目的 观察慢性阻塞性肺疾病急性加重期（AECOPD）患者应用基于Caprini量表评估的干预模式联合充气加压泵（IPC）预防静脉血栓（VTE）的效果。方法 选取河南省人民医院在2023年11月—2024年11月收入的82例AECOPD患者作为研究对象，经随机数表法分为对照组41例予以VTE常规干预，观察组41例在对照组的基础上接受基于Caprini量表评估的干预模式联合IPC预防。比较两组AECOPD患者肢体情况及深静脉血栓（VTE）发生情况、凝血指标及股静脉血流速度。结果 观察组肢体肿胀率、肢体疼痛率及VTE发生率均低于对照组（P＜0.05）。干预前，两组AECOPD患者凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体水平比较差异无统计学意义（P＞0.05）；干预后，两组患者TT、PT、APTT、D-二聚体水平均降低，观察组较低（P＜0.05）。干预前，两组AECOPD患者平均流速、血流峰速及阻力指数比较差异无统计学意义（P＞0.05）；干预后，两组患者平均流速、血流峰速均升高，观察组高于对照组（P＜0.05）；阻力指数均降低，观察组低于对照组（P＜0.05）。结论 AECOPD患者应用基于Caprini量表评估的干预模式联合IPC能有效降低肢体肿胀率、肢体疼痛率及VTE发生率，改善凝血指标与股静脉血流速。

   Objective To observe the effect of a Caprini score?based intervention model combined with intermittent pneumatic compression（IPC）in preventing venous thromboembolism（VTE）in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods A total of 82 AECOPD patients admitted to Henan Provincial People’s Hospital from November 2023 to November 2024 were selected as subjects and randomly divided into a control group（41 cases）and an observation group（41 cases）using a random number table．The control group received routine VTE prevention，while the observation group received the Caprini score?based intervention combined with IPC in addition to the routine care．The extremity conditions，occurrence of VTE，coagulation parameters，and femoral venous blood flow velocity were compared between the two groups．Results The rates of extremity swelling，extremity pain，and VTE incidence in the observation group were lower than those in the control group（P＜0.05）．Before the intervention，there were no statistically significant differences in thrombin time（TT），prothrombin time（PT），activated partial thromboplastin time（APTT），or D?dimer levels between the two groups（P＞0.05）．After the intervention，TT，PT，APTT，and D?dimer levels decreased in both groups，with lower values in the observation group（P＜0.05）．Before the intervention，there were no statistically significant differences in mean flow velocity，peak flow velocity，or resistance index between the two groups（P＞0.05）．After the intervention，mean flow velocity and peak flow velocity increased in both groups，with higher values in the observation group（P＜0.05），while the resistance index decreased，with a lower value in the observation group（P＜0.05）．Conclusions The application of a Caprini score?based intervention model combined with IPC in AECOPD patients can effectively reduce the rates of extremity swelling，extremity pain，and VTE incidence，and improve  coagulation parameters and femoral venous blood flow velocity．

