Research Status of TCM Rehabilitation in Chronic Obstructive Pulmonary Disease (COPD)

This paper mainly analyzes the application status of TCM rehabilitation in chronic obstructive pulmonary disease(COPD),hoping to provide support and help for clinical staff through this study,and promote the further development of COPD rehabilitation program.

A systematic review of the effectiveness of clinical nurse specialist interventions in patients with chronic obstructive pulmonary disease(COPD)

Objective： This review aimed to examine the effectiveness of clinical nurse specialist （CNS） interventions in patients with chronic obstructive pulmonary disease （COPD）. COPD significantly affects people＇s health worldwide. With the development in nursing, CNSs are playing increasingly important roles in different departments. However, the studies on the effectiveness of CNSs in COPD are not as well organized as the studies on the effectiveness of CNSs in bronchiectasis and asthma. Therefore, this review aims to find some updated evidence on the CNS interventions for patients with COPD and on whether these interventions are effective.Methods： A narrative analysis of the data was performed for the eligible studies. Four databases were chosen： CINAHL, MEDLINE, British Nursing Index, and Cochrane Library. Other websites such as the National Institute for Health and Clinical Excellence, National Health Service Evidence, Association of Respiratory Nurse Specialists, and National Association of Clinical Nurse Specialist were searched as well. Two reviewers performed study identification independently, and all the retrieved articles were stored using the EndNote X7 software. The risk of bias in the included studies was assessed using the Cochrane Collaboration＇s risk of bias tool. Results： A total of nine studies were included in this review. There were five current interventions by CNSs for patients with COPD. These interventions were home nursing support, CNS]s supported discharge, multidisciplinary cooperation programs, nurse-led care programs, and self-care management education. The effectiveness of these five interventions was evaluated individually. There is low- to moderate-quality evidence indicating that home nursing support interventions may have a positive effect on mortality and quality of life. No significant difference in quality of life has been found between the CNS-supported discharge intervention and the usual service. The multidisciplinary cooperation program probably had a positive effect on quality ot life in patients with COPD. Both nurse-led care and self-care management education intervention had a positive effect on mortality of patients with COPD.Conclusions： The findings of this review provide updated evidence on the effectiveness of CNS interventions for patients with COPD. Although nine trials were included and five types of interventions were identified, there is still lack of high-quality evidence.

Exploring the biological mechanism of qi deficiency syndrome with chronic obstructive pulmonary disease(COPD)based on integrated pharmacology

Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD.

Predictive role of interleukin-6 and CAT score in mechanical ventilation in patients with chronic obstructive pulmonary disease at the acute exacerbation stage in the emergency department

BACKGROUND:The study aimed to evaluate the predictive role of interleukin-6(IL-6)and chronic obstructive pulmonary disease(COPD)assessment test(CAT)score in mechanical ventilation(MV)in COPD patients at the acute exacerbation stage in the emergency department(ED).METHODS:For a one-year period,among adult patients in the ED who met the criteria of acute exacerbation of COPD,158 who received MV within 48 hours after admission were compared to 294 who didn't require MV within the same period after admission.IL-6 level and CAT score were compared between the two groups.The predicted value of IL-6 and CAT score was assessed by logistic regression analysis and a receiver operating characteristic(ROC)curve.RESULTS:The IL-6 and CAT scores in the 158 MV patients were much higher than those without.IL-6 and CAT scores were independent predictors of MV within 48 hours using logistic regression analysis(IL-6:odds ratio[OR]1.053,95%confidence interval[CI]1.039–1.067,P<0.001;CAT score:OR 1.122,95%CI 1.086–1.159,P<0.001).The combination of IL-6 and CAT scores(area under ROC curve[AUC]0.826,95%CI 0.786–0.866,P<0.001)improved the accuracy of predicting MV within 48 hours when compared with IL-6(AUC 0.752,95%CI 0.703–0.800,P<0.001)and CAT scores alone(AUC 0.739,95%CI 0.692–0.786,P<0.001).The sensitivity and specificity were 69.6%,74.1%,75.32%and 63.6%,respectively.CONCLUSION:The combined of IL-6 and CAT scores is useful for evaluating the risk of COPD patients at acute exacerbation in ED,and can provide a predictive value for MV or not within 48 hours.

