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find Keyword "肺功能" 97 results
  • Atypical Asthma with Chief Complaint of Palpitations: Twelve Cases Analysis

    ObjectiveTo explore the clinical features of atypical bronchial asthma with chief complaint of palpitations. MethodsTwelve cases with unexplained palpitations diagnosed by asthma were analyzed retrospectively. ResultsThe patients were diagnosed with asthma through bronchodilation test,skin prick tests,fractional exhaled nitric oxide (FeNO) and diagnostic treatment.The ratio of male to female cases was 1:5. The ventilation lung function of all patients was in normal range. The median time of misdiagnosis was 13.5(3-120) months. 41.6% of cases had dust mite positive skin prick test. The median value of FeNO was 32.75(18-54) ppb. The symptoms of all patients were relieved completely after standard treatment. ConclusionPalpatation may be a specific presentation of asthma characterized with eosinophilic airway inflammation which may be misdiagnosed as other diseases for a long time,especially in elder women. To improve the knowledge of this kind of atypical asthma,detailed medical history, experimental examinations and diagnostic treatment response are important to confirm the diagnosis in time.

    Release date:2016-08-30 11:31 Export PDF Favorites Scan
  • The Predictive Value of Fractional Exhaled Nitric Oxide in the Treatment Response of Adult Asthmatic Patients

    ObjectiveTo explore the predictive value of fractional exhaled nitric oxide (FeNO) in the treatment response of adult asthmatic patients. Methods64 adult outpatients with asthma from Peking Union Hospital between March and September 2013 were recruited in the study. All patients completed asthma control test (ACT) together with exhaled nitric oxide (FeNO) and pulmonary function test. Then the patients were classified into a higher FeNO group (n=33) and a normal FeNO group (n=31) according to FeNO level. All patients accepted regular inhaled ICS/LABA treatment (salmeterol and fluticasone 50/250). Three months later all patients reaccepted ACT,FeNO and pulmonary function test. ResultsThe ACT score increased in all patients,and was significantly higher in the higher FeNO group than that in the normal FeNO group[22.07±5.49 vs. 19.23±5.48,t=2.893,P<0.05]. The complete control rate of the higher FeNO group was higher than that in the normal FeNO group (42.42% vs. 19.35%,χ2=3.960,P<0.05). The FEV1 and FEV1%pred of two groups both increased significantly (P<0.05),but there was no significant difference between two groups (P>0.05). Correlation analysis showed that FeNO and the declined rate of FeNO was negatively correlated with the ACT score(r=-0.302,P<0.05;r=0.674,P<0.01) and positively correlated with the improvement of ACT score (r=0.514,P<0.01;r=0.674,P<0.01). No significant correlation was found between FeNO and FEV1 or FEV1%pred. ConclusionThe effect of ICS/LABA therapy is better for asthma patients with higher FeNO. FeNO can be used for predicting the response to ICS/LABA therapy in patients with asthma and guiding the treatment.

    Release date:2016-08-30 11:31 Export PDF Favorites Scan
  • 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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  • Study of Chronic Obstructive Pulmonary Disease with Diabetes Mellitus and Lung Function Characteristics of Blood Gas Analysis

    目的:探讨慢性阻塞性肺疾病(COPD)合并糖尿病患者的肺功能及血气分析特点并分析其临床意义。方法:选取2008年1月~2009年1月在我院门诊就诊的稳定期患者53例作为研究对象,并根据是否合并糖尿病分为COPD合并糖尿病组26例,单纯COPD组27例,并通过肺功能检测及血气分析,检测肺活量 (VC)、用力肺活量 (FVC)、第1秒钟用力呼气容积 (FEV1)、 FEV1/用力肺活量 (FVC)、用力呼气中期流速PEF(25%~75%) 、肺一氧化碳弥散(DLCO)及肺一氧化碳弥散量实测值占预计值的百分比(DLCO /PRED)等肺功能指标及PaO2、PaCO2等血气指标,并进行组间分析。结果:COPD合并糖尿病组肺通气功能指标VC、FVC、FEV1、PEF(25%~75%)和弥散功能指标DLCO、DLCO/PRED及PaO2显著低于单纯 COPD组。结论:COPD合并糖尿病时肺通气功能和弥散功能都可受损。

