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find Keyword "急性加重" 91 results
  • Salviae miltiorrhizae for chronic cor pulmonale: a systematic review

    Objective To evaluate the efficacy and safety of Salviae miltiorrhizae Injection (include Danshen Injection and Fufang Danshen Injection) for chronic cor pulmonale. Design A systematic review of randomized clinical trials. Method Randomized trials comparing Salviae miltiorrhizae Injection plus routine treatment versus muting treatment alone were identified by electronic and manual searches. No blinding and language limitations were applied. The Jadad scale assessed the methodological quality of trials. Results Thirty randomized trials (n=2 161) were identified. The methodological quality of all trials included was low. The combined results (RR and 95%CI) of symptom scores was 1.20 (1.15 to 1.26). Because of the significant heterogeneity, many other markers of the blood rheology can not be combined. The reason for heterogeneity should include the differences among cases and studies. Because of lacking enough studies, the conclusions about mortality and oxidants/antioxidants markers were not b. Only a few studies had reported adverse events. Conclusions Based in the review, Salviae miltiorrhizae Injection may have positive effect on symptom scores in patients with chronic cor pulmonale. But for mortality, the markers of blood rheology and oxidants/antioxidants, there is no reliable conclusion. However, the evidence is not b due to the general low methodological quality, the variations among studies and experimental markers themselves, and lacking of more relevant and important markers. Further large trials are needed.

    Release date:2016-08-25 03:17 Export PDF Favorites Scan
  • Effects of Pulmonary Rehabilitation on Patients with Stable COPD of Different Severity

    ObjectiveTo investigate the effect of pulmonary rehabilitation on pulmonary function,perception of dyspnea and quality of life in stable COPD patients of different severity. Methods300 patients with COPD in stable stage were divided into a moderate COPD group (n=120),a severe COPD group (n=100) and a very severe COPD group (n=80). Each group was randomly subdivided into a control group and a treatment group. The treatment groups received pulmonary rehabilitation for 6 months in addition to usual care,and the control groups received usual care without pulmonary rehabilitation. Pulmonary function(FEV1),6 minute walking distance (6MWD),modified medical research council (mMRC) scale,and acute exacerbation frequency of COPD were compared before and after intervention and among groups. ResultsAfter pulmonary rehabilitation for 6 months,the quality of life score and 6MWD were significantly improved in the treatment groups with moderate,severe,very severe COPD,and the increscent of 6MWD was greatest in the severe COPD patients. The mMRC of the patients with very severe COPD improved significantly after pulmonary rehabilitation(P<0.05). Lung function before and after the intervention in three groups all showed no significant difference (P>0.05). The acute exacerbation frequency of the severe COPD patients was significantly reduced by pulmonary rehabilitation (P<0.05), while there was no significant change in the moderate and very severe groups (P>0.05). ConclusionPulmonary rehabilitation can improve exercise tolerance and quality of life of COPD patients with different severity,reduce acute exacerbation frequency in severe COPD,reduce the dyspnea degree in very severe COPD. Pulmonary rehabilitation is a cost-effective treatment for stable COPD.

    Release date:2016-08-30 11:31 Export PDF Favorites Scan
  • Changes of B Lymphocyte-derived Microparticles in Bronchoalveolar Lavage Fluid of Patients with COPD

    ObjectiveTo explore the changes of the B lymphocyte-derived microparticles (BLMPs) in the bronchoalveolar lavage fluid in patients with chronic obstructive pulmonary disease (COPD),and analyze the correlation between BLMPs changes and the stages of the disease. Methods33 COPD patients in acute exacerbation and 12 COPD patients in stable phase in Southwest Hospital,Xinqiao Hospital,and First Affiliated Hospital of Chongqing Medical University between March 2012 and March 2013 were enrolled in the study. 31 subjects who underwent physical examination and bronchoscopy were recruited as control. The lavage fluid specimens were collected through fiberoptic bronchoscopy,then marked with the corresponding antibodies after centrifugation. The numbers of microparticles were analyzed by flow cytometry. ResultsThe number of the BLMPs was significant different among three groups (P<0.05). Compared with the control group and the stable COPD group,the number of BLMPs in the AECOPD group was significantly reduced (P<0.05). Compared with the control group,the number of the BLMPs in the stable COPD group was reduced but with no significant difference (P>0.05). The numbers of BLMPs had no correlation with the smoking history,gender,age and body surface area. ConclusionThe number of BLMPs is reduced in COPD,especially in the acute exacerbation stage,so the reductions of the BLMPs may be associated with the stages of the disease. Smoking,gender,age,body surface area have no effect on the number of BLMPs.

    Release date:2016-08-30 11:31 Export PDF Favorites Scan
  • Clinical Observation of Inhaled Tiotropium in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

    目的 观察噻托溴铵治疗慢性阻塞性肺疾病急性加重期(AECOPD)临床疗效与安全性。 方法 选取 2010 年 1 月-2011年12月入院的69例AECOPD 患者随机分为试验组(A组,n=36)和对照组(B组,n=33),A组在B组常规治疗的基础上吸入噻托溴铵。治疗起始及结束分别观察两组肺功能指标、慢性阻塞性肺疾病评估测试(CAT)评分、血气分析、6分钟步行距离、住院时间及药物不良反应。 结果 两组均显示出一定的临床效果,A组治疗后肺功能指标、CAT评分、血气分析、6分钟步行距离均优于B组,差异均具有统计学意义(P<0.05)。A组住院时间短于B组(P<0.05),且无严重不良反应。 结论 AECOPD患者在常规治疗同时吸入噻托溴铵,疗效显著且临床安全性较高。

