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find Author "范贤明" 3 results
  • Prospective research on persistent systemic inflammation of COPD patients

    ObjectiveTo investigate the existence of persistent systemic inflammation (PSI) among patients with chronic obstructive pulmonary disease (COPD) in local areas, and identify the risk factors of PSI.MethodsA total of 150 patients with stable COPD and 70 non-smoking healthy individuals were enrolled in our study. The levels of interleukin-6 (IL-6), IL-18 and activin A in serum were detected. Pulmonary function was tested, and basic information of the candidates was acquired at the same time. All of the patients were followed-up at 6 months, 12 months and 24 months for two years. The value at the 95th percentile of the concentration of inflammation markers of non-smoking healthy samples was defined as the threshold value, also known as normal ceiling limit value. Existence of PSI was defined as the condition that two or more kinds of inflammation markers exceed the threshold at each follow-up visit. The COPD patients were categorized into three classes, in which there were respectively none, one and two or more kinds of inflammation markers with over-threshold values. Based on a 2-year followup, patients with two or more kinds of inflammation markers exceeding threshold values were classified as PSI subgroup, and patients without inflammation markers exceeding threshold values as never inflamed subgroup.ResultsThere were 22 patients (14.7%) had persistent systemic inflammation, whereas 60 patients (40.0%) did not show evidence of systemic inflammation. Single factor analysis of two subgroups showed that the patients in PSI subgroup had higher body mass index (BMI), higher smoking index, higher prior frequency of time to exacerbation, higher proportion of patients at high risk for recurrent acute exacerbation during 2-year followup, higher SGRQ total score, lower FEV1%pred and lower FEV1/FVC ratio significantly (all P<0.05). Higher BMI and higher risk of recurrent acute exacerbation were independent risk factors leading to PSI, of which the higher risk of recurrent acute exacerbation had a more important effect on PSI.ConclusionsSome COPD patients have PSI in this region, which may constitute a novel COPD phenotype (called systemic inflammatory phenotype). Higher BMI and higher risk of recurrent acute exacerbation are independent risk factors leading to PSI. Individualized treatment to prevent acute exacerbation and appropriate weight control may be a better intervention for these patients.

    Release date:2021-01-26 05:01 Export PDF Favorites Scan
  • Expression and Clinical Significance of Oxidative Stress Markers in Serum of Patients with Stable Chronic Obstructive Pulmonary Disease

    ObjectiveTo detect the level of oxidative stress markers in serum, including malondialdehyde (MDA), protein carbonyls (PC), 8-hydroxy-2'-deoxyguanosine (8-OHdG) and total antioxidant capacity (TAC), in patients with stable chronic obstructive pulmonary disease (COPD), and explore the impacts of oxidant/antioxidant imbalance in pathogenesis of COPD. MethodsTwo hundred stable COPD patients (the COPD group) and 100 healthy individuals (the control group) were recruited in the study. The concentrations of MDA, PC, 8-OHdG and TAC in serum were detected. Pulmonary function test was performed and the general informations for each subjects were collected. The COPD patients were divided into a smoking subgroup and a non-smoking subgroup, or divided into a mild-moderate airflow limitation subgroup and a severe-extremely severe airflow limitation subgroup. ResultsThe levels of serum MDA, PC and 8-OHdG in the COPD group were significantly higher than those in the control group (all P < 0.01), but the level of serum TAC was significantly lower than that in the control group (P < 0.01). In the COPD patients, the levels of PC and 8-OHdG in the smoking subgroup were significantly higher than those in the non-smoking subgroup (both P < 0.05). The level of PC in the severe-extremely severe airflow limitation subgroup was significantly higher when compared with the mild-moderate airflow limitation subgroup (P < 0.01). Multiple linear regression analysis showed that the levels of PC and 8-OHdG were negatively related with FEV1% pred in the COPD patients, and the PC had greater impacts than 8-OHdG (β=-0.230, -0.219, P < 0.01). ConclusionSmoking can induce the abnormal increase of PC and 8-OHdG in serum which are negatively related with FEV1% pred in COPD patients, which suggests that oxidative stress might play an important role in pathogenesis of COPD.

    Release date:2016-11-25 09:01 Export PDF Favorites Scan
  • 血管介入联合气道介入治疗晚期中央型肺癌中心气道重度狭窄

    目的 探讨血管介入联合气道介入治疗在晚期中央型肺癌中心气道重度狭窄的临床应用价值。 方法 32 例晚期中央型肺癌中心气道重度狭窄患者于局麻下接受血管介入支气管动脉灌注化疗(BAC)和支气管动脉栓塞(BAE)肺癌供血血管介入治疗,然后在全麻下经电子支气管镜行冷冻切除、高频电、氩气刀(APC)、支架置入等气道介入治疗。测定患者治疗前及治疗后 2 周的气促指数、气道管径、FEV1%pred、Karnofsky 评分(KPS)、6 分钟步行距离(6MWD),以及血清鳞状细胞癌相关抗原(SCCA)、非小细胞肺癌相关抗原细胞角蛋白 19 片段抗原 21-1(CYFRA21-1)、神经元烯醇化酶(NSE)及癌胚抗原(CEA)水平。比较各指标治疗前后的变化,观察疗效及并发症。 结果 32 例患者均顺利完成 BAC+BAE 血管介入治疗联合气道介入治疗,临床有效率为 96.9%。气道介入麻醉方式:喉罩全麻 3 例,气管插管全麻 29 例。气道介入治疗方法:高频电烧灼治疗 28 例,电圈套 8 例,APC 治疗 16 例,冷冻切除治疗 26 例,气道支架置入 5 例。所有患者治疗后气促指数、气道管径、FEV1%pred、KPS 及 6MWD 各指标与治疗前比较均有显著改善(P 均<0.05),血清 SCCA、CYFRA21-1、NSE、CEA 水平较治疗前显著下降(P 均<0.05)。治疗过程中出现恶心呕吐 2 例,无气道大出血病例,无严重及致死性并发症。 结论 血管介入联合气道介入治疗晚期中央型肺癌中心气道重度狭窄具有微创、气道出血少、近期疗效确切的优势,具有很好的临床应用价值。

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