Evaluation of Airway Obstruction at Soft Palate Level in Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome:Dynamic 3-Dimensional CT Imaging of Upper Airway

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome（OSAHS） by using dynamic 3-Dimensional（3-D） CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller＇s maneuver.The soft palate length（SPL）,the minimal cross-sectional area of the retropalatal region（mXSA-RP）,and the vertical distance from the hard palate to the upper posterior part of the hyoid（hhL） were compared between the two breathing states.These parameters,together with hard palate length（HPL）,were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index（AHI） and the lowest saturation of blood oxygen（LSaO2）] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller＇s maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters（except the position of the hyoid bone） between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index（BMI）≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller＇s maneuver than those in group with BMI26（P0.05 for all）.It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI26.

Serum Neutrophil Gelatinase-associated Lipocalin(NGAL)Is Elevated in Patients with Asthma and Airway Obstruction

Neutrophilic airway inflammation is one of the features of severe asthma.Neutrophil gelatinase-associated lipocalin(NGAL),or lipocalin-2,is a glycoprotein associated with neutrophilic inflammation and can be detected in blood.Recently,blood NGAL levels have been reported to be elevated in chronic obstructive pulmonary disease.However,the clinical significance of serum NGAL levels in patients with asthma has not been elucidated.The aim of this study was to explore the association between serum NGAL level and clinical parameters in patients with asthma.Sixty.one non-smoking people with stable asthma were enrolled in this study.All patients underwent blood ollction and pulmonary function tests.The associations between serum NGAL levels and clinical parameters were analyzed retrospectively.Serum NGAL levels in patients with asthma and obstructive ventilatory defect were higher than those in patients with asthma without obstructive ventilatory defect(76.4±51.4 ng/mL vs.39.3±27.4 ng/mL,P=0.0019).Serum NGAL levels were correlated with forced expired flow at 50%of vital capacity%predicted and forced expired flow at 75%of vital capacity%predicted(r=-0.3373,P=0.0078 and r=0.2900,P=0.0234,respectively).Results of a multiple regression analysis demonstrated that serum NGAL level was independently associated with obstructive ventilatory defect.Serum NGAL levels were elevated in patients with asthma and obstructive ventilatory defect.NGAL may be involved in airway remodeling possibly mediated by neutrophilic inflammation in asthma.

Recent advances in managing obstructive sleep apnea

Obstructive sleep apnea(OSA)is a rapidly increasing global concern.If it remains untreated,it can lead to cardiovascular,metabolic,and psychiatric complications and may result in premature death.The efficient and effective management of OSA can have a beneficial effect and help reduce the financial burden on the health sector.There has been constant development in OSA management,and numerous options are available.The mainstay of therapy is still the conventional measures and behavioral modifications.However,in cases of failure of these modalities,surgical therapy is the only option.Numerous studies have shown that proper management of OSA has beneficial effects with good long-term outcomes.

Obstructive sleep apnea:Overlooked comorbidity in patients with diabetes

In this review article,we explore the interplay between obstructive sleep apnea(OSA)and type 2 diabetes mellitus(T2DM),highlighting a significant yet often overlooked comorbidity.We delve into the pathophysiological links between OSA and diabetes,specifically how OSA exacerbates insulin resistance and disrupts glucose metabolism.The research examines the prevalence of OSA in diabetic patients and its role in worsening diabetes-related complications.Emphasizing the importance of comprehensive management,including weight control and positive airway pressure therapy,the study advocates integrated approaches to improve outcomes for patients with T2DM and OSA.This review underscores the necessity of recognizing and addressing OSA in diabetes care to ensure more effective treatment and better patient outcomes.