       目的   探讨慢性阻塞性肺疾病急性加重期血嗜酸性粒细胞（EOS）、血清白细胞介素-5（IL-5）水平与第一秒用力呼气容积（FEV1）、第一秒用力呼气容积与用力肺活量的比值（FEV1/FVC）、用力肺活量（FVC）的相关性。方法   纳入2023年3月—2024年3月于佛山市顺德区第五人民医院住院的73例慢性阻塞性肺疾病急性加重期患者，以2%作为外周血EOS比例（EOS%）截断值分为两组，研究组（EOS%≥2%）34例，对照组（EOS%＜2%）39例，收集两组患者_{的一般临床资料、实验室检查结果、肺功能检查结果（FEV1}、FVC、FEV₁/FVC），比较组间差异，分析指标间的相关性。结果   对照组与实验组患者EOS%分别为0.5（0.1，0.9）%、5.15（2.60，10.05）%，两组患者EOS%差异有统计学意义（P＜0.05）。对照组与实验组患者IL-5水平分别为0.98（0.56，1.78）ng/L、3.6（1.73，6.77）ng/L，两组IL-5水平差异有统计学意义（P＜0.05）。对照组FEV₁（L）、FVC（L）、FEV₁/FVC水平分别为1.32（1.18，1.58）、2.07（1.92，2.62）、0.62（0.57，0.67）；实验组分别为1.24（1.00，1.52）、2.22（1.94，2.56）、0.58（0.47，0.67），两组FEV₁、FVC、FEV₁/FVC水平差异均无统计学意义（P＞0.05）。Spearman等级相关检验结果显示，EOS%与IL-5水平呈正相关（rs=0.870，P＜0.001）；按组别进行分层后结果显示，对照组、试验组EOS%与IL-5水平均呈正相关（r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）。EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（r_s=0.039，P＞0.05）。对照组EOS%、IL-5水平与FEV₁、FEV₁/FVC、FVC不相关（P＞0.05）；实验组EOS%、IL-5水平与FEV₁、FEV₁/FVC呈负相关（P＜0.05），与FVC不相关（P＞0.05）。结论 慢性阻塞性肺疾病急性加重期血EOS%与血清IL-5水平呈正相关，外周血EOS%≥2%时血EOS%、血清IL-5与FEV₁、FEV₁/FVC呈负相关，与FVC无关。

       Objective  To explore the correlation among blood eosinophil levels，serum interleukin-5（IL-5）levels，and forced expiratory volume in one second（FEV₁），the ratio of forced expiratory volume in one second to forced vital capacity（FEV₁/FVC），and forced vital capacity（FVC）during the acute exacerbation of chronic obstructive pulmonary disease（AECOPD）．Methods  From March 2023 to March 2024，73 patients hospitalized for AECOPD at Shunde District Fifth People’s Hospital of Foshan City were included，and divided into two groups based on a cutoff value of 2% for peripheral blood eosinophil（EOS%）．The experimental group（EOS%≥2%）included 34 patients，while the control group（EOS%＜2%）included 39 patients．General clinical data，laboratory test results，and pulmonary function test results（FEV₁，FVC，FEV₁/FVC）were collected from both groups．Results  The median quartiles of EOS% for the control group and experimental group were 0.5（0.10.9）% and 5.15（2.60，10.05）%，respectively．There was a statistically significant difference between the EOS% of two groups（P＜0.05）．The median quartiles of IL-5 levels for the control group and experimental group were 0.98（0.56，1.78）ng/L and 3.6（1.73，6.77）ng/L，respectively．There was also a statistically significant difference in IL-5 levels between the two groups（P＜0.05）．For the control group，the median quartiles of FEV₁，FVC，and FEV₁/FVC were 1.32（1.18，1.58），2.07（1.92，2.62）and 0.62（0.57，0.67），respectively．For the experimental group，they were 1.24（1.00，1.52），2.22（1.94，2.56）and 0.58（0.47，0.67）respectively．There was no statistically significant difference between the two groups in FEV₁，FVC and FEV₁/FVC levels（P＜0.05）．Spearman rank correlation analysis showed a positive correlation between EOS% and IL-5 level （r_s=0.870，P＜0.001）．Stratified by group，both the control and experimental groups showed a positive correlation between EOS% and IL-5 level （r_s=0.820，P＜0.001；r_s=0.938，P＜0.001）．There was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．In the control group，there was no correlation between EOS%，IL-5 level，and FEV₁，FEV1/FVC，or FVC（P＞0.05）．In the experimental group，there was a negative correlation between EOS%，IL-5 level，and FEV₁，FEV₁/FVC（P＜0.05），but no correlation with FVC（P＞0.05）．Conclusions  During AECOPD，blood EOS% is positivelycorrelated with serum IL-5 levels．When peripheral blood eosinophils are ≥2%，blood EOS%，serum IL-5，and FEV₁，FEV₁/FVC are negatively correlated，while there is no correlation with FVC．