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  • 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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  • Gastroesophageal reflux is associated with incresead exacerbation of chronic obstructive pulmonary disease

    Objective To investigate the prevalence and predisposing factors of gastroesophageal reflux(GER)in patients with chronic obstructive pulmonary disease(COPD)and its impacts on the frequency of COPD exacerbations.Methods 50 patients with acute exacerbation of COPD were enrolled in the study.All patients filled a modified version of clinically validated standardized Mayo Clinic GER questionnaire.Pulmonary function tests(PFT),body mass index(BMI),serum albumin,and medications were recorded.The patients were divided in to GER group(13 patients with GER symptoms longer than one year and diagnosed GER by gastroscope) and non-GER group(37 patients without GER symptoms).Results There were no significant differences in the BMI,serum albumin,use of inhaled steroids and theophylline between the two groups.Forced expiratory volume in one second as a percentage of the predicted value(FEV1%pred)(37% vs 38.3%,P=0.608.),residual volume % predicted(123.4 % vs 137.8%,P=0.222),and residual volume to total lung capacity(139.4% vs 141.5%,P=0.798) were not significantly different between the two groups.The number of COPD exacerbations per year was significantly higher in patients with GER compared to patients without GER(4.5 vs 1.3,P=0.006).Conclusions The severity of airflow obstruction and the hyperinflation is unlikely to contribute to the development of GER.Patients with GER experience significantly more exacerbations per year when compared to patients without GER,suggesting more highlight warrant in treatment of GER in COPD patients.

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • Acute exacerbation of chronic obstructive pulmonary disease:Update

    根据慢性阻塞性肺疾病全球创议(GOLD)的定义,慢性阻塞性肺疾病急性加重(AECOPD)是“在COPD的自然病程中发生的事件,气紧、咳嗽或/和咳痰等基础症状加重超出正常的日间变异的范围,急性发病,可能需要改变常规的治疗”[1]。AECOPD意味着对医疗卫生资源耗用的增加,如非预约的就医、使用药物增加,使用抗生素或口服皮质激素甚至住院,等等。仅仅依据是否占用卫生资源来定义AECOPD并不适当,这一点还要取决于医疗卫生资源的可获得性,同时有研究提示部分AECOPD可以是自限性的,特别是轻度急性加重。另一方面,占用医疗卫生资源的形式可以大致评估AECOPD的严重程度,如需要增加常规的吸人性药物常常意味着轻度AECOPD,需要短程口服抗生素或糖皮质激素意味着中度AECOPD,而需要住院者多为重度AECOPD。AECOPD是导致COPD患者健康状态降低乃至死亡的主要原因,也是耗用医疗卫生资源从而构成COPD疾病负担的主要部分,需要采用有力的干预措施以降低其发生率[2]。

    Release date:2016-08-30 11:37 Export PDF Favorites Scan
  • 早期应用无创通气治疗慢性阻塞性肺疾病急性加重疗效观察

    随着无创机械通气技术在临床的广泛应用及技术水平的不断提高,已取得了可靠有效的临床疗效。无创正压通气(NPPV)治疗慢性阻塞性肺疾病急性加重(AECOPD)合并呼吸衰竭,更是弥补了传统治疗的不足,早期应用治愈率高,死亡率低[1]。本文总结了大连市中心医院近两年使用NPPV治疗慢性阻塞性肺疾病急性加重(AECOPD)的情况,探讨AECOPD早期应用无创通气的价值及疗效。

    Release date:2016-09-14 11:53 Export PDF Favorites Scan
  • The effect of indoor environment on acute exacerbations of chronic obstructive pulmonary disease

    Objective To evaluate the effects of indoor temperature and relative humidity on acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods A total of 70 moderate to very severe COPD patients were recruited.The data including indoor temperature and relative humidity twice daily,increase over their stable symptoms in "major" symptoms(dyspnea,sputum purulence,sputum amount) and "minor" symptoms(nasal discharge/congestion,sore throat,cough),and adjustment of medication were recorded on diary cards.All data were collected from Jan 2005 to Dec 2005 by telephone inquiring or home visiting.Furthermore,the corresponding median outdoor temperature,relative humidity and air pressure from atmosphere bureau were compared with indoors parameters to examine the different effects on AECOPD.Results Fifty-five cases completed the whole investigation.Indoor temperature and relative humidity were both risk factors when logistic regression was used to evaluate the effect.Our research showed that AECOPD was significantly related to indoor and ourdoor environment factors.The correlation coefficient of all factors were r=-0.686(indoor temperature),r=-0.671(outer temperature),r=0.105(indoor humidity),r=-0.115(outer humidity),r=0.545(atmospheric pressure) respectively.Conclusions The indoor temperature and relative humidity,especially low temperature and high relative humidity,had important effects on AECOPD of moderate to very severe patients.It may be helpful to prevent AECOPD by adjusting the indoor temperature and relative humidity.

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • 适应性压力通气在慢性阻塞性肺疾病急性加重时的临床应用

    适应性压力通气(APV)模式是一种能适应患者通气需求的自动模式,即通过自动测定患者的呼吸力学参数而自动调节吸气的压力水平以达到目标潮气量的目的。目前这种模式在COPD患者的应用不多。本研究通过APV与压力支持通气(PSV)的比较,评估APV在COPD患者急性加重期的应用效果。

    Release date:2016-09-14 11:56 Export PDF Favorites Scan
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