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find Author "许能銮" 6 results
  • 临床病理讨论——反复咳嗽、发热、肺部阴影8个月

    病历摘要 患者女性,37岁。因“反复咳嗽20 d,发热15 d”于2008年8月6日第一次入院。患者于2008年1月因“发热、咳嗽”住当地医院,胸部CT示左上肺占位及右下肺背段阴影,行“左上肺叶切除术”。术后当地医院病理结果考虑炎性假瘤。入我院前20 d无诱因出现咳嗽,呈阵发性干咳,咳嗽剧烈时伴右侧胸痛。15 d前出现发热,体温38 ℃左右,发热时伴明显头痛。在当地医院就诊,查血常规:白细胞(WBC)总数8.11×109/L,中性粒细胞(N)0.785。胸部CT检查:①左上肺术后;②右上肺多发团块状及斑片状高密度影。痰培养检出“白色念珠菌”。给予乳酸左氧氟沙星、头孢替安、氟康唑治疗无好转来我院诊治。否认鸽粪接触史。

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • 成人Still病伴机化性肺炎一例

    成人Still病(AOSD)是一种原因不明的慢性系统性炎性疾患,属于全身性幼年型类风湿性关节炎的成人变异型,其主要临床表现为高热、多关节疼痛或肿胀、皮疹和中性粒细胞为主的白细胞增多,可累及多个系统。其临床表现复杂多变并凶险,缺乏临床特征,因而误漏诊率很高。现将我院最近收治的1例成人Still病伴继发性机化性肺炎报告如下,以引起临床医师的重视

    Release date:2016-09-14 11:53 Export PDF Favorites Scan
  • Significance of serum soluble intercellular adhension molecule-1 and soluble vascular cell adhension molecule-1 in patients with community-acquired pneumonia

    Objective To detect the levels and study the significance of serum soluble intercellular adhension molecule-1(sVCAM-1),soluble vascular cell adhension molecule-1 (sVCAM-1) in patients with community-acquired pneumonia(CAP).Methods sICAM-1 and sVCAM-1 were detected by enzymelinked immunosorbent assy(ELISA)in 25 patients with CAP before and after treatment as well as in 10 healthy controls.Results Before treatment, the levels of serum sICAM-1 and sVCAM-1 in the patients with CAP[(2.658 4±0.259 7)ng/mL,(2.680 9±0.255 4)ng/mL)] were significantly higher than those in controls[(2.472 8±0.077 6)ng/mL,(2.426 3±0.307 2)ng/mL](Plt;0.01,Plt;0.05). After treatment, the levels of serum sICAM-1, sVCAM-1 significantly decreased [(2.518 3±0.205 2)ng/mL,(2.523 0±0.279 4)ng/mL](Plt;0.01,Plt;0.01) and were not different from those in controls(Pgt;0.05).The levels of sICAM-1 were positively associated with neutrophil counts(r=0.602,Plt;0.001)rather than the levels of sVCAM-1(r=0.036,Pgt;0.05).Conclusion The changes of sICAM-1 and sVCAM-1 before and after treatment are predictive to the prognosis in patients with CAP.

    Release date:2016-09-14 11:52 Export PDF Favorites Scan
  • Case-control Study on Asthma-COPD Overlap Syndrome and Chronic Obstructive Pulmonary Disease

    ObjectiveTo investigate and compare the clinical characteristics of chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome (ACOS). MethodsA case-control study was conducted in 139 patients with COPD who admitted between March 2013 and September 2013. The patients were divided into a COPD-only group and an ACOS group. Clinical data were collected and compared between two groups. ResultsOf all 139 patients, 93 patients were diagnosed with COPD only (66.9%) and 46 patients were diagnosed with ACOS (33.1%). Compared with the COPD-only group, the ACOS group had a lower ratio of exposure to cigarette smoking (80.4% vs. 93.5%), but high possibility of a history of asthma (89.1% vs. 4.3%), allergies (60.9% vs. 9.6%) and airway hyperreactivity (80.4% vs. 6.5%) (P < 0.05). In clinical symptoms, the ACOS group had a higher ratio of breathless as the first complaint of symptom (26.1% vs. 8.6%) and dry and moist rales in lung by auscultation (67.4% vs. 31.2%) (P < 0.05). In laboratory examination, the ACOS group had increased levels of peripheral blood eosinophils and IgE than those of the COPD-only group (21.7% vs. 5.4%, 18.3% vs. 4.3%, P < 0.05). In treatment, the ACOS group was more likely to use systemic glucocorticoid (58.7% vs. 24.7%) and be treated with higher dosage of glucocorticoid (80 mg, P < 0.05). ConclusionsACOS and COPD-only are two subtypes of COPD. Compared with COPD-only patients, ACOS patients might be more likely to be breathless and have dry and moist rales in clinical symptoms, more likely to have increased levels of peripheral blood eosinophils and IgE in blood test, and more inclined to receive systemic glucocorticoid treatment.

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  • Relationship between pulmonary ventilation function and arterial stiffness assessed using brachial-ankle pulse wave velocity in physical examination population

    ObjectiveTo investigate the relationship between pulmonary ventilation function (obstructive and restrictive ventilation dysfunction) and atherosclerosis, and explore the correlation between brachial-ankle pulse wave velocity (ba-PWV, an effective index for evaluating atherosclerosis) and pulmonary ventilation function.MethodsFrom January to August 2018, a total of 6403 healthy subjects who reported no major chronic diseases such as stroke, myocardial infarction, cor pulmonale or malignant tumor were selected. Past history such as smoking history, hypertension, diabetes, blood biochemistry, and blood hypersensitive C reactive protein (hs-CRP), hemodynamic indexes such as systolic pressure, diastolic pressure and ba-PWV, body measurement indexes such as height, weight, waist circumference and pulmonary ventilation function were collected. The relationship between ba-PWV and pulmonary ventilation function were evaluated.ResultsA total of 2433 subjects were included, including 916 males and 1517 females. Ba-PWV showed significant positive correlations with age, smoking index, waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, cholesterol, low density lipoprotein, hs-CRP, glycosylated hemoglobin, and significant negative correlations with height, percentage of forced vital capacity (FVC) in the predicted value (FVC%pred), forced expiratory volume in one second (FEV1), percentage of FEV1 in the predicted value (FEV1%pred), FEV1/FVC ratio and percentage of maximun midexpiratory flow (MMEF) in the predicted value (MMEF%pred). The ba-PWV was not correlated with weight, body mass index, FVC, MMEF, γ-glutamyl transpeptidase, high density lipoprotein, creatinine or uric acid. In multiple regression analysis using factors other than ba-PWV and respiratory function as adjustment variables, both FVC%pred and FEV1%pred showed significant negative relationships with ba-PWV (P<0.05).ConclusionsThe results indicate that FEV1/FVC, an indicator of airflow limitation, is not a predictor of ba-PWV. However, since ba-PWV showed significant negative relationship with FVC%pred and FEV1%pred, clinically assessment of arterial stiffness might be considered in individuals with impaired pulmonary ventilation.

    Release date:2020-09-27 06:38 Export PDF Favorites Scan
  • 反复出现的肺部多发结节、空洞影

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