性研究

目的探讨血清IL-10水平、IL-10启动子区3个位点(IL-10-1082/-819/-592)的单核苷酸多态性(SNPs)与溃疡性结肠炎之间的相关性。方法选择溃疡性结肠炎患者60例(溃疡性结肠炎组),轻度24例、中—重度36例,并设健康对照组。采用ELISA法检测血清中IL-10,采用PCR-RFLP检测IL-10启动子区SNPs。结果中—重度溃疡性结肠炎患者血清IL-10水平低于健康对照组(P<0.05)。溃疡性结肠炎组IL-10-592位点AA型及AC型-819位点TT型和TC型与健康对照组比较有统计学差异(P均<0.05);两组IL-10-592位点CC型及IL-10-819位点CC型比较差异有统计学意义(P均<0.05);-592位点和-819位点基因型高度连锁。两组IL-10-1082位点AA型及GG型比较有统计学意义(P均<0.05)。结论 IL-10启动子区SNPs影响IL-10表达。血清IL-10的表达水平及其启动子区的不同基因型可反映溃疡性结肠炎的发病敏感性或活动度。     

French Oak Wood (Quercus robur) Extract (Robuvit) in Primary Lymphedema: A Supplement,Pilot, Registry Evaluation

The aim of this pilot supplement study was the evaluation of an oak wood extract (Robuvit, Quercus robur [QR], Horphag Research) in an 8-week registry study on lymphatic signs in primary lymphedema.Subjects with primary lymphedema confined to a single leg without skin changes or ulcerations were followed for at least 8 weeks. Lymphedema was mainly present distally (below the knee). Three groups were formed: one group used only the standard management for lymphedema; one used the same management plus 300 mg Robuvit; and one used the standard management plus 600 mg of Robuvit.The three groups were comparable. After 8 weeks the variation in leg volume was on average −6.2% with standard management, −15% in the QR 300 mg group, and −18.9% in the 600 mg group. The edema score was also significantly lower at 8 weeks in the two QR groups. The variation in proteins in the interstitial fluid in comparison with initial values was −14.8% in controls in comparison with −29.9% in QR 300 mg group and −36.9% in QR 600 mg group. Skin flux significantly improved (increased) in the two QR groups. Ultrasound pretibial skin thickness was decreased on average 6% in controls versus 10.3% in the low-dose QR group and 11.8% in the higher dose group. Perimalleolar thickness was decreased 7% in controls and more in the two QR groups. Ankle circumference was decreased 4.4% in controls and more in the two supplement groups.This pilot registry indicates that Robuvit can be effective in the management of primary lymphedema. More patients and longer evaluation periods are needed.     

患者年龄对无创通气治疗 ARDS 的结局影响

目的：本研究分析接受无创正压通气治疗的不同年龄阶段的 ARDS 患者的各项指标,统计 ARDS 患者的原发病和并发症,探讨无创正压通气的有效性和结局。方法收集2009~2015年诊断为 ARDS 且采用无创正压通气治疗的患者236例,将患者分为四组,18~44岁为青年组,45~59岁为中年组,60~74岁为老年前期组,75岁及以上为老年组；对其进行统计分析。结果老年前期组ARDS 患者选择无创正压通气治疗的比例最高(40.25%),青年组最小(6.36%)。老年组的体质量指数(BMI)指数为(22.71±1.6)kg/m2显著低于其他三组。ARDS 患者的急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分显示,青年组和中年组显著高于老年前期组和老年组。四组 ARDS患者的心率,青年组>中年组>老年前期组>老年组,且差异有统计学意义。青年组患者的 pH 显著高于其他各组。四组患者无创正压通气治疗的成功率(χ2=0.540,P =0.910)和病死率(P =0.481)差异均无统计学意义。对于无创正压通气治疗 ARDS 患者的持续时间,老年前期组显著高于其他三组,患者的住院时间,青年组显著高于其他三组。ARDS 患者人数原发病与并发症较多的是急性 COPD,心源性肺水肿以及呼吸道病变。结论大于60岁的 ARDS 患者接受无创正压通气治疗的比率高于18~60岁患者,无创正压通气的成功率以及 ARDS 患者的病死率在各年龄阶段间差异无统计学意义。