Salvia Polyphenolates Combined with Doxophylline in the Treatment of Patients with Chronic Pulmonary Heart Disease in the Compensated Stage

Objective:To statistically determine the effect of salvia polyphenolates combined with doxophylline treatment in patients with chronic pulmonary heart disease in the compensated stage.Methods:From January 2023 to January 2024,76 patients with chronic pulmonary heart disease in the compensated stage were selected as research subjects.The patients were divided into a research group and a reference group using a randomized numerical table method.The research group was treated with salvia polyphenolates combined with doxophylline,while the reference group received conventional therapy.The treatment effects of the two groups were compared.Results:The patients in the research group,treated with salvia polyphenolates combined with doxophylline,showed maximal ventilation of 73.26±4.83 L/min,left ventricular ejection fraction of 56.14±1.98%,and total effective treatment rate of 94.74%.These results were better than those of the reference group.The differences between the data of the research group and the reference group were statistically significant(P<0.05).Conclusion:For patients with chronic pulmonary heart disease in the compensated stage,treatment with salvia polyphenolates combined with doxophylline significantly improves maximum ventilation and left ventricular ejection fraction,and also results in a higher total effective treatment rate.

Diagnostic Value of the Padua Score Combined with Thrombotic Biomarker Tissue Plasminogen Activator Inhibitor-1 (tPAI-1) Detection for the Risk of Deep Vein Thrombosis in Patients with Pulmonary Heart Disease

This study explores the diagnostic value of combining the Padua score with the thrombotic biomarker tissue plasminogen activator inhibitor-1(tPAI-1)for assessing the risk of deep vein thrombosis(DVT)in patients with pulmonary heart disease.These patients often exhibit symptoms similar to venous thrombosis,such as dyspnea and bilateral lower limb swelling,complicating differential diagnosis.The Padua Prediction Score assesses the risk of venous thromboembolism(VTE)in hospitalized patients,while tPAI-1,a key fibrinolytic system inhibitor,indicates a hypercoagulable state.Clinical data from hospitalized patients with cor pulmonale were retrospectively analyzed.ROC curves compared the diagnostic value of the Padua score,tPAI-1 levels,and their combined model for predicting DVT risk.Results showed that tPAI-1 levels were significantly higher in DVT patients compared to non-DVT patients.The Padua score demonstrated a sensitivity of 82.61%and a specificity of 55.26%at a cutoff value of 3.The combined model had a significantly higher AUC than the Padua score alone,indicating better discriminatory ability in diagnosing DVT risk.The combination of the Padua score and tPAI-1 detection significantly improves the accuracy of diagnosing DVT risk in patients with pulmonary heart disease,reducing missed and incorrect diagnoses.This study provides a comprehensive assessment tool for clinicians,enhancing the diagnosis and treatment of patients with cor pulmonale complicated by DVT.Future research should validate these findings in larger samples and explore additional thrombotic biomarkers to optimize the predictive model.

Impact of Tobacco Smoking on Health Care Utilization and Medical Costs in Chronic Obstructive Pulmonary Disease,Coronary Heart Disease and Diabetes

Objective To determine the impact of smoking on disease-specific health care utilization and medical costs in patients with chronic non-communicable diseases(NCDs).Methods Participants were middle-aged and elderly adults with chronic NCDs from a prospective cohort in China.Logistic regressions and linear models were used to assess the relationship between tobacco smoking,health care utilization and medical costs.Results Totally,1020 patients with chronic obstructive pulmonary disease(COPD),3144 patients with coronary heart disease(CHD),and 1405 patients with diabetes were included in the analysis.Among patients with COPD,current smokers(β:0.030,95%CI:−0.032-0.092)and former smokers(β:0.072,95%CI:0.014-0.131)had 3.0%and 7.2%higher total medical costs than never smokers.Medical costs of patients who had smoked for 21-40 years(β:0.028,95%CI:−0.038-0.094)and≥41 years(β:0.053,95%CI:−0.004β0.110)were higher than those of never smokers.Patients who smoked≥21 cigarettes(β:0.145,95%CI:0.051-0.239)per day had more inpatient visits than never smokers.The association between smoking and health care utilization and medical costs in people with CHD group was similar to that in people with COPD;however,there were no significant associations in people with diabetes.Conclusion This study reveals that the impact of smoking on health care utilization and medical costs varies among patients with COPD,CHD,and diabetes.Tobacco control might be more effective at reducing the burden of disease for patients with COPD and CHD than for patients with diabetes.

