目的探讨呼吸困难指数气流受限程度指数(dyspnea index air flow restriction degree,ADO)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者近期预后评估中的价值。方法选取新疆医科大学第二附属医院呼吸内科自2021...目的探讨呼吸困难指数气流受限程度指数(dyspnea index air flow restriction degree,ADO)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者近期预后评估中的价值。方法选取新疆医科大学第二附属医院呼吸内科自2021年3月—2023年3月的COPD患者120例,并依照患者最终转归情况将其分为存活组(n=95)与死亡组(n=25)。观察2组患者的基础病情况及患者性别、年龄、第1秒用力呼气容积(first second forced expiratory volume,FEV1)占预计值的百分比和ADO指数等相关指标。比较ADO指数不同分数患者病死率。比较ADO指数预测180 d死亡的受试者工作特征(receiver operating characteristic,ROC)曲线面积。结果2组患者的高血压、冠心病、心律失常、糖尿病、慢性肝病、慢性肾病、亚临床甲减发生情况对比,差异无统计学意义(P>0.05)。死亡组患者的FEV1占预计值的百分比、FEV1占预计值的百分比评分、呼吸困难分[英国医学研究委员会(the Medical Research Council,MRC)]评分以及ADO指数均高于存活组患者(P<0.05)。ADO指数<5分者的死亡率高于ADO指数≥5分者(P<0.05)。ADO指数预测180 d死亡的ROC曲线面积为0.851(95%CI:0.767~0.928,P<0.001),ADO指数为5.5时,约登指数最大,为0.565。结论ADO可有效反映COPD病情严重程度,对于患者而言可准确反映其病情进展情况,帮助其获得良好的疾病治疗效果,对于患者近期预后而言也具有积极意义,临床应用效果良好。展开更多
目的观察海黄补肺方联合穴位贴敷治疗尘肺病的临床疗效。方法选取2019年8月—2021年8月本院治疗的尘肺病患者42例为研究对象,所有患者均为男性,按照随机数字表法分为观察组和对照组,其中,对照组患者22例,观察组患者20例。对照组采取常...目的观察海黄补肺方联合穴位贴敷治疗尘肺病的临床疗效。方法选取2019年8月—2021年8月本院治疗的尘肺病患者42例为研究对象,所有患者均为男性,按照随机数字表法分为观察组和对照组,其中,对照组患者22例,观察组患者20例。对照组采取常规西药治疗,观察组在对照组治疗的基础上采取海黄补肺方联合穴位贴敷治疗。治疗3周后,观察两组患者治疗前后临床症状、体征、6min步行试验评分和肺功能水平,影像学检查。结果观察组有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后6min步行距离高于对照组,差异有统计学意义(P<0.05);治疗后观察组呼吸困难指数较治疗前明显改善(P<0.05);观察组治疗后一秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1/FVC值高于对照组,差异有统计学意义(P<0.05)。结论在常规治疗基础上,采用海黄补肺方联合穴位贴敷治疗尘肺病,可改善尘肺病患者的临床症状和肺通气功能,提高患者生活质量,临床疗效较佳,值得推广应用。展开更多
BACKGROUND:It is not clear whether Emergency Severity Index(ESI)is valid to triage heart failure(HF)patients and if HF patients benefi t more from a customized triage scale or not.The aim of study is to compare the ef...BACKGROUND:It is not clear whether Emergency Severity Index(ESI)is valid to triage heart failure(HF)patients and if HF patients benefi t more from a customized triage scale or not.The aim of study is to compare the effect of Heart Failure Triage Scale(HFTS)and ESI on mistriage among patients with HF who present to the emergency department(ED).METHODS:A randomized clinical trial was conducted from April to June 2017.HF patients with dyspnea were randomly assigned to HFTS or ESI groups.Triage level,used resources and time to electrocardiogram(ECG)were compared between both groups among HF patients who were admitted to coronary care unit(CCU),cardiac unit(CU)and discharged patients from the ED.Content validity was examined using Kappa designating agreement on relevance(K*).Reliability of both scale was evaluated using inter-observer agreement(Kappa).RESULTS:Seventy-three and 74 HF patients were assigned to HFTS and ESI groups respectively.Time to ECG in HFTS group was signifi cantly shorter than that of ESI group(2.05 vs.16.82 minutes).Triage level between HFTS and ESI groups was signifi cantly different among patients admitted to CCU(1.0 vs.2.8),cardiac unit(2.26 vs.3.06)and discharged patients from the ED(3.53 vs.2.86).Used resources in HFTS group was significantly different among triage levels(H=25.89;df=3;P<0.001).CONCLUSION:HFTS is associated with less mistriage than ESI for triaging HF patients.It is recommended to make use of HFTS to triage HF patients in the ED.展开更多