Comparative Study on the Efficacy of Tiotropium Bromide Inhalation and Oral Doxofylline Treatment of Moderate to Severe Stable Chronic Obstructive Pulmonary Disease

This study compared the efficacy and safety of tiotropium bromide inhalation powder （spiriva） and doxofylline oral tablet （doxofylline） in the treatment of chronic obstructive pulmonary disease （COPD）. A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder （18 μg/day） or oral doxofylline tablets （0.2 g/time, 2 times a day） for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV1, FEV1/FVC% and 6-min walk distance were sig-nificantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases （9.9%） and 12 cases （12.9%）, respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day （two times a day） are effective and safe for the treatment of COPD.

Health Effect of Forest Bathing Trip on Elderly Patients with Chronic Obstructive Pulmonary Disease

Forest bathing trip is a short, leisurely visit to forest. In this study we determined the health effects of forest bathing trip on elderly patients with chronic obstructive pulmonary disease （COPD）. The patients were randomly divided into two groups. One group was sent to forest, and the other was sent to an urban area as control. Flow cytometry, ELISA, and profile of mood states （POMS） evaluation were performed. In the forest group,

The risk factors for chronic obstructive pulmonary disease in Li and Han ethnic groups in Hainan, China

Objective: To investigate the risk factors of chronic obstructive pulmonary disease(COPD) in Li and Han ethnic group in Hainan, China. Methods: All subjects were randomly selected from various regions in Hainan. General characteristics were compared between COPD cases and healthy control cases in both Li and Han ethnic groups. The odds ratio(OR), the corresponding 95% confidence interval(CI) of COPD were calculated by logistic regression.Results: A total of 277 Li COPD cases, 307 Li healthy control subjects, 290 Han COPD cases and 301 Han healthy control were included in this study. In both the Li and Han groups, the average age exceeded 65 years, and the cigarette number smoked per day and the smoking duration were correlated with risk of COPD. In the Li COPD subjects, low weight, smoking, and recurrent infection of respiratory tract were mainly risk factors; while the mainly risk factor of Han COPD subjects was family history of respiratory disease. Conclusions: The risk factors are different in COPD subjects of Han and Li nationalities in Hainan of China. The age and smoking are strongly correlated with COPD risk.

Regulatory Effect of Shenge Yifei Capsule on TGF-β1/Smad Signaling Pathway in Rats with Chronic Obstructive Pulmonary Disease

[Objectives]This study aimed to study the effects of Shenge Yifei capsule on the TGF-β1/Smad signaling pathway in rats with chronic obstructive pulmonary disease(COPD).[Methods]Ten rats were randomly selected as the control group,and the other 40 rats were selected for modeling by fumigation combined with Klebsiella pneumoniae infection.A total of 38 rats were successfully modeled.They were randomly divided into model group(8 rats),low-dose Shenge Yifei capsule group(10 rats),high-dose Shenge Yifei capsule group(10 rats)and theophylline group(10 rats)in accordance with the principle of half male and half female.The rats in the model and control groups were given with distilled water by gavage,and the rats in the drug administration groups were given with corresponding drugs.The TGF-β1 level in the serum,and the expression levels of TGF-β1,Smad2,Smad3 and Smad7 and TGF-β1,Smad3 and Smad7 in airway tissues were detected.[Results]After 12 weeks,the serum TGF-β1 levels of the theophylline group and high-dose Shenge Yifei capsule group were lower than that of the low-dose Shenge Yifei capsule group(P<0.05).The expression levels of TGF-β1 and Smad3 in the theophylline group and high-dose Shenge Yifei capsule group were lower than that in the low-dose Shenge Yifei capsule group(P<0.05).The expression levels of TGF-β1 and Smad3 in the high-dose Shenge Yifei capsule group were lower than those in the low-dose Shenge Yifei capsule group and theophylline group(P<0.05).The expression levels of Smad7 and the proteins in the model group were lower than those in the other groups(P<0.05).The expression levels of Smad7 in the theophylline group and high-dose Shenge Yifei capsule group were higher than that in the low-dose Shenge Yifei capsule group(P<0.05).After 18 weeks,no significant difference was found in serum TGF-β1 level among the theophylline group and low and high-dose Shenge Yifei capsule groups(P>0.05).The expression levels of Smad7 and the proteins in the model group were lower than those in the other groups.The expression level of Smad7 in the high-dose Shenge Yifei capsule group was lower than that in the theophylline group(P<0.05).[Conclusions]Shenge Yifei capsule can regulate the TGF-β1/Smads signaling pathway.They can down-regulate the expression of TGF-β1,Smad2 and Smad3 and up-regulate the expression of Smad7,reducing the degree of airway modeling,delaying the development of COPD disease.Conventional high-dose Shenge Yifei capsule is more effective in inhibiting the expression of Smad2.

