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find Keyword "慢性阻塞性肺疾病急性加重" 27 results
  • 噻托溴铵在慢性阻塞性肺疾病急性加重期治疗的临床观察

    目的 观察噻托溴铵治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效。 方法 将2010年5月-2012年4月住院的100 例年龄50~80岁的中重度AECOPD患者随机分为治疗组(50例)和对照组(50例)。对照组给予吸氧、止咳、祛痰、雾化吸入布地奈德4 mL+硫酸特布他林4 mL(2次/d)抗炎,氨茶碱扩张气道,以及静脉使用抗生素抗感染、支持等常规治疗,治疗组在常规治疗基础上给予噻托溴铵干粉剂(18 μg,1次/d)吸入,疗程14 d。观察两组用药前后肺功能指标,呼吸困难评分以及血气分析指标的变化。 结果 两组患者用药后肺功能、呼吸困难评分及血气分析均较治疗前有明显改善,用药后与用药前比较差异有统计学意义(P<0.05);治疗组改善更明显,与对照组比较差异有统计学意义(P<0.05)。 结论 噻托溴铵能明显改善中重度AECOPD患者的呼吸困难,肺功能及血气分析指标。

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  • AECOPD患者血清IL-1β、IL-1Ra与清晨皮质醇水平的关系

    目的 了解慢性阻塞性肺疾病急性加重期( AECOPD) 患者血清IL-1β、IL-1Ra 及IL-1β/ IL-1Ra 与清晨皮质醇水平的关系。方法 38 例AECOPD 患者在接受糖皮质激素治疗之前, 用酶联免疫吸附试验方法检测患者血清IL-1β、IL-1Ra, 用放射免疫方法检测患者清晨空腹血清皮质醇水平, 并用直线相关分析和方差分析来分析其相关性。结果 血清IL-1β、IL-1β/ IL-1Ra 与皮质醇呈直线负相关, IL-1Ra 与血清皮质醇呈直线正相关( P 均lt;0.05) 。结论 在AECOPD 患者中, IL-1β、IL-1Ra 的变化及IL-1β/ IL-1Ra 失衡参与了神经内分泌失调, 是机体内环境紊乱的重要病理生理机制。

    Release date:2016-08-30 11:56 Export PDF Favorites Scan
  • Predictive Value of Simplified Version of Clinical Pulmonary Infection Score for Efficacy of Noninvasive Ventilation Therapy in Patients with Acute Exacerbation of COPD

    Objective To investigate the influence of pulmonary infection on noninvasive ventilation ( NIV) therapy in hypercapnic acute respiratory failure ( ARF) due to acute exacerbation of chronic obstructive pulmonary disease ( AECOPD) , and evaluate the predictive value of simplified version of clinical pulmonary infection score ( CPIS) for the efficacy of NIV therapy in ARF patients with AECOPD. Methods Eighty-four patients with ARF due to AECOPD were treated by NIV, and were divided into a successful group and an unsuccessful group by the therapeutic effect of NIV. The CPIS and simplified version of CPIS between two groups was compared. The predictive value of simplified version of CPIS for the efficacy of NIV wasevaluated using ROC curve analysis. Results The CPIS and the simplified version of CPIS of the successful treatment group ( 4. 0 ±2. 8, 3. 2 ±2. 4) were lower than those of the unsuccessful group ( 8. 0 ±2. 1, 7. 2 ±1. 8) significantly ( P =0. 006, 0. 007) . The area under ROC curve ( AUC) of CPIS and simplified version of CPIS were 0. 884 and 0. 914 respectively, the cut oint of CPIS and simplified version of CPIS were 6 ( sensitivity of 78. 0% , specificity of 91. 2% ) and 5 ( sensitivity of 80. 0% , specificity of 91. 2% ) respectively. Conclusions The level of pulmonary infection is an important influencing factor on the therapeutic effect of NIV in patients with ARF due to AECOPD. Simplified version of CPIS is a helpful predictor for the effect of NIV on ARF of AECOPD.