Retropharyngeal abscess presenting as acute airway obstruction in a 66-year-old woman: A case report

BACKGROUND Adult retropharyngeal abscess(RPA)is extremely rare,and most cases reported in the literature were related to tuberculous infection.We present a case of RPA with acute airway obstruction as the main manifestation in a 66-year-old woman that was considered to be non-tubercular suppurative inflammation in the retropharyngeal space.CASE SUMMARY A 66-year-old woman complaining of chills and fever was admitted to our hospital.She was initially diagnosed with an acute upper respiratory tract infection.She lost consciousness twice during hospitalization.She regained consciousness immediately upon emergency tracheal intubation.Acute upper airway obstruction was suspected as arterial blood gas analysis showed obvious acute retention of carbon dioxide before the second tracheal intubation.The diagnosis of RPA was confirmed by computed tomography and magnetic resonance imaging.Kocuria kristinae was isolated from blood samples taken from both hands.The patient recovered and was subsequently discharged after receiving antibiotic therapy together with surgical incision and drainage of the abscess.CONCLUSION Clinicians should be alert to the possibility of RPA in patients with acute airway obstruction.Surgical incision and drainage is an effective treatment for RPA.

Airway Obstruction: Clinical Analysis of Cases in a Tertiary Hospital

Background: Acute upper airway obstruction is a life-threatening emergency that requires urgent evaluation and precise action to save life. It is the most crucial and dramatic emergency faced in otorhinolaryngology (ORL) practice, and occurs in both the old and young, male and female. Purpose: The study was aimed to analyze cases of acute upper airway obstruction seen in our tertiary Hospital over a decade and half, to ascertain the number of patients, their ages and sexes, causes and interventions. Methods: It was a retrospective study conducted in the Department of Otorhinolaryngology, Head & Neck Surgery, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria from January 2007 to December 2021. The charts and records of the patients were reviewed to extract the required data which were analyzed with descriptive statistics. Results: Two hundred and ninety one (291) cases of acute upper airway obstruction were studied. There were 200 (68.73%) males and 91 (31.27%) females, ratio 2.20:1.00. Their ages ranged from 1 day (0.002739 years) to 88 years, with a mean of 30.61 ± 26.56, 95% confidence interval (CI) 27.53 to 33.68 and median of 29. Children were 132 (45.36%) and adults 159 (54.64%). Causes of obstruction were many and varied, and included: congenital, trauma, infection, inflammation, neoplasm and others. Tracheostomy was the main surgical airway intervention. Conclusion: Incidence of acute upper airway obstruction was common and involved both the old and young, male and female, with varied causes. Vigilance and caution need be taken for early presentation and precise intervention offered to mitigate morbidity and mortality.

Unexpected Airway Obstruction Caused by Bilateral Hypoglossal Nerve Palsy Following Second Radical Neck Dissection

A 67-year-old woman underwent right radical neck dissection for cervical lymph node metastasis from maxillary gingival carcinoma. Two months later, metastasis in the left superior internal jugular lymph nodes were discovered, and left radical neck dissection was performed. Postoperatively, airway obstruction occurred despite performing extubation after confirming that the patient had fully recovered from anesthesia. Bilateral hypoglossal nerve palsy was diagnosed and the patient was reintubated. After extubation on the following day, airway obstruction was relieved, but slurred speech and impaired swallowing were persistent. In view of this, hypoglossal nerve function should be examined before the second radical neck dissection on the contralateral side.

Cryorecanalization after cryosurgery for immediate treatment on central airway obstruction via flexible bronchoscope

Objective In order to achieve immediate relief of central airway obstruction caused by malignant tumor after interventional therapy, we observed the efficacy and safety of cryorecanalization after cryosurgery via flexible bronchoscope.

Emergency Airway Obstruction in Newborn Due to Congenital Saccular Cyst

Laryngeal cyst causing neonatal airway obstruction during labor is a very rare condition [1]. Congenital laryngeal cysts are a rare cause of neonatal airway obstruction. Traditionally, these cysts have been treated surgically by endoscopic excision or marsupialization. However, the cyst often extends beyond the larynx. We describe a case of a newborn that, during delivery, became cyanotic due to airway obstruction and respiratory distress. To the best of our knowledge this is the first report of a saccular cyst obstructing airway during birth prior to intubation. The immediate and late treatments together with a literature review are described.

Airway Obstruction Caused by Neck Teratoma in an Infant: Case Report and Literature Review

Teratomas are congenital tumors that derive from all 3 germ layers. Most teratomas of the head and neck present in the pediatricage group. We report a case of a 5-month-old infant who presented with a teratoma showing possible obstruction of the airway. The tumor was successfully resected under general anesthesia. The postoperative course was uneventful, and she was fine at a 3-year follow-up.