Current status and progress of prevention andtreatment of chronic obstructive pulmonarydisease in China

Chronic obstructive pulmonary disease (COPD) is the most prevalent chronic respiratory disease, leading toa great number of death and a huge disease burden to China. Recently, as the promulgation of a series of national healthpolicies, the diagnosis and treatment of COPD has gradually gained attention. The prevention and treatment capacity ofCOPD in China has been greatly improved, but there are still problems of insufficient diagnosis and irregular treatment. Theproblem is mainly related to the lack of universal pulmonary function test, insufficient number and level of doctors, and thenonstandard use of drugs. The prevention and treatment of COPD in primary medical institutions is particularly lacking. Inorder to promote the prevention and treatment of COPD, China has innovatively adopted a number of measures, including"Happy Breathing" project, standardized diagnosis and treatment system and capacity building for respiratory diseases inprimary medical institutions, el at. Effective progress has been made through these methods, and great improvement of theprevention, diagnosis and treatment of COPD has been achieved.

Chronic Obstructive Pulmonary Disease and Semantic Language Abilities

Objective: The main aim of the present study is to evaluate the semantic language abilities of patients with Chronic Obstructive Pulmonary Disease (COPD) compared to normal group. Secondly to examine the role of hypoxemia, hypercapnia and pulmonary parameters on language scores. Method: We assessed 100 COPD patients with the use of a comprehensive battery of neurocognitive tests standardized for the Greek population, examining semantic language abilities, namely the Boston Naming Test (BNT), the Picture Peabody Vocabulary Test (PPVT) and the Controlled Oral Word Fluency Test (COWAT). Results: The results revealed that although the overall performance of our group of patients was within normal range, it was statistically significant lower compared to normal distribution on all semantic language tests. Moreover, we found that the percentile of COPD patients that performed in the deficient range was significantly higher compared to normal distribution. Further analysis of pulmonary parameters showed that Forced Expiratory Volume in 1 sec (FEV1, FEV1%), Forced Vital Capacity (FVC, FVC%) and FEV1/FVC were not correlated with patients’ performance on the language tests. Low Partial Pressure of Oxygen in blood oxygen levels (PaO2) was found to be able to predict the performance of patients on BNT, PPVT and semantic verbal fluency test. Abnormally elevated Partial Pressure of Carbon Dioxide (PCaO2) in blood were not found to be related to language dysfunctions. Conclusions: Our findings indicate that our group of COPD patients is more prone to present semantic language impairments compared to normal group while low blood oxygen levels were associated with reduced performance on BNT, PPVT and semantic verbal fluency tests.