    Release date:2016-08-26 02:21 Export PDF Favorites Scan
  • Relationship between pathogen and lung function in patients with acute exacerbations of COPD

    Objectives To investigate the pathogenic characteristics and the possible relationship between pathogen and respiratory function in patients with acute exacerbations of COPD (AECOPD).Methods Sixty-four patients with AECOPD were investigated with lung function test,quantitative and qualitative sputum bacteria culture,drug sensitive test,and Mycoplasma pneumoniae and Chlamydia pneumoniae specific antibodies test.The patients were divided into three groups according to FEV1%pred,50%≤FEV1lt;80%pred for the Group One,30%pred≤FEV1lt;50%pred for the Group Two,and FEV1lt;30%pred for the Group Three.Meanwhile according to the result of sputum culture,infective bacteria were divided into four kinds: Gram-positive cocci for kind A,Gram-negtive germ except kind C for kind B,Acinetobacter,Enterobacter and Pseudomonas spp for kind C,and negative result for kind D.Results ⑴Of 64 patients who were conducted quantitative sputum culture,germs isolated were mostly Streptococcus pneumoniae,Enterobacter,Moraxella Catarrhalis,and Pseudomonas.Of 38 patients who were conducted qualitative sputum culture,most of them were found mixed infection,and germs isolated were mostly Streptococcus pneumoniae,Staphylococcus epidermidis,Acinetobacter and Enterobacter.⑵Both quantitative and qualitative sputum culture revealed that Most of Group One patients were not infected by bacteria,and the Group Three patients were mainly by resistant kind A and kind C bacteria (Plt;0.01 and 0.05 respectively).⑶The infection of Mycoplasma pneumoniae or Chlamydia pneumoniae was identified in 29.4% of the cases.Conclusions There is a close correlation between the degree of functional damage and the infected bacterial strains for patients with AECOPD,the more chance of bacteria infection such as S pneumoniae,Acinetobacter,Enterobacter and Pseudomonas,the more damage of lung function.

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • Effects of inhaled bronchodilators on respiratory mechanics in patients with chronic obstructive pulmonary disease

    Objective To evaluate the effects of inhaled bronchodilators on respiratory mechanics in moderate and severe chronic obstructive pulmonary disease(COPD) patients during eupnea.Methods Twenty moderate to severe COPD subjects were divided into three groups.Lung function,Borg score,breathing pattern and respiratory mechanics indexes were measured at baseline and 30 min after inhaled placebo,salbutamol 400 μg (or ipratropium 80 μg),and ipratropium 80 μg (or salbutamol 400 μg) in sequence at interval as specified in different groups.Results In all groups,inhaled bronchodilators improved lung function (FEV1,FVC,IC) (Plt;0.05),decreased Pdi,Peso,PTPdi,PTPeso and Raw (Plt;0.05,respectively),in comparison with placebo.The reduction of PTPeso was positively correlated with the reduction of Peso (r=0.713,Plt;0.01)and Raw (r=0.602,Plt;0.01).Borg score decreased after inhaled bronchodilators (Plt;0.05).The reduction of dyspnea was positively correlated with the reduction of inspiratory work of breathing (ΔPTPeso%) (r=0.339,Plt;0.05) and Raw (ΔRaw) (r=0.358,Plt;0.05),while was not associated with the changes of FEV1,FVC and IC.Conclusions In COPD patients,inhaled bronchodilators can reduce inspiratory work of breathing and airway resistance,the reduction of inspiratory work of breathing contributed to the reduction of airway resistance.Alleviation of dyspnea by inhaled bronchodilators is suggested to be ascribed to reduction of airway resistance and inspiratory work of breathing.

    Release date:2016-08-30 11:35 Export PDF Favorites Scan
  • 药物治疗能改变慢性阻塞性肺疾病患者肺功能的下降速率吗?

