Analysis of the Effect of Traditional Chinese Medicine Nursing Intervention Combined with Acupoint Application in The Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective:To study the effect of Traditional Chinese medicine(TCM)nursing intervention combined with acupoint patch in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods:A total of 60 patients with acute exacerbation of COPD admitted between September 2022 and September 2023 were selected and randomly grouped into a control group(conventional care and treatment)and an observation group(joint interventions:traditional Chinese medicine nursing interventions,acupoint compresses),with 30 patients each.The arterial blood gas indexes of the two groups,hospitalization time,pulmonary function indexes,and TCM symptom scores were analyzed and compared between the two groups.Results:The arterial oxygen pressure(PaO_(2))(9.52±1.02 kPa)and partial pressure of carbon dioxide(PaCO_(2))(5.01±1.02 kPa)of the observation group were better than those of the control group after the intervention(P<0.05).The forced expiratory volume(FEV1)(3.38±0.15%),the FEV1% prediction value(72.52±2.25),and the FEV1/forced vital capacity(FVC)(79.52±1.41%)were higher than those of the control group(P<0.05).The hospitalization time(12.16±1.02 d)and TCM symptom score(4.12±1.26)of the observation group were better than those of the control group(P<0.05).Conclusion:Significant nursing effects were achieved by carrying out combined interventions(Chinese medicine nursing intervention and acupoint application)during the acute exacerbation of COPD.

Correlation of serum CRP and PCT levels with systemic inflammatory response in patients with acute exacerbation of COPD

Objective:To investigate the correlation of serum C-reactive protein (CRP) and procalcitonin (PCT) levels with systemic inflammatory response in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods:68 patients with acute exacerbation of COPD treated in our hospital between August 2012 and February 2016 were collected as observation group and 50 normal subjects receiving physical examination in our hospital during the same period were selected as normal control group. Radioimmunoassay was used to determine serum CRP and PCT levels;the observation group was further grouped according to the median of CRP and PCT levels, and serum levels of pro-inflammatory factors, anti-inflammatory factors and stress hormones of high level group and low level group were detected.Results:Serum CRP and PCT levels of observation group were significantly higher than those of normal control group (P<0.05);serum pro-inflammatory factors interleukin-1β (IL-1β), interleukin-6 (IL-6) and interleukin-8 (IL-8) levels of high CRP and PCT level groups within observation group were higher than those of low CRP and PCT level groups (P<0.05), anti-inflammatory factors interleukin-4 (IL-4) and interleukin-13 (IL-13) levels were lower than those of low CRP and PCT groups (P<0.05), and stress hormones angiotensin II (Ang II), aldosterone (ALD) and cortisol (Cor) levels were higher than those of low CRP and PCT level groups (P<0.05).Conclusions:Serum CRP and PCT levels in patients with acute exacerbation of COPD are positively correlated with the inflammatory response extent in the body, and can be used as the auxiliary means for early disease diagnosis, treatment effect evaluation and prognosis judgment.

Comparison of Protein Profiles in Sputum between COPD and Acute Exacerbation of COPD

Background and objective: Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation that is associated with an abnormal inflammatory response of the lung to noxious particles or gases. Cigarette smoking is the major risk factor for the development of COPD. This study evaluated the levels of cyclophilin B in sputa from patients with COPD and COPD with acute exacerbation (AECOPD). Materials and Methods: Two-dimensional electrophoresis was used for differential display proteomics. Western blotting was used to identify and quantify cyclophilin B in sputum from subjects with AECOPD and COPD. Results: Forty-nine protein spots differed in relative intensity between the AECOPD (n = 6) and COPD (n = 6) subjects. Twenty proteins showed increased expression in the sputum of AECOPD subjects, and 29 proteins were present at lower levels in AECOPD sputum compared with COPD sputum. One of these proteins was associated with cyclophilin B. Cyclophilin B concentrations were lower in sputum from subjects with COPD (n = 4) versus AECOPD (n = 4). Conclusion: The sputum proteomic analysis suggests that changes in various proteins are associated with the development of AECOPD.