Study on the Correlation between Temperature and Chronic Obstructive Pulmonary Disease in Shijiazhuang, China—Retrospective Cohort

Using the chronic obstructive pulmonary disease (COPD) medical records from January 1st to December 31st of 2013 and the Meteorological observation data, the air pollution data in the same time periods, generalized additive models were used to quantitatively analyze the relationship between COPD hospitalizations and temperature with controlling the confounding effects of time trend, meteorological factors and air pollution index (AQI). Results showed: variable temperature in 24 h (BT), 3d lagged minimum temperature (Tm3) and 5d lagged diurnal maximum temperature and minimum temperature range (Tc5) have different effects on COPD hospitalizations. When BT is between -4.4°C and -0.7°C, the relative risk (RR) increases to 1.0207 (95% CI: 1.0074 - 1.0342)with every 1°C increase in BT;when Tm3 is between -3.6°C and 3.2°C, the relative risk (RR) increases to 1.0118 (95% CI: 1.0015 - 1.0222)with every 1°C increase in Tm3, and when Tm3 is greater than 20.5°C, the relative risk (RR) increases to 1.0069 (95% CI: 1.0005 - 1.0133) with every 1°C increase in Tm3;when Tc5 is between 0.9°C and 8.6°C, if the Tc5 increases 1°C, the relative risk (RR) increases to 1.0125 (95% CI: 1.0066 - 1.0185. There are different effects for weather in different seasons on COPD hospitalizations: in autumn and winter, it is mainly of little BT and heavy air pollution weather;in spring, the large Tc5 weather is a main feature, and in summer, it’s mainly of high temperature and low pressure weather. The results help to provide some guidance on COPD forecasting services.

Ambulatory Oxygen in Chronic Obstructive Pulmonary Disease

Ambulatory oxygen has been shown to improve pulmonary hemodynamics and reduce dynamic hyperinflation in patients with Chronic Obstructive Pulmonary Disease. Therefore, it is hypothesized to be of benefit in patients with either exertional desaturation or dyspnoea. There is evidence of short-term improvements in exercise distance, exercise time, breathlessness, oxygen saturation and minute ventilation. However, longer term studies only identified improvements in oxygenation and minute ventilation. The benefits were even more limited in patients with no resting hypoxemia. The role in improving exercise training in pulmonary rehabilitation by increasing exercise time and reducing dyspnoea was marginal and no improvements were detected in walking distance or quality of life. Practical considerations make compliance with ambulatory oxygen therapy a major issue with the weight of oxygen and social unacceptability the most often quoted problems. The evidence for any benefit of ambulatory oxygen is therefore limited despite the theoretical benefits.

Efficacy Evaluation of Self-created"Lung Health Breathing Exercise"in Adjuvant Therapy for Patients with Stable Chronic Obstructive Pulmonary Disease

[Objectives]To evaluate the intervention effect and safety of self-created Lung Health Breathing Exercise on TCM syndromes,6-min walk test(6MWT)and quality of life in patients with stable chronic obstructive pulmonary disease(COPD).[Methods]76 cases of outpatient or inpatient patients who were diagnosed with stable COPD in Nanchong Traditional Chinese Medicine Hospital from January 2020 to March 2021 were selected,randomly divided into experimental group and control group,38 cases in each group.Both groups were given conventional western medicine treatment and nursing measures.The experimental group was added with the self-created Lung Health Breathing Exercise.After 12 weeks of treatment,the TCM syndrome score,6MWT distance,quality of life score and the incidence of adverse events were observed in the both groups.[Results]After treatment,the 6MWT distance and quality of life scores in both groups were significantly improved(P<0.01),and the TCM syndrome scores were significantly lower than those before treatment(P<0.01).[Conclusions]Lung Health Breathing Exercise can benefit patients in terms of symptom improvement,quality of life and exercise ability,and is a safe and effective rehabilitation measure for patients with stable COPD.

