抗生素在哮喘当中的应用一直备受争议。近年的研究主要集中于大环内酯类抗生素(Macrolides)的非抗菌效应，已有研究发现l4元环和l5元环的大环内酯类抗生素具有类激素样抗炎活性[1]。作为新一代大环内酯类衍生物的泰利霉素(Telithromycin)由于其独特的抗细菌耐药性，一问世便受到广泛关注，而近期公布的TELICAST试验(The Telithromycin，Chlamydophila，and Asthma Trial)中关于其在哮喘急性加重疗效方面的结果更是令人振奋。该试验发现，对已确诊的哮喘急性加重期患者，在指南推荐的常规治疗基础上加用为期10 d的泰利霉素口服(800 mg／d)，可使哮喘症状评分明显下降，肺功能指标改善，但其发挥疗效的机制尚不十分清楚[2]。
Objective To investigate the effects of immune—enhancing enteral nutritioin therapy on the inflammatory reaction and immune function in the rats of ventilation-induced lung injury．Methods Fourty rats were divided into four groups(EN1、EN2、SEN1、SEN2，n=10)．All groups were performed mechanic ventilation and fed isocaloric enteral nutrition．EN1 group：tidal Volume(VT) =8 mL／kg，traditional enteral nutrition；EN2 group：VT=40 mL／kg，traditional enteral nutrition；SEN1 group：VT：8 mL／kg，immune-enhancing enteral immunonutrition；SEN2 group：VT=40 mL／kg，immune-enhancing enteral immunonutrition．Lymphocyte subsets，TNF-α，IL-6 and contents of arachidonic acid(AA)were determined at different time point(0，4，24，72 h after ventilation)．Results The levels of CD3+，CD4+，CD4+／CD8+ in SEN2 group were lower(Plt;0.05)than in EN1，EN2 and SEN1 group after 24，72 h of ventilation．The serum concentrations of TNF-α，IL-6 and AA were significantly lower in EN2 than in other three groups(P lt;0.05)．Conclusion Immune-enhancing enteral nutrition feeding prior to machanie ventilatioin can alleriate the damage of immunological function and reduce infl ammotory responses
ObjectiveTo assess the fatigue in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyze the factors caused fatigue and the relationship between quality of life (QOL) and fatigue. MethodsOne hundred and sixty-nine patients with OSAHS and 78 subjects without OSAHS diagnosed by polysomnography (PSG) between December 2010 and March 2011 in West China Hospital were recruited in the study. Fatigue was assessed by using multidimensional fatigue inventory (MFI), excessive daytime sleepiness by Epworth sleepiness scale(ESS), QOL by functional outcomes of sleep questionnaire (FOSQ). ResultsFatigue in the patients with OSAHS was more severe than that of the controls (51.06±13.39 vs. 44.82±9.81, P < 0.001), but no difference was revealed in the patients with different degree of OSAHS. Fatigue was positively correlated with ESS score(r=0.210), total sleep time intervals(r=0.156), and the ratio of time of SpO2 below 90% in total sleep time(r=0.153)(P < 0.05), and was negatively correlated with the average oxygen saturation(r=-0.171, P < 0.05) and all subscales of FOSQ(P < 0.01). ConclusionsFatigue in patients with OSAHS is more severe than that of controls. Fatigue can significantly reduce QOL, and the impact is greater than that of excessive daytime sleepiness.
Objective To study the relationships among health-related quality of life( HRQL) ,social support, excessive daytime sleepiness ( EDS) and PSG parameters in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Eighty-five patients were recruited who were diagnosed as OSAHS by overnight polysomnography from August 2007 through November 2007 in West China Hospital.The Calgary sleep apnea quality of life index ( SAQLI) was used for HRQL, social support rating scale ( SSRS) was used for social support, and Epworth sleepiness scale( ESS) was used for EDS. The Pearson linear correlation and stepwise multiple regression analysis were used to analyze the correlation among SAQLI, SSRS, ESS, and PSG. Results The SAQLI was correlated with SSRS score ( r =0. 402, P lt;0. 01) ;ESS score ( r = - 0. 505, P lt;0. 01) ; apnea-hypopnea index ( AHI) ( r = - 0. 269, P lt; 0. 05) and lowest artery oxygen saturation ( LSaO2) ( r = 0. 226, P lt; 0. 05) . Stepwise multiple regression analysis determined two variables, the SSRS and ESS score, as independent factors for predicting the total score of SAQLI which accounted for 37. 3% of the total variance in the total score on SAQLI ( R2 = 0. 373, P lt; 0.001) .Conclusions The HRQL of patients with OSAHS was correlated with the SSRS score, ESS score and PSG parameters. The former two were the more important factors to affect the HRQL of patients with OSAHS.
Objective To investigate the implication of oxidation protein product ( advanced oxidation protein product, AOPP) , an index of oxidative stress in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 47 patients with OSAHS and 48 normal controls were enrolled. The concentration of AOPP was measured by spextrophotometry after ameliorated, while superoxide ( SOD) , malonaldehyde ( MDA) , glutathione peroxidase ( GSH-PX) in morning blood samples were detected by Xanthine oxidase test. Results ( 1) Plasma AOPP and MDA were significantly elevated in OSAHS compared with those in control group ( both P lt;0. 01) . Plasma SOD and GSH-PX were significantly lower in OSAHS compared with those in control group ( both P lt;0. 01) . There were significant differences in the plasma AOPP, MDA, SODand GSH-PX among different severity of OSAHS ( all P lt; 0. 01) . Plasma AOPP and MDA were increased and SOD and GSH-PX were gradually decreased with the progression of OSAHS. ( 2) Plasma AOPP correlated well with MDA, SOD and GSH-PX, moreover, AOPP was positively correlated with apnea hyponea index or lowest oxygen saturation. Conclusion AOPP is an alternative index reflecting both oxidative streess and tissue injury in patients with OSAHS.