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。

多索茶碱治疗COPD急性发作期的临床效果及对气道重塑和呼吸功能的影响

目的观察多索茶碱治疗慢性阻塞性肺疾病(COPD)急性发作期的临床效果及对气道重塑和呼吸功能的影响。方法选取2020年3月—2022年7月兰州市第二人民医院收治的COPD急性发作期患者70例,根据随机数字表法分为观察组和对照组,每组35例。在常规对症治疗基础上,观察组予多索茶碱治疗,对照组予氨茶碱治疗。比较2组治疗效果,治疗前后气道重塑血清指标[基质金属蛋白酶抑制因子-1(TIMP-1)、基质金属蛋白酶-3(MMP-3)、基质金属蛋白酶-9(MMP-9)、神经生长因子(NGF)]、呼吸功能指标[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气流量峰值(PEF)]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))]。结果观察组治疗总有效率为94.29%,高于对照组的71.43%(χ2=6.437,P=0.011)。治疗后,2组TIMP-1、MMP-3、MMP-9、NGF水平较治疗前降低,且观察组低于对照组(P均<0.01);2组FEV_(1)、FVC、PEF较治疗前升高,且观察组高于对照组(P<0.05或P<0.01);2组PaO_(2)、SaO_(2)水平高于对照组,PaCO_(2)水平低于对照组,且观察组变化幅度大于对照组(P均<0.01)。结论多索茶碱治疗COPD急性发作期患者疗效确切,可有效促进血气分析指标、气道重塑、呼吸功能改善。

小青龙汤加味联合西药治疗COPD急性加重期痰湿蕴肺证的临床疗效观察

目的观察小青龙汤加味联合西药治疗慢性阻塞性肺疾病急性加重期(AECOPD)痰湿蕴肺证的临床疗效。方法选取2022年1月—2022年12月临沂市中医医院收治的AECOPD痰湿蕴肺证患者80例,按照随机数表法均分为两组,各40例。两组均用常规治疗,观察组在常规西药治疗基础上联合加味小青龙汤治疗。计算两组临床疗效,观察两组咳嗽缓解时间、气喘消失时间、哮鸣音消失时间,治疗前后血清肿瘤坏死因子-α(TNF-α)、外周血白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)及用力肺活量(FVC)、第一秒用力呼气量(FEV_(1))、第一秒用力呼气量占用力肺活量的百分比(FEV_(1)/FVC)水平。结果观察组咳嗽缓解时间、气喘消失时间、哮鸣音消失时间均短于对照组,差异有统计学意义(P<0.05)。治疗后两组血清TNF-α、IL-6、hs-CRP水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组肺功能FVC、FEV_(1)、FEV_(1)/FVC水平较治疗前改善,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组总有效率明显优于对照组,差异有统计学意义(P<0.05)。结论小青龙汤加味治疗AECOPD痰湿蕴肺证,可以抑制炎症因子的表达,减少气道阻力,促进气道通畅,改善临床症状及肺功能,提高临床疗效。

Expressions and significance of plasma ET-1 and IL-8 in patients with AECOPD merged with CHD

Objective:To observe the expressions and clinical significance of plasma ET-1 and IL-8 in patients with AECOPD merged with CHD.Methods: A total of 120 patients with AECOPD who were admitted in our hospital from February, 2015 to December, 2015 were included in the study and divided into observation 1 group (AECOPD merged with CHD) and observation 2 group (pure AECOPD) with 60 cases in each group. Moreover, 30 healthy individuals who came for physical examinations in the same period were served as the control group. ELISA was used to detect the plasma ET-1 and IL-8 levels, and their correlation was analyzed. The arterial blood gas and coagulation fibrinolysis indicators among the three groups were compared.Results: The plasma ET-1 and IL-8 levels in observation 1 and 2 groups were significantly higher than those in the control group. The plasma ET-1 and IL-8 levels in observation 1 group were significantly higher than those in observation 2 group. PaO2 in observation 1 and 2 groups was significantly lower than that in the control group, while PaCO2 was significantly higher than that in the control group. The comparison of PaO2 and PaCO2 between the two groups was not statistically significant. PT and APTT in observation 1 and 2 groups were significantly shortened when compared with the control group, while TT was significantly delayed. PT in observation 1 group was significantly shortened when compared with observation 2 group. Fbg and t-PA contents in observation 1 and 2 groups were significantly higher than those in the control group. Fbg, t-PA, and D-D contents in observation 1 group were significantly higher than those in observation 2 group.Conclusions:The hypercoagulation state is presenting in patients with AECOPD merged with CHD, with increased ET-1 and IL-8, both of which can play a synergistic effect, and are involved in the pathogenesis.