Heart failure and chronic obstructive pulmonary disease: Two for tea or tea for two?

A combination of chronic obstructive pulmonary disease (COPD) and heart failure (HF) is common yet it is inadequately and rarely recognized. Because of the similar clinical manifestations, comorbidity is frequently not considered and appropriate diagnostic tests are not performed. It is very important that a combination of COPD and HF is recognized as these patients have a worse prognosis than patients with an individual disease. When present, COPD should not prevent the use of life-saving therapy in patients with HF, particularly β-blockers. Despite clear evidence of the safety and tolerability of cardioselective β-blockers in COPD patients, these drugs remain grossly underprescribed and underdosed. Routine spirometry and echocardiography in HF and COPD patients, respectively, is therefore warranted to improve current clinical practice.

Role of Voltage-gated Potassium Channels in Pathogenesis of Chronic Pulmonary Heart Disease

The influence of hypoxia on the activity of voltage-gated potassium channel in pulmonary artery smooth muscle cells （PASMCs） of rats and its roles in the pathogenesis of chronic pulmonary heart disease were investigated. Eighty male Sprague-Dawley rats were randomly allocated into control group （n=10）, acute hypoxic group （n=10）, and chronic hypoxic groups （n=60）. The chronic hypoxic groups were randomly divided into 6 subgroups （n=10 each） according to the chronic hypoxic periods. The rats in the control group were kept in room air and those in acute hypoxic group in hypoxia envi- ronmental chamber for 8 h. The rats in chronic hypoxic subgroups were kept in hypoxia environmental chamber for 8 h per day for 5, 10, 15, 20, 25, and 30 days, respectively. The mean pulmonary arterial pressure （mPAP）, right ventricular hypertrophy index （RVHI）, and the current of voltage-gated potas- sium channel （IK） in PASMCs were measured. Results showed that both acute and chronic hypoxia could decrease the IK in PASMCs of rats and the I-V relationship downward shifted to the right. And the peak Ir density at ＋60mV decreased with prolongation of hypoxia exposure. No significant difference was noted in the density oflK （at ＋60 mV） and I-V relationship between control group and chronic hy- poxic subgroup exposed to hypoxia for 5 days （P〉0.05）, but there was a significant difference between control group and chronic hypoxic subgroup exposed to hypoxia for 10 days （P〈0.05）. Significant dif- ferences were noted in the IK density （at ＋60 mV） and I-V relationships between control group and chronic hypoxic subgroups exposed to hypoxia for 20 days and 30 days （P〈0.01）. Compared with con- trol rats, the mPAP and RVHI were significantly increased after chronic exposure to hypoxia for 10 days （P〈0.05）, which were further increased with prolongation of hypoxia exposure, and there were signifi- cant differences between control group and chronic hypoxic subgroups exposed to hypoxia for 20 days and 30 days （P〈0.01）. Both the mPAP and the RVHI were negatively correlated with the density OflK （r---0.89769 and -0.94476, respectively, both P〈0.01）. It is concluded that exposure to hypoxia may cause decreased activity of voltage-gated potassium channel, leading to hypoxia pulmonary vasocon- striction （HPV）. Sustained HPV may result in chronic pulmonary hypertension, even chronic pulmonary heart disease, contributing to the pathogenesis of chronic pulmonary heart disease.

Off-pump coronary artery bypass grafting versus on-pump coronary artery bypass grafting： which is better in patients with chronic obstructive pulmonary disease？

To evaluate the clinic outcome of off-pump coronary bypass grafting (OPCABG) of patients with coronary heart disease and chronic obstructive pulmonary disease, we collected and analyzed 1998-2002 data on 28 patients with these two diseases who had received off-pump coronary bypass operation in our hospital, and compared with data on those who also had the same two diseases but received on-pump coronary artery bypass at same time. There were no operation-related death;one died of respiratory failure 14 days after operation while staying in hospital; there were more respiratory complications in the conventional coronary artery bypass grafting group (CCABG) than in the OPCABG group; and the PaO2/FiO2 in the CCABG group was higher than that in the OPCABG group during operation because of CPB, but lower than that in the OPCABG group 6-12 hours after operation. OPCABG seemed more suitable than CCABG for coronary artery disease patients with chronic obstructive pulmonary disease due to less damage to their oxygen-exchange capability and the fewer respiratory complications.