Continuous Positive Airway Pressure Effectively Alleviates Arrhythmias in Patients with Obstructive Sleep Apnea:Possible Relationship with Counteracting Oxidative Stress

This work is aimed at exploring the clinical efficacy of continuous positive airway pressuie(CPAP)in treatment of patients with arrhythmias combined with obstructive sleep apnea(OSA).Through evaluating serum native thiol,malonaldehyde(MDA)and nicotinamide adenine dinucleotide phosphate oxidase(NADPH oxidase)in these patients and describing the effects on oxidative parameters of CPAP therapy for 3 months,we confirmed the impact of oxidative stress on arrhythmias.A total of 64 patients with OSA combined with arrhythmias were collected from April 2014 to April 2017 with full clinical information.Patients were divided into two groups(paired experiment design):32 patients in group A(control group),who received unchanged anti-arrhythmia treatment and 32 patients in group B,who were subjected to unchanged pharmacological anti-arrhythmia therapy combined with CPAP.OSA related parameters were compared between the two groups after 3-month therapy.And the levels of parameters of oxidative stress in patients were measured before and after CPAP therapy.After 3 months of CPAP therapy,compared with the control group,the percentage of sage N3(NREM 3)and stage R(REM)in total sleep time was significantly increased,while apnea-hypopnea index(AHI)and the Epworth Sleepiness Scale(ESS)score were evidently decreased.Meanwhile,the lowest oxygen saturation(LSpCh)was also elevated after CPAP treatment for 3 months.The CPAP therapy significantly prevented the occurrence of arrhythmias(P<0.05).Both the MDA level and NADPH oxidase levels were significantly lower in the group B than in the group A(P<0.05).But serum native thiol was improved by CPAP treatment(P<0.05).In conclusion,proper use of CPAP therapy provides significant benefits for the treatment of arrhythmia in patients with OSA.

Sildenafil versus continuous positive airway pressure for erectile dysfunction in men with obstructive sleep apnea： a comparat-ive study of their efficacy and safety and the patient＇s satisfaction with treatment

Aim： To assess the efficacy of sildenafil and continuous positive airway pressure （CPAP） in the treatment of concurrent erectile dysfunction （ED） with obstructive sleep apnea （OSA）, and to gauge the level of treatment satisfaction in patients and their partners. Methods： Forty men were treated for 12 weeks with sildenafil 100 mg （20 men） or CPAP during nighttime sleep （20 men）. Treatment efficacy was assessed by the rate of successful intercourse attempts, and satisfaction with treatment was assessed by patients＇ and partners＇ answers to question 1 of the Erectile Dysfunction Inventory of Treatment Satisfaction. Results： Under sildenafil, 128 of 249 （51.4%） intercourse attempts were successful; under CPAP, 51 of 193 （26.9%） attempts were successful （^cp 〈 0.001）. Erectile function was improved in both groups. After sildenafil and CPAP treatment, the mean International Index for Erectile Function domain scores were 14.3 and 10.8, respectively （^bp = 0.025）, compared to 7.8 and 7 at baseline, respectively. CPAP and sildenafil were well tolerated. Sporadic episodes of nasal dryness under CPAP and transient headache and flushing under sildenafil were not significant. Fifty percent of patients treated with sildenafil and 25% with CPAP were satisfied with the treatment, and their partners were equally satisfied. The satisfaction scores for both patients and partners under sildenafil were superior to those under CPAP （^cP 〈 0.002）. Conclusion： Both sildenafil 100 mg and CPAP, used separately, had positive therapeutic impact but sildenafil was superior. Patients and their partners were more satisfied with sildenafil for the treatment of ED. However, because of the high proportion of dissatisfied men and partners, new therapeutic agents or a combination of the two methods must be studied further.