    GOLD 指南将COPD定义为肺部的“异常炎症反应性疾病”已被大家所熟知, GOLD 还指出COPD 的气流受限为“进行性”发展, COPD 肺功能的下降与疾病过程密切相关, 用FEV1 作指标即表现为每年下降速率超过正常健康人群。不同的报道显示COPD 患者FEV1 的下降速率从47~69 mL/年不等[ 1,2] , 而健康成年人大约为30 mL/ 年[ 3] 。FEV1 是目前评价COPD 病情严重度最重要的客观指标之一, 而戒烟是已知唯一可以减缓COPD 患者肺功能下降速率的干预方法[ 4] 。既往研究显示吸入性激素( ICS) [ 1,5] 、N-乙酰半胱氨酸[ 6] 等均不能减缓COPD 患者肺功能下降的速率。Anzueto 等[ 7] 在一项回顾性研究中发现 托溴铵可以显著地改善COPD 患者的FEV1 下降速率, 但是回顾性研究的说服力有限。

    Release date:2016-09-14 11:22 Export PDF Favorites Scan
  • The diagnosis of chronic obstructive lung disease using pulmonary function test is notcompletely the same with the criteria of obstructive ventilatory defect

    COPD是以不完全可逆性气流受限为特征的进展性肺疾病, 与肺部对香烟烟雾等有害气体或有害颗粒的异常炎症反应有关。病理改变存在于外周气道、中央气道、肺实质和肺血管系统等, 也可引起肺外的不良效应, 但外周气道病变和功能异常是导致不完全可逆气流受限的主要原因。国内外采用吸入支气管舒张剂后一秒率( FEV1/FVC) 小于70%来进行定性诊断。

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • 客观评价慢性阻塞性肺疾病的肺功能诊断标准

    诊断的GOLD标准采用吸入支气管舒张剂后一秒率(FEV1/FVC)lt;70%来进行定性诊断。该标准简单、方便,在国际及国内被广泛采用。随着GOLD标准的进一步推广和对传统肺功能重视程度的下降,也出现了一些有争议的问题。一、COPD是否就是阻塞性通气障碍?二、FEV1/FVClt;70%是否就是COPD和阻塞性通气障碍的共同标准?三、COPD的分级标准是否是阻塞性通气障碍的分级标准?四、COPD和其他气道阻塞性疾病是否一定出现一秒率的下降?五、气道舒张试验后的一秒率对诊断COPD是否合理?六、COPD诊断指标与疗效评价指标为什么不一致?七、如何评价肺功能对鉴别诊断的价值?

    Release date:2016-09-14 11:23 Export PDF Favorites Scan
  • Effects of Insulin-Like Growth Factor-1 on Apoptosis of Diaphgramatic Muscle Cell and Pulmonary Function in Rats with COPD

    Objective To investigate the protective effects of recombinant human insulin-like growth factor-1 ( rhIGF-1) on apoptosis of diaphragm in rats with COPD and its impact on pulmonary function. Methods Forty-five male Wistar rats were randomly divided into three groups, ie. a normal control group, a model group, and an IGF-1 intervention group, with 15 rats in each group. The rats in the model group and IGF-1 group were exposed to 5% smoke ( 30 min perday, lasting 28 days) in a sealed box, and 200 μg lipopolysaccharide was injected intratracheally on the 1st and 14th day. The rats in the IGF-1 group were given rhIGF-1 ( 60 μg /100 g) additionally by subcutaneous injection once a day, lasting 28 days. On the 1st, 14th, 28th day, 5 rats from each group were sacrificed. The weight, rate of apoptosis, Fas gene and Fas protein expression of isolated diaphragms were detected. The pulmonary function was measured on the 28th day before sacrificed. Results The mass of diaphragms, minute ventilation ( VE) , peak expiratory flow ( PEF) , inspiratory capacity ( IC) , forced expiratory volume in 0. 3 second ( FEV0. 3) of themodel groupand IGF-1 group were all decreased compared with the control group ( P lt; 0. 05) . The mass of diaphragms, VE, IC of the IGF-1 group were higher than those of the model group ( P lt;0. 05) , and the differences of PEF and FEV0. 3 were not significant ( P gt; 0. 05) . On the 14th, 28th day, rate of apoptosis, Fas gene and protein expressions in the IGF-1 group were lower than those in the model group, and still higher than those in the control group ( P lt; 0. 05) . Conclusions Fas/FasL mediated apoptosis way is involved in the diaphragm apoptosis. rhIGF-1 may reduce the apoptosis of the diaphragmand improve the VE and IC of rats with COPD by intervening Fas/FasL pathway.

    Release date:2016-09-14 11:24 Export PDF Favorites Scan
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