Short-term outcomes in heart failure patients with chronic obstructive pulmonary disease in the community

AIM:To establish the short term outcomes of heart failure(HF)patients in the community who have concurrent chronic obstructive pulmonary disease(COPD).METHODS:We evaluated 783 patients(27.2%)with left ventricular systolic dysfunction under the care of a regional nurse-led community HF team between June 2007 and June 2010 through a database analysis.RESULTS:One hundred and one patients(12.9%)also had a diagnosis of COPD;94% of patients were treated with loop diuretics,83% with angiotensin converting enzyme inhibitors,74% with β-blockers;10.6% with bronchodilators;and 42% with aldosterone an-tagonists.The mean age of the patients was 77.9 ± 5.7 years;43% were female and mean New York Heart Association class was 2.3 ± 0.6.The mean follow-up was 28.2 ± 2.9 mo.β-blocker utilization was markedly lower in patients receiving bronchodilators compared with those not taking bronchodilators(overall 21.7% vs 81%,P < 0.001).The 24-mo survival was 93% in patients with HF alone and 89% in those with both comorbidities(P = not significant).The presence of COPD was associated with increased risk of HF hospitalization [hazard ratio(HR):1.56;95% CI:1.4-2.1;P < 0.001] and major adverse cardiovascular events(HR:1.23;95% CI:1.03-1.75;P < 0.001).CONCLUSION:COPD is a common comorbidity in ambulatory HF patients in the community and is a powerful predictor of worsening HF.It does not however appear to affect short-term mortality in ambulatory HF patients.

Effect of ivabradine in the treatment of acute exacerbation of chronic obstructive pulmonary disease with heart failure

Objective: To observe the effectiveness and safety of ivabradine in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and heart failure. Methods:Patients who were admitted to hospital with AECOPD during the period from August 2017 to July 2018. Then those both had heart failure with reduced ejection fraction(HFrEF) and a resting heart rate>70 beats/min were enrolled. A total of 86 cases were screened and completed, which were randomly divided into two groups for treatment. The control group(41 cases) received standard treatments, such as oxygen, anti-infection, anti-spasmodic, hormone, diuretic, ACEI/ARB, recombinant human brain natriuretic peptide (rhBNP), etc. The bisoprolol was given 2.5~5 mg orally once a day to control heart rate, and the test group(45 cases) was further treated with ivabradine 2.5~5 mg orally twice a day on the basis of the control group. The average heart rate, cardiac function, lung function, and 6-minute walking test were compared between the two groups. Results: After treatment, the average heart rate of the test group was lower than the control group, and the heart rate control rate(<70 beats/min%) of the test group was superior to the control group. The level of N-terminal B-type natriuretic peptide(NT-proBNP) in test group was significantly lower than that in control group. The distance of the 6-minute walking test in e test group was significantly longer than that in control group. Conclusion: Ivabradine combined with bisoprolol could help patients with AECOPD and heart failure to further reduce the heart rates, improve heart function and exercise tolerance. Moreover, the therapeutic safety was acceptable during the short term.

Effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients

Objective:To discuss the effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients.Method: A total of 90 cases of chronic pulmonary heart disease complicated with respiratory failure patients, who were treated in our hospital between May, 2012 and Feb., 2016, were selected, and were divided into study group (n=45) and control group (n=45) based on random number table. Patients in control group were given auxiliary - control ventilation. (A/C) treatment during the whole course, while patients in study group were given A/C+BiPAP treatment. Cardio-pulmonary function and serum inflammatory factor content difference was compared inboth groups before and after operation.Results: Before treatment, difference ofcardiac function indicator, ABG level and inflammatory factor content in both groups had no statistical significance. After treatment, cardiac function indicator (PASP, RVd) levels in both groups were lower than before treatment, and EFRV levels were higher than before treatment, and changes in study group were more obvious than that in control group;ABG indicator (PaO2) levels in both groups were higher than before treatment, and PaCO2 levels werelower than before treatment, and changes in study group were more obvious than that in control group;serum inflammatory factor (hs-CRP, IL-6, TNF-α) content in both groups was lower than before treatment, and changes in study group were more obvious than that in control group.Conclusion: sequential assist-control ventilation could optimize the cardio-pulmonary function of chronic pulmonary heart disease complicated with respiratory failure patients and reduce the systemic inflammatory response.