eCASH理念下的进阶式肺康复护理对COPD急性加重期患者的影响

目的:探讨eCASH理念下的进阶式肺康复护理对慢性阻塞性肺疾病(COPD)急性加重期患者的影响。方法:选取2022年5月1日~2023年9月30日收治的87例COPD急性加重期患者作为研究对象,随机分为对照组43例和干预组44例,对照组实施常规肺康复护理,干预组实施eCASH理念下的进阶式肺康复护理;比较两组干预前后疾病活动度[包括膈肌活动度(DE)、膈肌增厚分数(DTF)、气道阻力(Raw)、气道峰压(PIP)、气道平台压(Pplat)],临床指标及并发症发生情况。结果:干预14 d,两组DE、DTF均高于干预前(P<0.05),Raw、PIP、Pplat均低于干预前(P<0.05),且干预组优于对照组(P<0.01);干预组镇静达标时间、机械通气时间、ICU入住时间短于对照组(P<0.01),肌力评分高于对照组(P<0.01);干预组并发症发生率低于对照组(P<0.05)。结论:eCASH理念下的进阶式肺康复护理能有效控制COPD急性加重期患者疾病活动度,改善呼吸力学相关指标,缩短镇静达标、机械通气及ICU入住时间,提高肌力水平,防止不良事件发生。

AECOPD合并呼吸衰竭开展无创呼吸机联合高流量氧疗的效果

目的探讨慢阻肺急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并呼吸衰竭患者开展无创呼吸机联合高流量氧疗(high-flow nasal cannula,HFNC)的临床效果。方法选取2022年6月—2023年6月兖矿新里程总医院呼吸内科收治的AECOPD合并呼吸衰竭患者92例,根据治疗方法的不同分为对照组(n=46)与观察组(n=46)。对照组采用无创呼吸机治疗,观察组采用无创呼吸机联合HFNC治疗。对2组患者的并发症发生率、再插管率、治疗前后血气指标、肺功能及血清生化指标进行比较。结果观察组患者并发症总发生率为6.52%,明显低于对照组的21.74%(P<0.05)。观察组再插管率为2.17%,与对照组再插管率(8.70%)相比,差异无统计学意义(P>0.05)。治疗前组间患者血气指标、肺功能及血清生化指标比较,差异无统计学意义(P>0.05);治疗后观察组血气指标、肺功能及血清生化指标改善均优于对照组(P<0.05)。结论无创呼吸机联合HFNC对于AECOPD合并呼吸衰竭患者病情有良好地控制效果,能够改善其肺功能和呼吸功能,因此在临床中有较高的推广价值。

沙美特罗替卡松联合噻托溴铵对COPD急性加重期患者炎性反应及肺功能的影响

目的探讨沙美特罗替卡松联合噻托溴铵对COPD急性加重期(AECOPD)患者炎性反应及肺功能的影响。方法86例AECOPD患者随机分为两组。在常规治疗基础上,对照组给予噻托溴铵粉雾剂吸入治疗,观察组采用噻托溴铵粉雾剂吸入联合沙美特罗替卡松气雾剂治疗。比较两组的炎性因子、肺功能以及不良反应。结果治疗后,观察组的IL-8、TNF-α及hs-CRP水平均低于对照组,FEV_(1)、PEF、FVC均高于对照组(P<0.05)。两组治疗期间的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论沙美特罗替卡松联合噻托溴铵治疗AECOPD可显著减轻患者的炎性反应,改善患者的肺功能,且安全性较高。

异丙托溴铵联合布地奈德可改善COPD急性加重期患者肺功能和全身免疫炎性反应指数的影响

目的探究异丙托溴铵联合布地奈德可改善COPD急性加重期患者肺功能和全身免疫炎性反应指数的影响。方法选取我院2020年11月至2022年11月COPD急性加重期患者共100例,均行基础治疗。随机分为对照组与观察组两组,对照组50例,实施异丙托溴铵;观察组50例,联合应用异丙托溴铵溶液和吸入用布地奈德混悬液。比较两组患者治疗前后肺功能指标,IL-6(白介素6)、TNF-α(肿瘤坏死因子),全身免疫炎性反应指数(SIRI)变化。比较两组患者治疗后症状好转时间和临床疗效评估。统计两组患者不良反应发生情况。结果观察组患者治疗后临床有效率明显高于对照组患者(P<0.05)。观察组患者治疗后肺功能指标改善情况显著优于对照组患者(P<0.05)。观察组患者治疗后肺IL-6,TNF-α和SIRI与对照组患者相比明显降低(P<0.05)。对照组患者治疗过程中咳嗽缓解时间,气促消失时间,喘息消失时间和肺部体征消失时间明显长于观察组(P<0.05)。两组患者不良反应统计无差异(P>0.05)。结论布地奈德联合异丙托溴铵治疗COPD急性加重期患者可有效减轻患者炎症反应,改善患者肺功能,提升患者疗效,并且不会增加患者不良反应的发生。