目的 探讨复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期患者的疗效。方法 选取张掖市第二人民医院2020年1月—2023年10月收治的128例特发性肺间质纤维化急性加重期患者,应用随机数字表法分为两组,每组各64例。对照组采取泼尼松治疗,观察组采取复方甘草口服液联合泼尼松治疗。对比其临床疗效,治疗前后血清肺纤维化指标及炎症因子水平,最后对比其不良反应发生率。结果 观察组总有效率93.75%,高于对照组的79.69%（χ²=5.490,P=0.019）;治疗前两组层黏连蛋白（LN）、Ⅲ型前胶原肽（PC-Ⅲ）、透明质酸（HA）对比差异无统计学意义（P>0.05）,治疗后两组患者LN、PC-Ⅲ、HA均降低,观察组[（89.25±7.61）μg/L;（68.33±7.68）mg/L;（81.53±8.54）μg/L]低于对照组[（96.17±8.34）μg/L;（75.68±8.25）mg/L;（95.68±9.25）μg/L],对比差异有统计学意义（t₁=4.903,P₁<0.001;t₂=5.217,P₂<0.001;t₃=8.992,P₃<0.001）;治疗前两组患者肿瘤坏死因子-α（TNF-α）、白细胞介素-4（IL-4）、IL-10、转化生长因子（TGF-β1）对比差异无统计学意义（P>0.05）,治疗后两组TNF-α、IL-4、IL-10、TGF-β1水平降低,观察组[（61.94±8.24）ng/L;（4.43±1.17）ng/mL;（65.49±13.24）g/L;（114.73±13.12）pg/mL]低于对照组[（75.52±9.43）ng/L;（6.31±1.28）ng/mL;（79.27±9.38）g/L;（147.76±15.46）pg/mL],对比差异有统计学意义（t₁=8.675,P₁<0.001;t₂=8.673,P₂<0.001;t₃=6.794,P₃<0.001;t₄=13.032,P₄<0.001）;两组不良反应发生率对比差异无统计学意义（7.81% vs 6.25%,χ²=0.120,P=0.730）。结论 复方甘草口服液联合泼尼松治疗特发性肺间质纤维化急性加重期疗效显著,可辅助延缓患者肺纤维化发展进程,减轻机体炎症反应,安全性较高。

Objective To investigate the efficacy of compound licorice oral liquid combined with prednisone in patients with acute exacerbations of idiopathic pulmonary interstitial fibrosis. Methods A total of 128 patients with acute exacerbation of idiopathic pulmonary interstitial fibrosis admitted to Zhangye Second People's Hospital from January 2020 to October 2023 were divided into two groups by random number table method,with 64 patients in each group．The control group received prednisone treatment,while the observation group received compound licorice oral liquid combined with prednisone treatment．Compare its clinical efficacy,serum pulmonary fibrosis indicators and inflammatory factor levels before and after treatment,and finally compare its incidence of adverse reactions. Results The total response rate in the observation group was 93.75%,which was higher than the 79.69% in the control group（χ²=5.490,P=0.019）．There was no difference between the two groups of LN,PC-III,and HA（P>0.05）,LN,PC-III and HA were decreased in both groups,while the observation group[（89.25±7.61）μg/L;（68.33±7.68）mg/L;（81.53±8.54）μg/L] was lower than the control group[（96.17±8.34）μg/L;（75.68±8.25）mg/L;（95.68±9.25）μg/L],the contrast difference was statistically significant（t₁=4.903,P₁<0.001;t₂=5.217,P₂<0.001;t₃=8.992,P₃<0.001）．There was no difference in TNF-α,IL-4,IL-10,and TGF-β1 between the two groups before treatment（P>0.05）,lower levels of TNF-α,IL-4,IL-10,and TGF-β1 in the two patient groups after treatment,the observation group[（61.94±8.24）ng/L;（4.43±1.17）ng/mL;（65.49±13.24）g/L;（114.73±13.12）pg/mL] was lower than the control group[（75.52±9.43）ng/L;（6.31±1.28）ng/mL;（79.27±9.38）g/L;（147.76±15.46）pg/mL],the contrast difference was statistically significant（t₁=8.675,P₁<0.001;t₂=8.673,P₂<0.001;t₃=6.794,P₃<0.001;t₄=13.032,P₄<0.001）．There was no difference in the incidence of adverse effects between the two groups（7.81% vs 6.25%,χ²=120,P=0.730）. Conclusions The combination of compound licorice oral liquid and prednisone has a significant therapeutic effect on the acute exacerbation of idiopathic pulmonary interstitial fibrosis．It can assist in delaying the progression of pulmonary fibrosis in patients,reducing the body's inflammatory response,and has high safety．