Effects of Huang Qi Wu Wu Decoction on Plasma Proteins in 70 Cases of Chronic Pulmonary Heart Disease

Simple immune agar diffusion test was used to assay the contents of 12 plasma proteins in 70 cases of chronic pulmonary heart disease treated by Huang Qi Wu Wu Decoction (黄芪五物汤), with the other 70 cases who were not given Huang Qi Wu Wu Decoction as the control group. The total clinical effective rate in the treatment group was 90.0%, while that in the control group was 75.7%, with a statistically significant difference between the two groups (P<0.05). In the treatment group, the levels of prealbumin, transferrin and fibronectin elevated obviously after treatment, and the contents of C-reactive protein, ceruloplasmin, haptoglobin, a 1-antitrypsin and a 1-acid glycoprotein decreased markedly (P<0.01). In the control group, only the levels of ceruloplasmin and C-reactive protein decreased significantly (P<0.05). It is shown that Huang Qi Wu Wu Decoction may enhance the therapeutic effects for pulmonary heart disease, regulate the metabolism of plasma proteins, and improve the life quality of the patients.

Plasma brain natriuretic peptide, platelet parameters, and cardiopulmonary function in chronic obstructive pulmonary disease

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious complications.AIM To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease.METHODS From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the study.The pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery pressure.Plasma BNP and platelet parameters were estimated and compared among each group and subgroup.The correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then analyzed.RESULTS In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P<0.05),while an increasing trend was found in platelet count(PLT)and plateletcrit(PCT)levels among the three groups(P<0.05).In the pulmonary hypertension mild,moderate,and severe subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was observed in PLT levels(P<0.05);however,PCT levels showed no significant difference among the three subgroups(P>0.05).In the cardiac function grade I,II,III,and IV subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pulmonary heart disease were positively correlated with their pulmonary artery pressure(P<0.05),while PLT was negatively correlated with their pulmonary artery pressure(P<0.05).Moreover,plasma BNP,PDW,and MPV levels were positively correlated with cardiac function grade(P<0.05)of these patients,while PLT and PCT levels were negatively correlated with their cardiac function grade(P<0.05).CONCLUSION Plasma BNP and PLT parameters are significantly correlated with the cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease,indicating that these parameters have high clinical relevance in reflecting the health condition of these patients and for guiding their treatment.

Effects of serum Fractalkine on vascular remodeling and oxidative stress activation in patients with COPD complicated by pulmonary heart disease

Objective: To study the effects of serum Fractalkine on vascular remodeling and oxidative stress activation in patients with COPD complicated by pulmonary heart disease. Methods:Patients who were hospitalized in Chongqing Armed Corps Police Hospital due to COPD between June 2014 and April 2017 were selected, the patients with COPD alone were included in COPD group, and the patients with COPD complicated by pulmonary heart disease were included in COPD+PHD group;healthy volunteers who underwent physical examination during the same period were selected as the control group of the study. The serum was collected to determine the contents of Fractalkine, vascular remodeling indexes and oxidative stress indexes. Results: Serum Fractalkine, ANG-2, MMP2, MMP9, VEGF, FGF2, Nogo-B, ET-1 and MDA contents of COPD+PHD group and COPD group were higher than those of control group whereas T-AOC contents were lower than that of control group;serum Fractalkine, ANG-2, MMP2, MMP9, VEGF, FGF2, Nogo-B, ET-1 and MDA contents of COPD+PHD group were higher than those of COPD group whereas T-AOC content was lower than that of COPD group. Serum ANG-2, MMP2, MMP9, VEGF, FGF2, Nogo-B, ET-1 and MDA contents of COPD+PHD group of patients with high Fractalkine content were significantly higher than those of COPD+PHD group of patients with low Fractalkine content whereas T-AOC content was lower than that of COPD+PHD group of patients with low Fractalkine content. Conclusion: The increase of serum Fractalkine in patients with COPD complicated by pulmonary heart disease can aggravate the vascular remodeling and promote the oxidative stress activation.