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  • Moxifloxacin versus Levofloxacin for Acute Exacerbation of Chronic Obstructive Pulmonary Diseases: A Systematic Review

    Objective To assess the effectiveness and safety of moxifloxacin versus levofloxacin for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Such databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI and VIP were electronically searched, and the relevant conference proceedings were also hand-searched. The search time was up to July, 2011. Randomized controlled trials (RCTs) on moxifloxacin versus levofloxacin for AECOPD were included. Literature was screened according to inclusive and exclusive criteria, data were extracted, quality was assessed, and then meta-analysis was performed using RevMan 5.0. Results A total of 6 RCTs involving 482 patients with AECOPD were included. The results of meta-analysis showed that moxifloxacin group was significantly superior to levofloxacin group in the effective rate (OR=3.15, 95%CI 1.80 to 5.49, Plt;0.000 1). The bacterial clearance rate in moxifloxacin group was also higher than that in the levofloxacin group (OR=2.79, 95%CI 1.30 to 5.97, P=0.008). In addition, adverse effects of moxifloxacin group were less than levofloxacin (OR=0.48, 95%CI 0.24 to 0.98, P=0.04). Conclusion Based on current studies, moxifloxacin is superior to levofloxacin in improving effective rate and bacterial clearance rate, and in lowering side effects when treating AECOPD. Hence it is considerable to use moxifloxacin instead of levofloxacin in the treatment of AECOPD if necessary. Due to the limitation of both quantity and quality of included studies, this conclusion should be further confirmed with more high quality and large sample studies.

    Release date:2016-09-07 10:59 Export PDF Favorites Scan
  • 采取体位引流促进排痰对减轻慢性阻塞性肺疾病急性加重期患者肺部感染的疗效分析

    目的 探讨体位引流促进排痰在减轻慢性阻塞性肺疾病急性加重期(AECOPD)患者肺部感染中的应用。 方法 将2011年5月-2012年10月入重症监护室治疗的58例存在肺部感染的AECOPD患者随机分为对照组和试验组,每组各29例。对照组给予翻身拍背每2小时1次,抗感染治疗,雾化吸入4次/d,并鼓励咳嗽咳痰;试验组在此基础上于雾化吸入结束5 min后,在医生的陪护下对患者采取体位引流治疗及护理,疗程为15 d。分别对两组患者治疗结果进行对比,评价体位引流促进排痰的疗效。 结果 58例患者中,试验组有2例因合并心力衰竭退出试验。试验组患者经过体位引流治疗及护理后,较对照组呼吸机相关性肺炎发生率低,肺功能好转(P<0.05);治疗后两组间感染恢复情况比较,差异具有统计学意义(P<0.05)。 结论 体位引流的合理应用,能减轻AECOPD患者的肺部感染,从而改善患者的临床症状和肺功能,提高患者的生活质量。

    Release date:2016-09-07 02:33 Export PDF Favorites Scan
  • Clinical Analysis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients Complicated with Pulmonary Embolism

    目的 探讨慢性阻塞性肺疾病急性加重(AECOPD)合并肺栓塞(PE)的临床特点。 方法 回顾性分析2009年1月-2012年6月38例AECOPD合并PE患者(栓塞组)的临床资料,并与42例单纯AECOPD(对照组)临床资料进行对比。 结果 栓塞PE组不对称性下肢水肿发生率明显高于对照组(P<0.05),另外肺动脉高压、D-二聚体及修改的Geneva评分与对照组比较存在一定差异,且差异有统计学意义(P<0.05)。 结论 AECOPD合并PE的临床表现并不特异,当AECOPD出现不对称性水肿、D-二聚体升高、肺动脉高压及修改的Geneva评分升高等表现不能解释原因时,要考虑PE的可能,并尽快选择CT肺动脉成像或肺动脉造影以明确诊断。

    Release date:2016-09-07 02:38 Export PDF Favorites Scan
  • Application of Dexmedetomidine Hydrochloride in Sedation Practices during NPPV for Patients with Acute Exacerbations of COPD and Respiratory Failure

    Objective To investigate the feasibility of dexmedetomidine hydrochloride in sedation practices during NPPV for patients with acute exacerbation of COPD ( AECOPD) and respiratory failure. Methods 50 patients with AECOPD and respiratory failure, admitted in ICU between January 2011 and April 2012, were divide into an observation group and a control group. All patients received conventional treatment and noninvasive positive pressure ventilation ( NPPV) . Meanwhile in the observation group, dexmedetomidine hydrochloride ( 1 μg/kg) was intravenously injected within 10 minutes, then maintained using a micropump by 0.1 ~0. 6 μg·kg- 1 ·h- 1 to maintaining Ramsay Sedation Scale ( RSS) score ranged from 2 to 4. The patients’compliance to NPPV treatment ( conversion rate to invasive ventilation) and ICU stay were compared between two groups. Heart rate,mean arterial pressure, respiratory rate, and arterial blood gas ( pH, PaO2 , PaCO2 ) before and 24 hours after treatment were also compared. Results After 24 hours treatment, heart rate, mean arterial pressure, respiratory rate, and arterial blood gas were all improved in two groups, while the improvements were more remarkable in the observation group. The conversion rate to invasive ventilation ( 4% vs. 16% ) and ICUstay [ ( 5.47 ±3.19) d vs. ( 8.78 ±3.45) d] were lower in the observation group than those in the control group. ( P lt;0.05) . Conclusion Dexmedetomidine hydrochloride may serve as a safe and effective sedative drug during NPPV in patients with AECOPD and respiratory failure.