目的 探析慢性阻塞性肺疾病急性加重（AECOPD）患者在全身糖皮质激素（激素）使用过程中检测呼出气一氧化氮（FeNO）的价值。方法 于2019年1月—2021年12月梅州市人民医院采集病例展开随机对照研究,实施对象为58例AECOPD患者,均检测FeNO水平,根据FeNO水平是否>25 ppb,分组为FeNO高水平组和FeNO低水平组,根据是否接受全身激素治疗分为治疗组和对照组,对照组予以常规治疗,治疗组实行常规+全身激素治疗;检测治疗前后FeNO、肺功能指标水平变化,判定COPD评估测试（CAT）评分,对比组间差异。结果 FeNO高水平组全身激素治疗后（治疗组）FeNO降低（P<0.05）,高水平组常规治疗后（对照组）FeNO前后比较差异无统计学意义（P>0.05）,低水平组中治疗组和对照组治疗前后FeNO比较差异无统计学意义（P>0.05）;FeNO高水平组治疗后第一秒用力呼气容积（FEV₁）、第一秒用力呼气量占用力肺活量比值（FEV₁/FVC）均升高,且治疗组升高程度较对照组更大（均P<0.05）,FeNO低水平组治疗后FEV₁、FEV₁/FVC均升高（均P<0.05）,但治疗组与对照组相比无差异（P>0.05）;FeNO高水平组、低水平组治疗后CAT评分较治疗前均下降（均P<0.05）,FeNO高水平组下降更明显。结论 AECOPD患者实施FeNO测定,其水平变化在一定程度上可反映气道炎症,并预测激素治疗反应,指导合理有效地应用全身激素,避免出现激素过度使用情况。

Objective To explore the value of detecting exhaled nitric oxide(FeNO)during systemic glucocorticoid use in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A randomized controlled study was conducted from January 2019 to December 2021 at the People's Hospital of Meizhou City. The subjects were 58 AECOPD patients,all of whom were tested for FeNO levels. Based on whether the FeNO levels were>25 ppb,they were divided into a high level FeNO group and a low level FeNO group. They were divided into a treatment group and a control group based on whether they received systemic glucocorticoid therapy. The control group received routine treatment,while the treatment group received routine and systemic glucocorticoid therapy. Changes in FeNO and lung function indicators before and after treatment were detected,COPD assessment test(CAT)scores were determined,and differences between groups were compared. Results After systemic glucocorticoid therapy,the high level group of FeNO showed a decrease in FeNO(P<0. 05),while the high level group showed no statistically significant difference in FeNO before and after routine treatment(P>0. 05). The low level group showed no statistically significant difference in FeNO between the treatment group and the control group before and after treatment(P>0. 05). The first second forced expiratory volume(FEV₁)and the ratio of first second forced expiratory volume to forced vital capacity(FEV₁/FVC)in the high level group of FeNO significantly increased after treatment,and the degree of increase in the treatment group was greater than that in the control group(all P<0. 05). The FEV₁ and FEV₁/FVC in low level group of FeNO significantly increased after treatment(all P<0. 05),but the difference between the treatment group and the control group was not significant(P>0. 05). The CAT scores of the high and low levels of FeNO groups decreased after treatment compared to before treatment(all P<0. 05),and the decrease was more significant in the high level FeNO group. Conclusions The implementation of FeNO measurement in AECOPD patients can reflect airway inflammation to a certain extent,predict glucocorticoid treatment response,guide the rational and effective application of systemic glucocorticoid and avoid excessive glucocorticoid use.