Plasma endothelin-1 and nitric oxide correlate with ligustrazine alleviation of pulmonary artery hypertension in patients of chronic cor pulmonale from high altitude plateau during acute exacerbation

Objective To explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension(PAH) in patients of chronic obstructive pulmonary disease(COPD) associated with chronic cor pulmonale(CCP) during exacerbation.Methods Seventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group.The control group received standard treatment with antibiotics,antiasthmatic and expectorant medications,and oxygenation;and the ligustrazine treatment group received ligustrazine treatment(80 mg/d;i.v.;for 2 weeks) in addition to the standard treatment.Before and at the end of 2 week treatment,the clinic responses of the two regimens were evaluated,plasma levels of endothelin-1(ET-1) and nitric oxide(NO) were determined;arterial oxygen partial pressure(PaO_2),mean pulmonary arterial pressure(mPAP),outflow tract of right ventricle(RVOT),and internal diameter of right ventricle(RV) were measured.Results Good clinic benefits were achieved in both the standard and ligustrazine regimens,plasma level of ET-1,values of mPAP,RV and RVOT decreased significantly,plasma level of NO and PaO_2 values decreased(all P<0.01 vs pretreatment to all parameters).Compared with the control group,ligustrazine greatly enhanced the clinic efficacy from 77.1%to 97.1%(P<0.05),and also resulted in more significant changes of all these parameters(P<0.01 vs control group for all parameters).For both groups,the levels of plasma ET-1 were positively correlated with values of mPAP,RVOT,and RV(r = 0.710,0.853,and 0.766,respectively,all P = 0.000),and negatively correlated with plasma NO and PaO_2(r =- 0.823,and- 0.752,respectively,all P = 0.000).Conclusion Ligustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area.The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells,thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.

Investigating the Correlation between Patient Education on Web-Based Portal Functionality and the Reduction in 30-Day Hospital Readmission Rates

Background: The growing use of web-based patient portals offers patients valuable tools for accessing health information, communicating with healthcare providers, and engaging in self-management. However, the influence of educating patients on these portals’ functionality on clinical outcomes, such as all-cause readmission rates, remains underexplored. Objective: This research proposal tested the hypothesis that educating a subset of patients with Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF), on how to effectively access and utilize the functionality of web-based patient portals can reduce all-cause readmission rates. Methods: We performed a prospective, quasi-experimental study at Bon Secours St. Mary’s Hospital in Richmond, Virginia, USA;dividing participants into an intervention group, receiving education about accessing and navigating “My Chart”, the Bon Secours Web based portal, and a control group, receiving standard care. We then compared 30-day readmission rates, patient engagement, and self-management behaviors between the groups. Data was analyzed using statistical tests to assess the intervention’s impact. Results: We projected that educated patients will exhibit lower readmission rates, improved engagement, and better self-management. The results of the study showed that there was a significant decrease in 30-day readmissions in the intervention group in comparison with the control group (22.7% and 40.9%, respectively). This reduction of 18. 2% of readmissions evaluated here for a trial of meaningful clinical effect is statistically insignificant (p = 0. 184). The practical significance of the intervention is considered small-to-moderate (Cramer V = 0. 20) suggesting that the observed difference has a potential clinical importance even though the difference was not statistically significant. Conclusion: These results imply that the proposed educational intervention might have a positive impact on readmissions;nonetheless, the patient’s characteristics that make him or her capable of readmission cannot be changed and are assessed by the RoR (Risk of Readmission) score. The potential impact of the intervention may be offset, in part, by these baseline risk factors. The study’s power may be limited by sample size, potentially affecting the detection of significant differences. Future studies with larger, multi-center samples and longer follow-up periods are recommended to confirm these findings.

Exclusive cigar smoking in the United States and smoking-related diseases: A systematic review