Impact of continuous positive airway pressure therapy for nonalcoholic fatty liver disease in patients with obstructive sleep apnea

BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for OSA.AIM To clarify the efficacy of effective CPAP therapy on NAFLD of OSA patients by serum markers and transient elastography(TE)using FibroScan®(Echosens,Paris,France).METHODS We prospectively enrolled 123 consecutive patients with OSA who met the indications for CPAP.Liver fibrosis and steatosis were assessed using TE.Before and after 6 mo of CPAP therapy,serum markers and TE were assessed for all patients.The mean usage rate of CPAP therapy for 6 mo was arbitrarily calculated in each patient and expressed as“mean compliance index”(m-CI).RESULTS In 50 OSA patients with NAFLD,both aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were significantly decreased after 6 mo of CPAP therapy.Univariate analysis showed that decreased body weight(BW),decreased body mass index(BMI),decreased AST level,decreased hemoglobin A1c,and high m-CI were significantly related with improved ALT level.In multivariate regression model adjusted for quantities of BW change during 6 mo of CPAP therapy,high m-CI tended to improve ALT level(P=0.051).All 17 OSA patients with NAFLD,high m-CI and no BMI changes showed significant improvements in AST and ALT levels.Meanwhile,no significant changes in TE data or serum fibrosis markers were seen.CONCLUSION Some NAFLD could be associated with chronic intermittent hypoxia due to OSA independent of BW changes.In those cases,adequate reoxygenation from effective CPAP therapy may improve NAFLD.

Computational Fluid Dynamics Simulation of the Upper Airway of Obstructive Sleep Apnea Syndrome by Muller Maneuver

This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and the Muller maneuver（MM）. Seven patients with OSAS were involved to perform computed tomographic（CT） scanning during quiet respiration and the MM. CT data in DICOM format were transformed into an anatomically three-dimensional computational fluid dynamics（CFD） model of the upper airway. The velocity magnitude, relative pressure, and flow distribution were obtained. Numerical simulation of airflow was performed to discuss how the MM affected airflow in the upper airway. To measure the discrepancy, the SPSS19.0 software package was utilized for statistic analysis. The results showed that the shape of the upper airway became narrower, and the pressure decreased during the MM. The minimal cross-sectional area（MCSA） of velopharynx was significantly decreased（P〈0.05） and the airflow velocity in MCSAs of velopharynx and glossopharynx significantly accelerated（P〈0.05） during the MM. This study demonstrated the possibility of CFD model combined with the MM for understanding pharyngeal aerodynamics in the pathophysiology of OSAS.

The Diagnosis Value and Its Implication of Impulse Oscillometry in Obstructive Sleep Apnea Syndrome Patients

The change of measurements of impulse oscillometry (105) in obstructive sleep apnea syn- drome (OSAS) patients and its mechanism were observed. The respiratory impedance was measured by using IOS technique and polysomnography (PSG) was monitored synchronously in 36 OSAS pa- tients,14 patients with chronic obstructive pulmonary disease (COPD) and 12 normal controls. Re- sults showed that R20 in OSAS group was significantly higher than in COPD group and control group (P<0.01). R5-R20 in OSAS group was lower than that in COPD group, but significantly higher than that in control group(P<0. 01). The levels of R20 and R5-R20 were positively correlated with severity degree of the disease. In addition, apnea-hyponea index (AHI) was positively correlated with R5 and R20 with the correlation index (r)being 0. 66 and 0. 86 respectively. The lowest SO2 was negatively correlated with R5 and R5-R20, with r being-0. 66 and- 0. 79 respectively. The mean SO2 was negatively correlated with R5 and R5-R20 with r being-0. 81 and-0. 69 respectively. IOS technique could be used as a valuable tool for assessing the degree of upper airway obstruction in the patients with OSAS, and could help to explore its pathological mechanism.