目的 本文旨在研究穿心莲内酯对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者血清学中的炎症反应因子及肺部功能改变的影响。方法 从我院已出院的患者中挑选2017年6月—2018年6月期间收治的AECOPD患者共80例,其中给予哌拉西林舒巴坦抗感染和雾化吸入布地奈德及复方异丙托溴铵治疗的患者为对照组,对照组的治疗方法基础上给予喜炎平注射液的患者为观察组,各40例。对2组患者接受治疗前后血清学中的基质金属蛋白酶-9 (matrix metalloproteinase-9, MMP-9)、降钙素原 (procalcitonin, PCT)、白介素-6 (interleukin-6, IL-6) 水平和肺功能指标等方面进行比较。结果 2组治疗前血清学MMP-9、PCT、IL-6和肺功能指标第1秒用力呼气容积(forced expiratory volume in one second, FEV1)、用力肺活量(forced vital capacity, FVC)、一秒率(FEV1/FVC)无差异(P＞0.05)。观察组经过治疗后MMP-9为(1995.13±347.281)pg/mL、IL-6为(7.98±3.23)pg/mL,低于对照组的(2159.30±367.477)pg/mL、(10.03±5.45)pg/mL(P＜0.05);观察组治疗后的PCT、FEV1、FVC和FEV1/FVC与对照组相比差异无统计学意义 (P＞0.05)。结论 穿心莲内酯在AECOPD患者中可以减少血清学中炎症因子,值得在临床中推广。

Objective To investigate the effect of andrographolide on levels of serum inflammatory factors and pulmonary function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Eighty patients with AECOPD who were treated in our hospital from June 2017 to June 2018 were selected. Forty patients in the control group were given anti-infection treatment with piperacillin and sulbactam and aerosol inhalation with compound ipratropium bromide and budesonide, while other 40 patients in study group were given andrographolide additionally. The levels of serum matrix metalloproteinase-9 (MMP-9), procalcitonin (PCT), interleukin-6 (IL-6) and the pulmonary function indexes of patients in the two groups were observed and compared before and after treatment. Results There were no statistically significant differences in the serum levels of MMP-9, PCT and IL-6 and the pulmonary function indexes forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC of the two groups before treatment (P>0.05). After treatment, in the study group, the MMP-9 and IL-6 levels in serum were (1995.13±347.281)pg/mL and (7.98±3.23)pg/mL respectively, which were significantly lower than that in the control group [(2159.30±367.477) pg/mL and (10.03±5.45) pg/mL (P＜0.05)].Compared with the control group, differences in the PCT, FEV1, FVC and FEV1/FVC in the study group were not statistically significant (P>0.05). Conclusion Andrographolide had significant clinical effect on the treatment of AECOPD, which could reduce the levels of serum inflammatory factors and it is worthy of clinical application.