BACKGROUND Little information has been published on the risks of cigar smoking.Since 1990 cigar smoking has become more prevalent in the United States.AIM To summarise the evidence from the United States relating exclusive cigar smoking to risk of the major smoking-related diseases.METHODS Literature searches detected studies carried out in the United States which estimated the risk of lung cancer,chronic obstructive pulmonary disease(COPD),heart disease,stroke or overall circulatory disease in exclusive cigar smokers as compared to those who had never smoked any tobacco product.Papers were identified from reviews and detailed searches on MEDLINE.For each study,data were extracted onto a study database and a linked relative risk database.Relative risks and 95%CIs were extracted,or estimated,relating to current,former or ever exclusive cigar smokers,and meta-analysed using standard methods.Sensitivity analyses were conducted including or excluding results from studies that did not quite fit the full selection criteria(for example,a paper presenting combined results from five studies,where 86%of the population were in the United States).RESULTS The literature searches identified 17 relevant publications for lung cancer,four for COPD and 12 for heart disease,stroke and circulatory disease.These related to 11 studies for lung cancer,to four studies for COPD and to eight studies for heart disease,stroke or overall circulatory disease.As some studies provided results for more than one disease,the total number of studies considered was 13,with results from four of these used in sensitivity analyses.There was evidence of significant heterogeneity in some of the meta-analyses so the random-effects estimates are summarized below.As the results from the sensitivity analyses were generally very similar to those from the main analyses,and involved more data,only the sensitivity results are summarized below.For lung cancer,relative risks(95%CI)for current,former and ever smokers were respectively,2.98(2.08 to 4.26),1.61(1.23 to 2.09),and 2.22(1.79 to 2.74)based on 6,4 and 10 individual study estimates.For COPD,the corresponding estimates were 1.44(1.16 to 1.77),0.47(0.02 to 9.88),and 0.86(0.48 to 1.54)based on 4,2 and 2 estimates.For ischaemic heart disease(IHD)the estimates were 1.11(1.04 to 1.19),1.26(1.03 to 1.53)and 1.15(1.08 to 1.23)based on 6,3 and 4 estimates,while for stroke they were 1.02(0.92 to 1.13),1.08(0.85 to 1.38),and 1.11(0.95 to 1.31)based on 5,3 and 4 estimates.For overall circulatory disease they were 1.10(1.05 to 1.16),1.11(0.84 to 1.46),and 1.15(1.06 to 1.26)based on 3,3 and 4 estimates.CONCLUSION Exclusive cigar smoking is associated with an increased risk of lung cancer,and less so with COPD and IHD.The increases are lower than for cigarettes.

依那普利在中老年慢性肺心病患者肺动脉高压中的应用效果分析

目的 分析依那普利在中老年慢性肺源性心病(简称慢性肺心病)患者肺动脉高压中的应用效果。方法 随机选择2021年2月—2022年2月右江民族医学院附属医院呼吸内科收治的70例中老年慢性肺心病患者为研究对象,采用抽签法将其分为对照组和观察组(各35例),对照组采用福辛普利钠片治疗,观察组采用依那普利联合福辛普利钠片治疗,治疗3个月后,对比两组患者的临床疗效、心功能指标、内皮素-1(Endothelin-1, ET-1)、氨基末端脑利钠肽前体(Nterminal Pro Brain Natriuretic Peptide, NT-proBNP)水平、血氧指标及不良反应等。结果 观察组疗效(94.29%)高于对照组(74.29%),差异有统计学意义(χ^(2)=5.285,P<0.05);两组患者治疗后右心室射血分数指标相较于治疗前均有所提高,且观察组高于对照组,两组患者右心室舒张末期内径、肺动脉收缩压水平指标均有所降低,且观察组低于对照组,差异有统计学意义(P均<0.05);相较于对照组,观察组ET-1、NT-proBNP水平更低,差异有统计学意义(P均<0.05)。观察组治疗后动脉血氧分压水平高于对照组,动脉血二氧化碳分压水平低于对照组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 依那普利在中老年慢性肺心病患者肺动脉高压中的应用效果明确,可以改善患者的心功能指标,防止右心室重构,降低脉动脉高压,且不会增加患者不良反应。

有氧八段锦联合踏车运动训练对慢性阻塞性肺疾病合并慢性心力衰竭的干预效果

目的:观察有氧八段锦联合踏车运动训练对慢性阻塞性肺疾病(COPD)合并慢性心力衰竭(CHF)的干预效果。方法:纳入2019年1月至2021年6月间绵阳市中心医院收治的COPD合并CHF患者180例,根据随机数字表法均分为对照组(基础治疗及干预)和试验组(在对照组基础上给予有氧八段锦联合踏车运动训练),两组均干预12周。比较两组干预前、4周、8周和12周后的慢阻肺评估测试量表(CAT)评分、左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)和左心室舒张末期容积(LVEDV)、改良呼吸困难指数(mMRC)和明尼苏达心力衰竭生活质量问卷(MLHFQ)评分。结果:干预12周期间,两组CAT评分、LVESV、LVEDV、mMRC及MLHFQ评分呈逐渐降低趋势,LVEF呈逐渐升高趋势(P<0.05或<0.01)。与对照组相比,干预12周后试验组CAT评分[(17.47±3.96)分比(13.36±3.42)分]、LVEDV[(139.44±7.12)ml比(131.74±6.47)ml]、LVESV[(81.84±8.54)ml比(74.29±9.18)ml]、mMRC评分[(1.67±0.47)分比(1.42±0.50)分]和MLHFQ各维度分及总分[(40.07±6.86)分比(32.54±6.61)分]均显著降低,LVEF[(41.29±4.76)%比(44.56±4.42)%]显著升高,P均<0.001。结论:在基础治疗上增加有氧八段锦联合踏车运动训练,可显著改善COPD合并CHF患者的心肺功能,缓解呼吸困难并提高生活质量,值得推广。