Spontaneous resolution of idiopathic intestinal obstruction after pneumonia: A case report

BACKGROUND Duodenal obstruction is a common clinical scenario that can either be mechanical or a pseudo-obstruction.Clinical management of intestinal obstruction starts from localization and proceeds to histological examination of the stenotic intestine.Systemic factors and dysfunction of distant organs might contribute to the development of intestinal obstruction.Here,we report a unique case of idiopathic mechanical duodenal obstruction,which resolved spontaneously after 3 mo of conservative treatment,but was followed by intestinal pseudo-obstruction.CASE SUMMARY An 84-year-old woman presented with worsened postprandial vomiting accompanied by prolonged pneumonia.Thorough noninvasive investigations revealed complete circumferential stenosis in the descending duodenum without known cause.Exploratory surgery was postponed due to septic shock and possible pulmonary fungal infection.Conservative treatment for 3 mo for ileus and control of pulmonary infection resolved the intestinal obstruction completely.Unfortunately,2 wk later,she had regurgitation and postprandial vomiting again,complicated by deteriorating wheezing and dyspnea.Computed tomography revealed a dilated stomach and proximal duodenum without new intestinal stricture or pulmonary infiltration.The patient fully recovered after combined treatment with antireflux agents,enema,prokinetics,and bronchodilators.CONCLUSION This complicated case highlights the inter-relationship of local and systemic contributions to ileus and gut dysfunction,which requires multidisciplinary treatment.

Computational Analysis of Airflow in Upper Airway under Light and Heavy Breathing Conditions for a Realistic Patient Having Obstructive Sleep Apnea

Background:Obstructive sleep apnea is a sleeping disorder that has troubled a sizeable population.There is an active area of research on obstructive sleep apnea that intends to better understand airflow behaviors and therefore treat patients more effectively.This paper aims to investigate the airflow characteristics of the upper airway in an obstructive sleep apnea(OSA)patient under light and heavy breathing conditions by using Turbulent Kinetic Energy(TKE),an accurate method in expressing the flow concentration mechanisms of sleeping disorders.It is important to visualize the concentration of flow in the upper airway in order to identify the severity level of the obstruction during sleep.Methods:Computational fluid dynamic(CFD)analysis was used as a solution tool to evaluate the airflow during light and heavy breathing conditions.A medical imaging technique was used to extract the 3D model from the CT scan images.Additionally,mesh generation and simulation were carried out via CFD software to evaluate the light and heavy breathing characteristics related to obstructive sleep apnea.Steady state Reynold’s averaged Navier-Stoke(RANS)with the k-ωshear stress transport(SST)turbulence model was utilized.The airflow characteristics were quantified using parameters such as pressure distribution,skin friction coefficient,velocity profile,Reynolds number,turbulent Reynolds number and turbulence kinetic energy.Results:Contour plots at different planes were used to visualize the airflow distribution as it passed through different cross-sectional areas of the airway.The results revealed that the presence of a smaller cross-sectional area of the airway caused an increase in airflow parameters,especially during heavy breathing.Furthermore,turbulent airflow conditions along the airway were noticed during heavy breathing.The severity of OSA could be measured by the turbulent kinetic energy which is able to show the behavior and concentration of mean flow.This study is expected to provide crucial and important results by visualizing the concentration of airflow mechanisms and characteristics of a patient’s airway during light and heavy breathing. These findings enable TKE to be used as a new tool for characterizing theseverity of obstructive sleep apnea in the upper airways of patients.

Effect of Fufei Gushen Decoction on airway inflammation and glucocorticoid receptor of chronic obstructive pulmonary disease rat