CRP与IL-6及PCT检测在老年COPD患者中的应用价值

目的探讨分析CRP、IL-6及PCT检测在老年慢性阻塞性肺疾病(COPD)患者中的应用价值。方法选择涟水县人民医院2023年1月至2023年8月收治的老年COPD患者123例、同期健康体检者123例,均采血检测CRP、IL-6及PCT水平,比较两组检测值,评估联合检测对COPD的诊断效能;将COPD患者分为稳定、急性加重两个亚组,对比血清指标检测值。结果COPD组血清CRP、IL-6与PCT水平均高于健康组,差异有统计学意义(P<0.05)。联合检测诊断准确率95.93%、灵敏度97.56%、特异度94.31%。根据临床检查结果,有急性加重患者51例,稳定期患者72例。急性加重组血清PCT、CRP、IL-6水平均高于稳定组,差异有统计学意义(P<0.05)。结论老年COPD患者CRP、IL-6与PCT水平明显异常,联合检查的诊断效能高,且急性加重患者这三项指标均明显更高。

基于GC-TOFMS技术对痰浊壅肺型COPD急性加重期血清代谢组学研究

目的:研究痰浊壅肺型慢性阻塞型肺疾病急性加重期(AECOPD)患者血清代谢物的特异性变化。方法:采用气相色谱-飞行时间质谱联用(GC-TOFMS)技术检测60例痰浊壅肺型AECOPD患者和30例健康人的血清标本,用多元统计分析方法和t检验分析两组间的差异代谢物,关联相关代谢途径,解释痰浊壅肺型AECOPD患者的人体相应变化。结果:痰浊壅肺型AECOPD患者与健康组血清代谢轮廓存在明显的差异,找到其中17个差异代谢物。痰浊壅肺型AECOPD患者乳酸、琥珀酸、硫辛酸、新橙皮苷、D-神经鞘氨醇、葡萄糖、亚油酸甲酯、天门冬酰胺、尿素等15种物质表达均显著上调,而苏氨酸、牛磺酸显著下调。结论:痰浊壅肺型AECOPD患者能量代谢、脂肪代谢、氨基酸代谢等发生特异性变化,鉴定的差异代谢物可为痰浊壅肺型AECOPD患者的机制研究提供一条新的途径。

氟替美维联合孟鲁司特对缓解期COPD患者再次急性加重发生及肺功能的影响分析

目的 分析氟替美维联合孟鲁司特对缓解期慢性阻塞性肺疾病(COPD)患者再次急性加重发生及肺功能的影响。方法 回顾性选取长沙市第四医院2020年4月~2022年3月收治的缓解期COPD急性加重患者100例,其中行单纯氟替美维治疗的患者49例为对照组,在对照组基础上联合孟鲁司特治疗的患者51例为联合组。两组患者均完成3周的治疗后,评价两组患者的治疗效果,并分别检测患者白细胞介素-6(IL-6)水平、肿瘤坏死因子-α(TNF-α)水平,同时检测免疫指标的变化和完成6 min步行距离(6MWT)测试。于完成治疗后进行为期3个月的随访,记录两组患者的不良反应发生情况及COPD再次急性加重情况。结果 两组缓解期COPD急性加重患者治疗后病情明显好转,联合组的治疗总有效率(92.16%)明显高于对照组的治疗总有效率(73.47%),差异有统计学意义(P <0.05)。联合组的IL-6及TNF-α水平显著低于对照组,联合组免疫指标CD4~+/CD8~+显著高于对照组,差异有统计学意义(P <0.05)。联合组6MWT显著大于对照组,差异有统计学意义(P <0.05)。随访期间,联合组不良反应发生5例(9.80%),无COPD再次急性加重情况发生;对照组不良反应发生3例(6.12%),2例(4.08%)患者出现COPD再次急性加重,组间比较效应无统计学意义(P> 0.05)。结论 氟替美维联合孟鲁司特用药较单纯氟替美维在避免缓解期COPD患者再次急性加重发生的治疗上效果更佳,同时有利于肺功能的恢复。