腹部肥胖对COPD急性加重的影响

目的探讨腹部肥胖相关指标对慢性阻塞性肺疾病(COPD)患者急性加重的影响。方法对“新疆多民族自然人群队列建设及健康随访研究”招募的和田墨玉县常住居民经肺功能检测诊断为COPD的患者,进行问卷及常规检查测量腰围,体成分检测内脏脂肪等级,计算腰高比、体重调整腰围指数(WWI),随访患者至少1年急性加重住院情况。以急性加重住院为结局分析腹部肥胖相关指标对COPD急性加重的影响,并比较不同腹部肥胖指标对COPD急性加重的预测价值。结果631名COPD患者经过随访,报告了186例COPD急性加重住院病例。整个随访期间,COPD急性加重和无急性加重患者在年龄、肺结核疾病史、吸烟、二手烟、烹饪和取暖燃料、慢阻肺患者评价评分(CAT评分)等方面的比较差异有统计学意义(均P<0.05)。单因素及模型1和2显示,腰围、腰高比、WWI、内脏脂肪等级均对COPD急性加重有影响,指标每增加一个单位急性加重均有增加;腰高比及内脏脂肪等级对COPD急性加重影响的结果较稳定,多重调整后腰高比OR=1.304(1.010~1.683),内脏脂肪等级OR=1.912(1.122~3.257)。腹部肥胖相关指标对COPD急性加重均有预测价值,其中WWI的曲线下面积最大,为0.614。结论腹部肥胖指标腰高比、WWI、内脏脂肪等级是COPD急性加重的危险因素,COPD的防控应考虑减少腹部肥胖的干预策略。

吴茱萸热罨包联合穴位贴敷治疗COPD无创通气患者腹胀的效果

目的观察吴茱萸热罨包联合穴位贴敷治疗慢性阻塞性肺疾病(COPD)无创通气患者并发腹胀的效果。方法选取南昌大学第二附属医院呼吸与危重症医学科收治的60例COPD无创通气腹胀患者作为研究对象,按照随机数字表法将其分为观察组和对照组,每组30例。对照组予常规治疗及护理,观察组在对照组基础上加用吴茱萸热罨包联合穴位贴敷,2组均连续治疗3 d。比较2组患者治疗前后的肠鸣音次数、腹围及临床疗效。结果治疗后观察组每分钟肠鸣音次数多于对照组(P<0.05),腹围小于对照组(P<0.05),治疗总有效率高于对照组(P<0.05)。结论吴茱萸热罨包联合穴位贴敷治疗COPD无创通气患者并发腹胀,可促进患者肠道蠕动,改善腹胀状况。

COPD病人睡眠障碍发生率及其影响因素的Meta分析

目的:系统评价慢性阻塞性肺疾病(COPD)病人睡眠障碍的影响因素,为早期识别和干预病人睡眠剥夺、提高病人应对能力提供依据。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、EMbase、Web of Science、the Cochrane Library数据库中关于COPD病人睡眠障碍影响因素的相关文献,检索时限为建库至2023年5月4日。结果:共纳入13篇文献,睡眠障碍发生率为52%,其中呼吸困难指数(mMRC)≥2分[OR=2.01,95%CI(1.14,3.53),P<0.05]、COPD病人自我评估测试(CAT)≥10分[OR=1.24,95%CI(1.01,1.53),P<0.05]、肺功能评估(GOLD)分级Ⅲ~Ⅳ级[OR=2.76,95%CI(1.64,4.65),P<0.05]、合并阻塞性睡眠呼吸暂停后通气综合征(OSA)[OR=2.12,95%CI(1.64,2.74),P<0.05]、疲乏[OR=4.56,95%CI(2.47,8.43),P<0.05]、焦虑[OR=1.13,95%CI(1.07,1.18),P<0.05]、抑郁[OR=1.25,95%CI(1.09,1.45),P<0.05]、长期卧床[OR=2.18,95%CI(1.43,3.32),P<0.05]是COPD病人睡眠障碍的主要影响因素。结论:现有证据表明,COPD病人睡眠障碍发生率较高,mMRC≥2分、CAT≥10分、GOLD分级Ⅲ~Ⅳ级、合并OSA、疲乏、焦虑、抑郁、长期卧床是COPD病人睡眠障碍的主要影响因素。