目的探讨BNP、CA125和气急鉴别指数在呼吸困难病因鉴别中的诊断价值。方法 65例入选患者分为心源性呼吸困难组和肺源性呼吸困难组,分别测定BNP、CA125、动脉PaO2和呼气峰值流速(PEF),并根据公式(PEF X PaO2)/1000,计算气急鉴别指数(DDI...目的探讨BNP、CA125和气急鉴别指数在呼吸困难病因鉴别中的诊断价值。方法 65例入选患者分为心源性呼吸困难组和肺源性呼吸困难组,分别测定BNP、CA125、动脉PaO2和呼气峰值流速(PEF),并根据公式(PEF X PaO2)/1000,计算气急鉴别指数(DDI)。结果心源性呼吸困难组BNP、CA125和DDI明显高于肺源性呼吸困难组(P<0.01),且随心功能级别的增加,BNP、CA125水平显著升高(P<0.01);对BNP 100～500Pg/ml区间患者,应用DDI诊断肺源性呼吸困难的敏感性为83.33%,特异性为72.73%。结论测定呼吸困难患者血清BNP、CA125水平,同时应用DDI能更准确地鉴别呼吸困难的病因。展开更多
文摘目的探讨呼吸困难指数气流受限程度指数(dyspnea index air flow restriction degree,ADO)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者近期预后评估中的价值。方法选取新疆医科大学第二附属医院呼吸内科自2021年3月—2023年3月的COPD患者120例,并依照患者最终转归情况将其分为存活组(n=95)与死亡组(n=25)。观察2组患者的基础病情况及患者性别、年龄、第1秒用力呼气容积(first second forced expiratory volume,FEV1)占预计值的百分比和ADO指数等相关指标。比较ADO指数不同分数患者病死率。比较ADO指数预测180 d死亡的受试者工作特征(receiver operating characteristic,ROC)曲线面积。结果2组患者的高血压、冠心病、心律失常、糖尿病、慢性肝病、慢性肾病、亚临床甲减发生情况对比,差异无统计学意义(P>0.05)。死亡组患者的FEV1占预计值的百分比、FEV1占预计值的百分比评分、呼吸困难分[英国医学研究委员会(the Medical Research Council,MRC)]评分以及ADO指数均高于存活组患者(P<0.05)。ADO指数<5分者的死亡率高于ADO指数≥5分者(P<0.05)。ADO指数预测180 d死亡的ROC曲线面积为0.851(95%CI:0.767~0.928,P<0.001),ADO指数为5.5时,约登指数最大,为0.565。结论ADO可有效反映COPD病情严重程度,对于患者而言可准确反映其病情进展情况,帮助其获得良好的疾病治疗效果,对于患者近期预后而言也具有积极意义,临床应用效果良好。
文摘目的观察海黄补肺方联合穴位贴敷治疗尘肺病的临床疗效。方法选取2019年8月—2021年8月本院治疗的尘肺病患者42例为研究对象,所有患者均为男性,按照随机数字表法分为观察组和对照组,其中,对照组患者22例,观察组患者20例。对照组采取常规西药治疗,观察组在对照组治疗的基础上采取海黄补肺方联合穴位贴敷治疗。治疗3周后,观察两组患者治疗前后临床症状、体征、6min步行试验评分和肺功能水平,影像学检查。结果观察组有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后6min步行距离高于对照组,差异有统计学意义(P<0.05);治疗后观察组呼吸困难指数较治疗前明显改善(P<0.05);观察组治疗后一秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1/FVC值高于对照组,差异有统计学意义(P<0.05)。结论在常规治疗基础上,采用海黄补肺方联合穴位贴敷治疗尘肺病,可改善尘肺病患者的临床症状和肺通气功能,提高患者生活质量,临床疗效较佳,值得推广应用。
基金the Vice Chancellor of Research in Mashhad University of Medical Sciences(Grant No.950170)
文摘BACKGROUND:It is not clear whether Emergency Severity Index(ESI)is valid to triage heart failure(HF)patients and if HF patients benefi t more from a customized triage scale or not.The aim of study is to compare the effect of Heart Failure Triage Scale(HFTS)and ESI on mistriage among patients with HF who present to the emergency department(ED).METHODS:A randomized clinical trial was conducted from April to June 2017.HF patients with dyspnea were randomly assigned to HFTS or ESI groups.Triage level,used resources and time to electrocardiogram(ECG)were compared between both groups among HF patients who were admitted to coronary care unit(CCU),cardiac unit(CU)and discharged patients from the ED.Content validity was examined using Kappa designating agreement on relevance(K*).Reliability of both scale was evaluated using inter-observer agreement(Kappa).RESULTS:Seventy-three and 74 HF patients were assigned to HFTS and ESI groups respectively.Time to ECG in HFTS group was signifi cantly shorter than that of ESI group(2.05 vs.16.82 minutes).Triage level between HFTS and ESI groups was signifi cantly different among patients admitted to CCU(1.0 vs.2.8),cardiac unit(2.26 vs.3.06)and discharged patients from the ED(3.53 vs.2.86).Used resources in HFTS group was significantly different among triage levels(H=25.89;df=3;P<0.001).CONCLUSION:HFTS is associated with less mistriage than ESI for triaging HF patients.It is recommended to make use of HFTS to triage HF patients in the ED.
文摘目的探讨BNP、CA125和气急鉴别指数在呼吸困难病因鉴别中的诊断价值。方法 65例入选患者分为心源性呼吸困难组和肺源性呼吸困难组,分别测定BNP、CA125、动脉PaO2和呼气峰值流速(PEF),并根据公式(PEF X PaO2)/1000,计算气急鉴别指数(DDI)。结果心源性呼吸困难组BNP、CA125和DDI明显高于肺源性呼吸困难组(P<0.01),且随心功能级别的增加,BNP、CA125水平显著升高(P<0.01);对BNP 100～500Pg/ml区间患者,应用DDI诊断肺源性呼吸困难的敏感性为83.33%,特异性为72.73%。结论测定呼吸困难患者血清BNP、CA125水平,同时应用DDI能更准确地鉴别呼吸困难的病因。
