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find Author "郝迎迎" 2 results
  • 单核细胞 HLA-DR 和 T 淋巴细胞亚群预测严重创伤继发感染的临床研究

    目的 探讨连续监测单核细胞人类白细胞抗原 DR(HLA-DR)表达率变化及外周血 T 淋巴细胞亚群比例变化对严重创伤继发感染的预测价值。 方法 纳入 2014 年 6 月至 2016 年 6 月南京大学医学院附属鼓楼医院重症医学科收治的 26 例严重创伤患者,用流式细胞学方法检测其入院当天及第 3、5、7 d 外周血 HLA-DR 表达率及 T 淋巴细胞亚群比例,根据患者 28 d 内感染情况分为非感染组、局部感染组和全身感染组,分析 HLA-DR 表达率变化规律和 T 淋巴细胞亚群比例变化规律与感染的关系。 结果 26 例严重创伤患者中发生局部感染 10 例,全身感染12 例,感染率达 84.6%。与非感染组及局部感染组比较,全身感染组第 7 d 的 HLA-DR 表达率显著降低。与非感染组比较,局部感染组和全身感染组第 7 d 的 CD4+/CD8+ 比例显著降低。 结论 外周血单核细胞表面 HLA-DR 表达率及外周血 T 淋巴细胞亚群比例的连续监测在预测严重创伤患者继发感染、判断预后和预防治疗感染中具重要价值。

    Release date:2017-07-24 01:54 Export PDF Favorites Scan
  • Clinical study on the predictive value of dynamic energy expenditure monitoring to guide the weaning from mechanical ventilation

    ObjectiveTo compare the predictive values of dynamic energy expenditure (EE) monitoring and the traditional method (rapid shallow breath index) for weaning in patient who is suitable for weaning from mechanical ventilation and accepts sequentially reduced support of ventilator.MethodsThis study included a total of 93 patients who were admitted to the Department of Intensive Care Medicine in 2018 to 2019, and were eligible for weaning from mechanical ventilation. The energy expenditure monitoring device of GE ventilator (CARESCAPE R860) was used to record the patient's change rate of EE [δEE(%), T1 (PSV 20/5), T2 (PSV 15/5), T3 (PSV 10-5/5), T4 (PSV 5/5)] while the ventilation support was declined. The differences in δEE were compared between the two groups of patients who were successful weaned (a successful group S) or failed (a failed group) at different phases. The receiver operator characteristic (ROC) curve was used to analyze the predictive value of δEE to the success rate of weaning.ResultA total of 36 patients failed weaning procedure. There was no significant difference in the basic status and disease type between the successful group and the failed group. There was no difference in δEE1 between T1-T2 phases [(5.67±2.31)% vs. (6.40±1.90)%, P>0.05], but significant difference in δEE between T2-T3 and T3-T4 phases [δEE2: (11.35±5.39)% vs. (14.21±6.33)%, P<0.05; δEE3: (8.39±3.90)% vs. (17.32±9.07)%, P<0.05]. The area under the ROC curve predicted by δEE2 and δEE3 for the patient's weaning results was higher than rapid shallow breath index (0.83 and 0.75 vs. 0.64, P<0.05).ConclusionDynamic energy expenditure monitoring can effectively evaluate and predict the success rate of weaning from mechanical ventilation, and can be applied to the clinical treatment process.

    Release date:2021-06-30 03:37 Export PDF Favorites Scan
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