    Release date:2016-09-13 03:46 Export PDF Favorites Scan
  • Genotype Distribution of Haemophilus Parainfluenzae from Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease and Their Effects on A549 Cells

    Objective To observe the genotype distribution of Haemophilus parainfluenzae from patients with acute exacerbations of chronic obstructive pulmonary disease ( AECOPD) and their effects on A549 cells. Methods 80 hospitalized patients with AECOPD in our hospital were enrolled. Haemophilus parainfluezae were collected by sputum culture and genotyped, then inoculated with cell line A549. IL-6 and IL-8 concentrations in the supernatant were detected and cell morphology was observed at different time points. Results The patients were divided into three groups according to their symptoms. 15 Haemophilus parainfuenzae strains were collected and the positive culture rate between type 1 and type 3 COPD patients were statistically different. The concentrations of IL-6 and IL-8 were both significantly higher than control and increased as time passed. 4 genotypes were got by random amplification of polymorphic DNA ( RAPD) . In RAPD Ⅲ group, the IL-8 concentration was higher at 12h and 24h than others. No morphologic change was found in the cells inoculated with Haemophilus parainfuenzae by microscope after fixing. Conclusions Positive culture rate of Haemophilus parainfuenzae was different in different COPD groups according to symptoms. Haemophilus parainfuenzae can stimulate a cytokine response in A549 cells, maybe one of the pathogens of AECOPD, especially the RAPDⅢ type. Haemophilus parainfuenzae is not an intracellular bacteria.

    Release date:2016-09-13 03:53 Export PDF Favorites Scan
  • 清热化痰法治疗慢性阻塞性肺疾病急性加重期的研究进展

    慢性阻塞性肺疾病(COPD)是临床多发病,急性加重期的有效防控是疾病预后的关键所在。中医对COPD有较好的治疗效果,其中清热化痰法是主要的治疗方法,现就清热化痰法近年在COPD的治疗研究作一综述。

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  • Safety and Efficacy of Non-invasive Positive Pressure Ventilation Treatment Combined with Fiberoptic Bronchoscopy on AECOPD Patients with Acute Respiratory Failure

    ObjectiveTo evaluate the safety and efficacy of non-invasive positive pressure ventilation (NIPPV) combined with fiberoptic bronchoscopy(FB) on acute exacerbation of chronic obstructive puhmonary disease (AECOPD) patients with acute respiratory failure. MethodsA prospective study was conducted on the AECOPD patients with respiratory failure in respiratory intensive care unit of Tangdu Hospital of Fourth Military Medicine University from February 2010 to February 2011.They were randomly divided into a case group and a control group.The case group was administrated FB and lavage after one hour of NIPPV treatment.The control group was administrated NIPPV without FB and lavage.Other treatment regimen was the same in two groups. ResultsThere were 51 subjects recruited in the study, 25 subjects in the case group and 26 subjects in the control group.All variables at baseline were matched (P > 0.05).All variables improved after one hour of NIPPV before FB, without significant difference between two groups (P > 0.05).During the period of FB, heart rate in the case group was faster than that in the control group (P < 0.05), and other variables were not significantly different between two groups (P > 0.05).Both groups received NIPPV for one hour after FB, the variables including heart rate, respiratory rate, pH, PaO2, PaCO2 were statistically significant between two groups(P < 0.05).At the time of 24 hours after FB, the variables including mean arterial pressure, heart rate, respiratory rate, pH, PaO2 and PaCO2 in the case group were nearly recovered, and differences between two groups were significant (P < 0.05).The positive rate of sputum culture was significantly higher in the case group than that in the control group[88.0%(22/25) vs.58.6%(14/26)].Success rate in the case group were obviously superior to that in control group.The cases of failure, death and refusing in the case group were lower than those in the control group.Complications in two groups had no significant difference (P > 0.05).There was not serious complication such as hear arrest, hemoptysis and apnea during the process of NIPPV combined with early FB. Conclusion It deserves to be used in clinic because of the safety, efficacy and feasible for most of AECOPD patients through NIPPV combined with early FB.

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