COPD急性加重期合并焦虑抑郁研究进展

从慢性阻塞性肺疾病急性加重期合并焦虑抑郁的现状、焦虑抑郁的评估工具、焦虑抑郁的危险因素、焦虑抑郁的治疗措施进行论述。

COPD急性加重期患者血清SIRT1与炎症因子水平的相关性及临床意义

目的研究慢性阻塞性肺疾病急性加重期(AECOPD)患者血清沉默信息调控因子1(SIRT1)与炎症因子水平的相关性及临床意义。方法选择188例COPD患者,按照是否急性加重期分为AECOPD组和稳定期组;按照病情严重程度分为1级、2级、3级;按照预后分为预后良好组和预后不良组。另取同期体检健康者100例为对照组。比较各组SIRT1、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B1(HMGB1)水平;分析SIRT1与炎症因子的相关性,及其对AECOPD患者病情严重程度和预后的意义。结果患者SIRT1水平AECOPD组<稳定期组<对照组,1级>2级>3级,预后良好组>预后不良组;IL-6、TNF-α、HMGB1水平AECOPD组>稳定期组>对照组,1级<2级<3级,预后良好组<预后不良组(P<0.05)。AECOPD患者血清SIRT1与IL-6、TNF-α、HMGB1呈负相关(P<0.05)。SIRT1对AECOPD患者预后具有良好的预测价值(P<0.05)。结论AECOPD患者血清SIRT1水平与炎症因子相关,SIRT1对判断AECOPD患者病情和预后有临床意义。

Interventional study of neutrophil elastase-mediated pathway for biliary head to interfere with high secretion of airway mucus in patients with chronic obstructive pulmonary disease

Objective:To observe the effect of Elephantopus scaber Linn on chronic obstructive pulmonary disease(COPD),to investigate its effect on the MUC5AC hypersecretion of airway mucus mediated by neutrophil elastin in patients with acute exacerbation of COPD,and to observe its effect on lung function(FEV1,FEV1/FVC),so as to provide new ideas and theoretical basis for the prevention and treatment of COPD.Methods:160 patients with acute exacerbation of COPD were randomly divided into observation group and control group with 80 cases each according to the numerical table method.The observation group was treated with aerosol inhalation of Elephantopus scaber Linn on the basis of conventional treatment.Both groups were treated for 2 weeks.During the same period,80 healthy patients were selected as the healthy control group.The expression of NE and MUC5AC in serum of observation group,control group and healthy control group before and after treatment was detected by enzymelinked immunosorbent assay(ELISA).The changes of lung function(FEV1,FEV1/FVC)after treatment in the observation group and the control group were compared and analyzed,and the efficacy of Elephantopus scaber Linn in patients with acute exacerbation of copd was observed.Results:Compared with the control group,the total effective rate of the observation group was significantly better than that of the control group,with statistical significance(P<0.05).Compared with the healthy control group,there were significant differences in serum NE and MUC5AC between the observation group and the control group(P<0.05).Serum NE,MUC5AC,FEV1 and FEV1/FVC were significantly different in the observation group before and after treatment(P<0.05).Serum NE,MUC5AC,FEV1 and FEV1/FVC were significantly different in the observation group before and after treatment(P<0.05).Compared with the control group after treatment,there were significant differences in serum NE and MUC5AC in the observation group after treatment(P<0.05),and the increase of FEV1/FVC and FEV1 was significantly better than that of the control group after treatment(P<0.05).Conclusion:Elephantopus scaber Linn can significantly improve the clinical treatment effect of patients with acute exacerbation of COPD,improve lung function and airway mucus hypersecretion.It can effectively inhibit the expression of NE and MUC5AC in the blood.There were significant differences in serum NE and MUC5AC between the observation group and the control group after treatment(P<0.05),showing a positive correlation,suggesting that inhibition of MUC5AC secretion by Elephantopus scaber Linn in patients with COPD may be related to NE-mediated pathways.