肝细胞特异性对比剂增强磁共振动脉期呼吸运动伪影的影响因素

目的分析肝细胞特异性对比剂增强磁共振患者动脉期呼吸运动伪影的影响因素,为采取针对性护理干预降低伪影发生率提供参考。方法回顾性分析233例初次行肝细胞特异性对比剂增强磁共振检查住院患者的临床资料,采用单因素及logistic回归分析确定动脉期呼吸运动伪影的危险因素。结果30.90%患者发生动脉期呼吸运动伪影。回归分析显示,文化程度、身体质量指数、心力衰竭、慢性阻塞性肺疾病、腹水是肝细胞特异性对比剂增强磁共振动脉期呼吸运动伪影发生的危险因素(均P<0.05)。结论肝细胞特异性对比剂增强磁共振检查患者动脉期呼吸运动伪影发生率高,影响因素较多。对高风险患者应及时干预,以降低动脉期呼吸运动伪影发生率。

心脉隆注射液联合穴位贴敷治疗慢性肺源性心脏病临床疗效观察

目的 探讨心脉隆注射液联合穴位贴敷治疗慢性肺源性心脏病的临床疗效。方法 选择2022年1月至2023年12月医院符合诊断肺源性心脏病患者90例,随机分为A、B、C三组,各30例。A组采用常规治疗,B组在A组基础上接受心脉隆注射液治疗,C组在B组基础上联合穴位贴敷治疗。比较三组心脏射血分数、临床症状改善情况及改善时间、血气分析指标及并发症发生率。结果 治疗后,C组6 min步行试验优于A、B组,C组每搏输出量(SV)、左室射血分数(LVEF)、左心室舒张末期内径(LVEDd)、左心室后壁厚度(LVPWT)均优于A、B组(P<0.05);治疗后,C组动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))水平更高,动脉血二氧化碳分压(PaCO_(2))水平更低,与A、B组相比差异有统计学意义(P<0.05);进一步对比A、B组的差异发现,B组的步行试验、心功能指标及血气分析指标均优于A组(P<0.05);C组并发症发生率最少,B组次之,两组均明显少于A组(P<0.05)。结论 心脉隆注射液联合穴位贴敷治疗肺源性心脏病能显著提高疗效,缩短患者治疗时间,改善患者心肺功能,减少其并发症的发生,促进预后。

托伐普坦治疗慢性肺源性心脏病合并右心衰竭的临床效果

目的观察托伐普坦治疗慢性肺源性心脏病(CPHD)合并右心衰竭(RHF)的临床效果。方法选取2018年5月至2022年5月在我院住院的60例CPHD合并RHF患者为研究对象,根据治疗方案将其分为观察组(常规综合治疗基础上采用托伐普坦治疗)与对照组(常规综合治疗基础上采用呋塞米片治疗),各30例。比较两组的症状及体征改善情况、用药后1周内平均24 h尿量、住院时长、因RHF 30 d再入院率、N末端脑钠肽前体(NT-pro BNP)水平及不良反应发生情况。结果观察组用药后24 h症状(呼吸困难)改善总有效率高于对照组,差异具有统计学意义(P<0.05)。观察组用药后48 h体征(下肢水肿)改善总有效率高于对照组,差异具有统计学意义(P<0.05)。观察组用药后1周内平均24 h尿量多于对照组,住院时长短于对照组,因RHF 30 d再入院率低于对照组,差异具有统计学意义(P<0.05)。治疗前,两组的NT-proBNP水平比较,差异无统计学意义(P>0.05);治疗后,两组的NT-proBNP水平低于治疗前,差异具有统计学意义(P<0.05);治疗后,观察组的NT-proBNP水平低于对照组,差异具有统计学意义(P<0.05)。观察组的不良反应总发生率低于对照组,差异具有统计学意义(P<0.05)。结论托伐普坦可明显缓解CPHD合并RHF患者的症状(呼吸困难)和体征(下肢水肿),增加尿量,缩短住院时长,降低因RHF 30 d再入院率、NT-proBNP水平及不良反应发生率,值得临床应用与推广。