稳定期COPD病人肺康复锻炼依从性干预方案的构建及可行性研究

目的:构建稳定期慢性阻塞性肺疾病(COPD)病人肺康复锻炼依从性干预方案并评价其可行性。方法:以健康行为改变整合理论(ITHBC)为框架,通过文献研究和半结构化访谈拟定干预方案初稿,经德尔菲专家咨询法修订方案。采用目的抽样法在北京市某三级医院门诊选取稳定期COPD病人,随机分为试验组和对照组实施干预,对照组采用常规护理干预,试验组按照构建的干预方案指导病人实施肺康复并评价其可行性。结果:构建的干预方案包括准确评估、知信合“依”、自我成长和“依”路相伴4个主题、17条内容。干预12周,试验组呼吸和运动锻炼依从性高于对照组(P<0.05)。结论:基于ITHBC理论构建的稳定期COPD病人肺康复锻炼依从性干预方案具有较好的临床可行性和实用性,有助于提高病人的呼吸和运动锻炼依从性。

Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD

[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.

血清CAR及ELR与AECOPD合并肺部感染患者预后的相关性研究

目的探讨血清C反应蛋白/白蛋白比值(CAR)及嗜酸性粒细胞/淋巴细胞比值(ELR)与慢性阻塞性肺疾病急性加重(AECOPD)合并肺部感染患者预后的相关性。方法2019年1月-2022年6月募集180例AECOPD患者,依据是否合并肺部感染将180例AECOPD患者分为感染组(105例)和非感染组(75例),105例感染组患者依据入院治疗后预后情况,分为预后良好组(62例)和预后不良组(43例)。检测所有受试者的血清CAR和ELR水平,Logistic回归模型分析影响AECOPD合并肺部感染患者预后的危险因素,绘制ROC曲线分析CAR、ELR单独和联合检测对AECOPD合并肺部感染患者预后的影响。结果与非感染组相比,感染组患者血清CAR(t=45.25,P<0.001)、ELR(t=20.11,P<0.001)水平升高。与预后良好组相比,预后不良组患者血清CAR、ELR水平升高(均P<0.05),且患者年龄较大、病程较长、合并肺心病比例、无创呼吸机治疗比例高,FEV1、FEV1/FVC、FVC水平低(P<0.05)。Logistic结果显示,病程、无创呼吸机治疗、CAR、ELR是影响AECOPD合并肺部感染患者预后不良的独立危险因素。ROC结果显示,血清CAR、ELR单独预测AECOPD合并肺部感染患者预后的AUC为0.778、0.787,二者联合预测的AUC为0.875,二者联合检测的AUC显著大于CAR、ELR单独检测(Z=2.128,3.236,P<0.05)。结论AECOPD合并肺部感染患者血清CAR、ELR水平升高,二者联合检测能提高对AECOPD合并肺部感染患者预后评估的水平。

不同频次康复锻炼对COPD患者运动耐力、肺功能及生存质量的影响

目的探讨不同频次康复锻炼对慢性阻塞性肺疾病(COPD)患者运动耐力、肺功能和生存质量的影响。方法选择2021年9月至2022年8月收治的COPD患者98例,按治疗方案不同分为对照组和观察组,每组49例,对照组给予常规治疗,观察组采用不同频次康复锻炼。比较治疗前后运动耐力[6 min步行试验(6MWT)、Borg劳累度评估量表]、肺功能[用力肺活量(FVC)、第1秒用力呼气量(FEV_(1))、FEV_(1)/FVC]及血气分析[动脉血氧分压(PO_(2))、氧合指数、动脉血二氧化碳分压(PCO_(2))]变化情况;随访3个月,比较2组生存质量情况。结果治疗后,2组6MWT变长,Borg劳累度评估量表评分降低,且观察组更明显(P<0.05);治疗后,2组肺功能明显改善,且观察组更明显(P<0.05);治疗后,2组血气指标改善,观察组更为明显(P<0.05)。治疗后,观察组生活质量高于对照组(P<0.05)。结论老年COPD患者采取不同频次康复锻炼,可提高运动耐力,利于肺功恢复,提高生存质量。