多索茶碱联合甲强龙治疗急性加重期COPD患者的疗效及对血清炎症因子水平的影响

目的以急性加重期的慢阻塞性肺部疾病患者为例,以其血清炎症因子水平、临床疗效为研究目标,分析联合开展多索茶碱和甲强龙治疗的作用价值。方法选取74例COPD急性加重期患者作为研究对象,按随机数表法1:1将患者划分两组,对照组(n=37)采用多索茶碱治疗,观察组(n=37)予以多索茶碱与甲强龙共同治疗,以治疗疗效、血清炎症因子和肺功能为判定指标,分析不同药物治疗后的效果。结果以治疗后为判定时间,临床疗效分析,对照组低于观察组,即83.78%<97.30%(P<0.05)。以治疗前为判定时间,患者肺功能指标、炎症因子水平比较,差异小(P>0.05);治疗后为判定时间,相比对照组,观察组更优(P<0.05)。结论对急性加重期的慢性阻塞性肺疾病患者采取多索茶碱联合甲强龙的临床治疗效果较为显著,有利于炎症因子的水平下降,肺部呼吸功能得到改善,临床应用价值较高。

老年AECOPD患者IL-8和NF-κB及ICAM-1与肺功能的关系

目的分析老年慢性阻塞性肺疾病急性加重(AECOPD)患者血清白细胞介素-8(IL-8)、核转录因子(NF-κB)及细胞黏附分子-1(ICAM-1)与肺功能的关系。方法125例老年AECOPD患者作为观察组,60例老年健康体检人群为对照组,比较两组受试者初入院或体检时第1 s用力呼气容积/用力肺活量(FEV1/FVC)、第1 s用力呼气容积占预计值的百分比(FEV1%)和血清IL-8、NF-κB、ICAM-1水平;根据AECOPD患者严重程度(COPD分级)将观察组分为观察a组(COPD重度、极重度,n=72)和观察b组(COPD轻度、中度,n=53)两亚组,对比两亚组患者肺功能指标、血清IL-8、NF-κB及ICAM-1水平;采用Pearson分析血清IL-8、NF-κB、ICAM-1与肺功能指标的相关性。结果观察组AECOPD患者FEV1/FVC、FEV1%均明显低于对照组,血清IL-8、NF-κB、ICAM-1水平高于对照组,差异有统计学意义(P<0.05);观察a组FEV1/FVC、FEV1%均低于观察b组,血清IL-8、NF-κB、ICAM-1水平均高于观察b组,差异有统计学意义(P<0.05);老年AECOPD患者血清IL-8、NF-κB、ICAM-1水平与肺功能指标FEV1/FVC、FEV1%呈负相关性(P<0.05)。结论老年AECOPD患者血清IL-8、NF-κB、ICAM-1与肺功能关系密切,患者炎症反应越高,其肺功能损伤越严重。

COPD急性加重期患者血清DcR3、TLR4、EOS的表达及预后相关分析

目的探究慢性阻塞性肺疾病急性加重期(AECOPD)患者血清诱骗受体3(DcR3)、Toll样受体4(TLR4)及嗜酸性粒细胞(EOS)的表达水平,并分析以上指标与AECOPD预后的关系。方法选取成都市双流区第一人民医院2019年1月—2021年12月收治的97例AECOPD患者纳入观察组,另选取同期在本院接受治疗的40例稳定期COPD患者纳入稳定组,同期体检健康志愿者40例为对照组。对比三组研究对象的临床治疗和血清DcR3、TLR4、EOS说,并分析各项指标与AECOPD预后的关系。结果三组血清DcR3、TLR4、EOS水平相比,观察组>稳定组>对照组,组间差异有统计学意义(P<0.05)。在随访期间,AECOPD患者预后不良31例,其中8例死亡,23例再次入院。预后不良组患者的血清DcR3、TLR4、EOS水平明显高于预后良好组,组间差异具有统计学意义(P<0.05)。logistics回归模型显示,血清DcR3、TLR4、EOS均为AECOPD预后不良的显著影响因素(OR=0.790、0.963、0.437,P<0.05)。ROC模型显示:血清DcR3、TLR4、EOS对AECOPD预后不良的预测效能一般,而三项联合的预测性较高,联合预测的AUC、约登指数、灵敏度、特异度分别为0.931、0.723、93.50%、78.80%。结论AECOPD患者的血清DcR3、TLR4、EOS水平均存在异常表达,且三项指标均为AECOPD预后不良的影响因素,三项联合可以提高临床对AECOPD预后质量的预测效能。