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。
【摘要】 目的 〖JP2〗探讨血管内皮生长因子（VEGF）联合血清肿瘤标志物对肺癌早期诊断意义。 方法 2008年1月-〖JP〗2009年8月收治的92例患者中肺癌患者64例，采集静脉血清标本采用酶联免疫法检测其VEGF水平。 结果 64例肺癌与28例非肺癌患者VEGF表达水平分别为（255.72±566.00）、（299.46±795.8） pg/mL，两者比较无统计学意义（Pgt;0.05）；43例中晚期肺癌VEGF值（125.07±68.2） pg/mL，表达显著高于12例早期肺癌（196.00±260.60） pg/mL （Plt;0.05）；CEA与CYFRA21-1的表达对判断26例发生胸膜转移的肺癌有统计学意义（Plt;0.05）。 结论 结合血清VEGF水平和常规肿瘤标志物，可评估现状及临床分期，VEGF结合CEA与CYFRA21-1表达水平为预测肺癌患者早期发生胸膜转移提供理论依据。【Abstract】 Objective To evaluate the effect of combined detection value of serum vascular endothelial growth factor (VEGF) and tumor markers on early diagnosis of lung cancer. Method Intravenous serum levels of VEGF and tumor markers were assayed by ELISA in 92 patients including 64 lung cancer from January 2008 to August 2009. Results The difference in serum levels of VEGF between the 64 patients with lung cancer [(255.72±566.0) pg/mL] and 28 health adult [(299.46±795.8) pg/mL] was not significant (Pgt;0.05). The level of VEGF in 43 patients with middle and late lung cancer [(125.07±68.2) pg/mL] was significantly higher than that in the 12 patients with early lung cancer [(196.00±260.60) pg/mL] (Plt;0.05). There were statistical significance in expression of serum CEA and CYFRA21-1 on diagnosis in 26 patients having lung cancer with early metastasis pleural fluid (Plt;0.05). Conclusion Combined diagnostic of serum VEGF and tumor markers can assess the state of an illness and clinical stage, and the serum levels of serum VEGF,CEA and CYFRA21-1 may be a good predictor for lung cancer with early metastasis pleural fluid.
ObjectiveTo investigate the clinical significancy of K-ras gene mutation in peripheral blood free DNA in patients with non-small cell lung cancer (NSCLC). MethodsA total of 242 patients pathologically diagnosed with NSCLC in the Third People's Hospital of Chengdu were recruited between January 2013 and August 2015. Both tumor tissues and peripheral blood free DNA were collected for detection of K-ras gene mutation by mutant-enriched liquidchip technology. The detection rate was compared between these two kinds of samples. ResultsIn tumor tissues, the K-ras gene mutation was detected in 12 cases with a positive rate of 4.96%. While in peripheral blood samples, the K-ras gene mutation was detected in 10 cases with a positive rate of 4.13%. The detection yield of K-ras gene mutation in peripheral blood had a good consistency with that of lung cancer tissues (Kappa value=0.81). ConclusionK-ras in peripheral blood plasma free DNA can be a surrogate marker for tumor tissues' K-ras gene mutation in screening patients with NSCLC.
ObjectiveTo investigate diagnostic and prognostic value of pulmonary embolism severity index (PESI), troponin I (cTnI) and brain natriuretic peptide (BNP) in patients with acute pulmonary embolism (APE). MethodsA total of 96 patients confirmed with APE were collected from January 2010 to January 2013, and 50 cases of non-APE controls were also selected in the same period. According to the PESI scores, patients were divided into low-risk, mid-risk, and highrisk group. According to the results of cTnI and BNP, patients were divided into positive group and negative group. Then, we evaluated the diagnostic and prognostic value of the PESI score, cTnI and BNP for patients with APE. ResultsFor the APE patients, the higher the risk was, the higher the constituent ratio of massive and sub-massive APE was (P<0.01). In the cTnI positive group, massive and sub-massive APE accounted for 82.9%, and in the cTnI negative group, non-massive APE was up to 81.9%; in the BNP positive group, massive and sub-massive APE accounted for 73.3%, and in the BNP negative group, non-massive APE was up to 86.3%. The patients with positive cTnI and BNP had a higher rate of right ventricular dysfunction, cardiogenic shock and mortality than the negative group (P<0.01). ConclusionThe combined detection of cTnI, BNP and PESI score is important in the diagnosis and risk stratification in APE patients.
【Abstract】 Objective To survey the prevalence and risk factors of chronic obstructive pulmonary disease ( COPD) , and establish database for community intervention of COPD.Methods A cluster-randomsampling survey was carried out. The population aged over 40 years old in eight communities of Chengdu were investigated from August 2007 to August 2009 using the standard protocol and questionnaire. The spirometry was performed for each participant. Results A total of 4315 residents were enrolled in this survey and 3687 case reports were analyzed, including 1529 males and 2148 females, with an average age of 60. 35 ±13. 21 years old. Total prevalence of COPD was 9. 6% . The prevalence of COPD in the males was significantly higher than that in the females ( 14. 0% vs. 6. 4%, P lt;0. 01) . The prevalence of COPD increased with the age. The major risk factors were cigarettes smoking ( OR = 3. 012, 95% CI 2. 390-3. 797, P lt; 0. 01) and indoor cooking smoking ( OR = 2. 546, 95% CI 1. 734-3. 425, P lt; 0. 01) . Conclusion The prevalence of COPD in Chengdu city is significantly higher than average level of the whole country, which warrant moreattention to better prevention and treatment of COPD in communities.
Objective To survey the prevalence of coexisting chronic obstructive pulmonary disease ( COPD) and chronic heart failure in Chengdu communities. Methods A cross-sectional study was performed in the population aged over 40 years in eight communities of Chengdu city. The subjects were selected by stratified cluster random sampling. Using the same protocol and questionnaire, all participants underwent medical history taking, physical examination and spirometry. Results Of 354 participating patients with a diagnosis of COPD, 74 ( 20. 90% ) cases were complicated with chronic heart failure. The prevalence of chronic heart failure in COPD in male was significantly higher than that in female ( 22. 69%vs. 18. 12% , P lt; 0. 05) . The major causes of chronic heart failure were hypertension ( 31. 64% ) , ischaemic heart disease ( 18. 93% ) , chronic pulonary heart disease ( 17. 51% ) and diabetes ( 11. 86% ) .Conclusions The prevalence of coexisting COPD and chronic heart failure in Chengdu city is significantly higher than the average level of the whole country, which warrant more attention in prevention and treatment of COPD in communities.