The epidemic caused by the new coronavirus infection is a global public health emergency. The new coronavirus pneumonia (COVID-19) has caused more deaths in China than the SARS-CoV outbreak in 2003. Since the virus ha...The epidemic caused by the new coronavirus infection is a global public health emergency. The new coronavirus pneumonia (COVID-19) has caused more deaths in China than the SARS-CoV outbreak in 2003. Since the virus has a high homology with SARS-CoV, it is speculates that it may infect cells through the S protein-ACE2 pathway then cause tracheal epithelial cell damage and alveolar damage, further induce inflammatory factor storm and trigger apoptosis cascade reaction and other mechanisms leading to acute lung injury. At early stage, the new coronavirus pneumonia mainly presents with non-specific manifestations of fatigue, fever, cough, etc., Then the respiratory tract will be involved, and evolved into the new type of infectious disease with lung lesions. Under radiology images, ground glass-like changes can be observed in the lungs. With its aggravation, progressive hypoxemia, acute respiratory distress syndrome, and even death occurs. At present, the correlation between the new coronavirus pneumonia and acute lung injury is not yet clear. This article reviews the characteristics of the new coronavirus, the possible mechanism of acute lung injury in new coronavirus pneumonia, post-infection diagnosis and current treatment options in order to provide evidence for its treatment.展开更多
文摘目的探讨迷你营养评估简表(mini nutritional assessment short-form,MNA-SF)联合国家早期预警评分(national early warning score,NEWS)对脓毒症急性呼吸窘迫综合征预后的影响。方法选取南京中医药大学附属南京市中西医结合医院2017年1月至2021年1月收治的脓毒症急性呼吸窘迫综合征患者150例作为研究对象。入院后监测患者生命体征,一般资料,记录基础疾病、体质量指数(body mass index,BMI),呼吸机参数,机械通气时间,入住ICU时间,血生化,血气分析,降钙素原(procalcitonin,PCT),去甲肾上腺素(noradrenaline,NE)最大剂量,并进行MNA-SF和NEWS评分,随访患者28天死亡率。根据患者28天生存情况分为存活组91例,死亡组59例,比较两组患者PCT、CRP、PH值、乳酸、平台压(plateau pressure,Pplat)、呼气末正压(positive end expiratory pressure,PEEP)、机械通气时间、入住ICU时间、MNA-SF和NEWS评分差异。采用二分类Logistic回归模型和ROC曲线下面积来评估MNA-SF和NEWS评分及两者联合评分对脓毒症急性呼吸窘迫综合征患者预后的预测价值。分析MNA-SF、NEWS评分与呼吸衰竭患者预后指标包括乳酸、平台压、机械通气时间的相关性。结果MNA-SF、NEWS及联合评分对患者预后均有较高的价值(AUC=0.796、0.799、0.860),联合评分的价值较单独评分系统更高(联合评分vs MNA-SF,Z=4.568>1.96,P<0.001;联合评分vs NEWS,Z=4.447>1.96,P<0.001,预测死亡风险的灵敏度和特异度分别为89.6%和81.1%)。另外,MNA-SF评分与患者乳酸、平台压、机械通气时间,具有良好的负相关性(r=-0.38、-0.30、-0.33,P均<0.01),而NEWS评分具有良好的正相关性(r=0.36、0.42、0.38,P均<0.001)。结论MNA-SF和NEWS评分,对脓毒症急性呼吸窘迫综合征患者预后均有较高的预测价值,两者联合优于单项评分。
基金AHQDS study on the treatment of paraquat poisoning(ZDYF2019125)Midkine on the proliferation of airway smooth muscle cels in SD rat COPD model and its molecular mechanism(81660011)CAMS Innovation Fund for Medical Sciences(2019-I2M-5-023)
文摘The epidemic caused by the new coronavirus infection is a global public health emergency. The new coronavirus pneumonia (COVID-19) has caused more deaths in China than the SARS-CoV outbreak in 2003. Since the virus has a high homology with SARS-CoV, it is speculates that it may infect cells through the S protein-ACE2 pathway then cause tracheal epithelial cell damage and alveolar damage, further induce inflammatory factor storm and trigger apoptosis cascade reaction and other mechanisms leading to acute lung injury. At early stage, the new coronavirus pneumonia mainly presents with non-specific manifestations of fatigue, fever, cough, etc., Then the respiratory tract will be involved, and evolved into the new type of infectious disease with lung lesions. Under radiology images, ground glass-like changes can be observed in the lungs. With its aggravation, progressive hypoxemia, acute respiratory distress syndrome, and even death occurs. At present, the correlation between the new coronavirus pneumonia and acute lung injury is not yet clear. This article reviews the characteristics of the new coronavirus, the possible mechanism of acute lung injury in new coronavirus pneumonia, post-infection diagnosis and current treatment options in order to provide evidence for its treatment.