Objective:To investigate the effect of Fufei Gushen Decoction on airway inflammation and glucocorticoid receptor in rats with chronic obstructive pulmonary disease.Methods:Fifty Wistar male rats were randomly divided into 5 groups:blank control group,COPD model group,Fufei Gushen Yin high,medium and low dose groups,10 rats in each group,except the blank control group,the remaining 4 groups were Smoked combined with lipopolysaccharide(LPS),cold air stimulation to create CODP rat model.After successful modeling,the blank control group and COPD model group were fed with distilled water 3ml/only,Fufei Gushen Yin high,medium and low dose groups were given 1.02,0.51,0.26g Chinese medicine granules/100g/day,respectively.2 times a day for 28 consecutive days.Samples were collected,hematoxylin-eosin(HE)staining was used to observe the pathological changes of lung tissue,and enzyme-linked immunosorbent assay(ELISA)was used to detect the tumor necrosis factor alpha(TNF-α)in the serum and right alveolar lavage fluid(BALF)of rats in each group.),the content of transforming growth factorβ1(TGF-β1),interleukin-17(IL-17A)and matrix metalloproteinase(MMP-9)and tissue inhibitor of metalloproteinase-1(TIMP-1)in the left lung tissue The expression level of real-time fluorescence quantitative polymerase chain reaction(Real-time PCR)rat left lung tissue GRmRNA,immunohistochemistry(IHC)to determine the expression level of left lung tissue glucocorticoid receptor(GR).Results:The content of TNF-α,TGF-β1 and IL-17A in the serum of COPD rats in Fufei Gushen Yin high,medium and low dose groups and BALF were significantly reduced compared with the COPD model group(P<0.05);The expressions of TIMP-1 and MMP-9 in tissues were lower than those in COPD model group(P<0.05);the expressions of GRmRNA and GR in lung tissues were higher than those in COPD model group(P<0.05),and were higher in Fufei Gushen Yin Among the middle-and low-dose groups,the middle-dose group has the most significant effect.Conclusion:Fufei Gushen Decoction can inhibit the release of inflammatory factors in lung tissue of COPD rats,improve airway inflammation and remodeling,and increase hormone sensitivity.

Changes in Brachial and Central Blood Pressure after Short Term Continuous Positive Airway Pressure Treatment of Patients with Moderate-to-Severe Obstructive Sleep Apnoea and Impaired Renal Function

Background: Previous studies of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) have shown conflicting results on the effect on blood pressure (BP), and patients with chronic kidney disease (CKD) have not been included in these studies. As OSA is a frequent comorbidity in patients with CKD, it is of relevance to evaluate the effect of CPAP treatment on BP in this population. Aim: In this prospective follow-up study, we measured the effect of short term CPAP treatment of moderate-to-severe OSA on brachial and central BP, plasma level of syndecan-1 and vasoactive hormones, renal handling of sodium, subjective sleepiness, and quality of life in patients with impaired renal function. Methods: From December 2015 until March 2017, 25 patients were invited to participate in the study at the University Clinic in Nephrology and Hypertension, Aarhus University and Holstebro Hospital. At baseline and at follow-up after three to four months of CPAP treatment, we performed 24 h brachial and central ambulatory BP measurement, blood sampling measurements of plasma concentrations of syndecan-1, renin, angiotensin II, aldosterone, vasopressin, creatinine, haemoglobin A1c, and cholesterol, cardio respiratory monitoring, 24 h urine collection for measurement of urinary excretion of albumin, aquaporin-2, and epithelial sodium channel, Epworth Sleepiness Scale (ESS), and SF-36 (quality of life). Results: At follow-up, the 17 included patients with mean baseline estimated glomerular filtration rate 66 mL/min/1.73 m2 had a significant decrease in systolic office-, 24 h- and daytime-BP (13, 7, and 8 mmHg, respectively, p Conclusion: Short-term CPAP treatment of patients with moderate-to-severe OSA and reduced renal function decreased 24 h- and daytime-BP significantly and reduced urinary albumin excretion. Our results underline the importance of treatment of OSA in hypertensive patients with impaired renal function.

“肺主行水”理论在慢性阻塞性肺疾病气道黏液高分泌中的应用探讨

慢性阻塞性肺疾病是一种以持续性气流受限为主要特征的慢性气道炎症性疾病。气道黏液高分泌是慢性阻塞性肺疾病重要临床特征,主要是由于气道受到长期炎症刺激,杯状细胞产生过多,导致黏液堆积,产生咳嗽、咳痰等临床表现。气道黏液高分泌的实质是津液的代谢失常,而“肺主行水”是指肺气通过宣发和肃降推动和调节全身的津液代谢。慢性阻塞性肺疾病是肺失宣降的病理表现,气道黏液高分泌则是“肺主行水”功能异常的体现。在治疗上,西医以减少黏液分泌、抑制炎症等为主;中医以调理肺气宣降、调节水液代谢为基本治疗原则。“肺主行水”理论为慢性阻塞性肺疾病气道黏液高分泌的研究提供了新思路。