目的 探讨噻托溴铵喷雾剂(能倍乐)对合并有前列腺肥大(BPH)的慢性阻塞性肺疾病急性加重的影响。方法 2017年9月—2019年9月在我院呼吸与危重症医学科的AECOPD的男性患者167例,年龄51～96岁,平均(74.26±7.6)岁。分别为AECOPD组、AECOPD+噻托溴铵喷雾剂治疗组。比较AECOPD合并BPH与能倍乐的关系。结果 AECOPD患者合并有BPH的45人(52.94%),能倍乐治疗合并有BPH的AECOPD患者48人(58.53%),两组比较差异无统计学意义(P＞0.05)。其中,AECOPD患者合并有BPH患者中有10人(11.76%)出现尿频、夜尿多;尿潴留的4人(4.7%);同时口服哈乐和保列治的16人(18.82%);要置尿管导尿的5人(5.8%)。能倍乐治疗AECOPD患者合并有BPH患者中有7人(8.53%)出现尿频、夜尿多;尿潴留的1人(1.21%);同时口服哈乐和保列治的20人(24.39%);要置尿管导尿的3人(3.6%),比较差异均无统计学意义(P＞0.05)。结论 能倍乐不增加合并BPH的COPD患者的急性加重;也不增加治疗BPH的药物使用。能倍乐对于稳定期合并BPH的COPD患者治疗是安全的。

Objective To investigate the effect of Spiriva Respimat on acute exacerbation of COPD with benign prostatic hyperplasia(BPH). Methods The 167 patients who were hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD)(aged 51～96 years) with an average age of (74.26±7.6) years and the 82 patients treated with Spiriva Respimat in the department of respiratory and critical care medicine of our hospital from September 2017 to September 2019 were reviewed. In our pilot study, 48 AECOPD patients with BPH patients were enrolled as the treatment group and another 45 similar cases as the control group. In the former group Spiriva Respimat was administered and the control group was not. Results There were 45 patients (52.94%) with BPH in AECOPD group and 48 patients (58.53%) with BPH in Spiriva Respimat group. There was no statistical significance between the two groups (P>0.05). Among them, 10 patients (11.76%) with AECOPD and BPH had frequent urination and night urination, 4 patients (4.7%) of urinary retention, 16 patients (18.82%) who had oral Harnal and Finasteride, 5 patients (5.8%) need catheterization. In the AECOPD patients with BPH treated with Spiriva Respimat, 7 patients (8.53%) had frequent urination and night urination, 1 patient (1.21%) had urinary retention, 20 patients (24.39%) had oral Harnal and Finasteride, and 3 patients (3.6%) were managed through catheterization (P>0.05). Conclusion Spiriva Respimat does not increase the acute exacerbation of COPD patients with BPH, nor does it increase the use of drugs to treat BPH. It is safe to treat COPD patients with BPH in stable stage.

目的 探讨特发性肺纤维化(IPF)患者和结缔组织病相关性纤维化间质性肺疾病(CTD-fILD)患者急性加重(AE)的短期内死亡的危险因素。方法 回顾性分析2017年10月—2019年9月在深圳大学和广州医科大学附属第一医院住院的25例 AE-CTD-fILD和26例AE-IPF患者临床信息,Kaplan-Merier法对两组患者进行生存分析,Cox回顾分析年龄、性别、吸烟、白细胞总数、C反应蛋白、红细胞沉降率及肿瘤指标在急性加重患者死亡中的作用。结果 与AE-CTD-fILD比较,AE-IPF患者组男性比例、年龄、吸烟比例较高,红细胞沉降率较低(24/26 vs 10/25,P<0.001;63.77±9.97 vs 58.00±10.32,P=0.048;16/26 vs 9/25,P=0.02;28.07±29.45 vs 64.35±40.34,P=0.002 );90天内,26例AE-IPF患者11例死亡,25例AE-CTD-fILD患者5例死亡,死亡率无明显差异(42.3% vs 20%,P=0.073);Cox回归分析显示,白细胞计数是AE-IPF和AE-CTD-fILD患者的死亡危险因素(HR=1.305,P=0.001;HR=1.529,P=0.009);CA15-3是AE-IPF患者死亡危险因素(HR=1.015,P=0.005)。结论 急性加重IPF和CTD-fILD患者短期内死亡风险相似,白细胞计数及外周CA15-3水平可能是肺纤维化急性加重患者短期内死亡的危险因素。

Objective To explore the risk factors for acute exacerbation (AE) in patients with idiopathic pulmonary fibrosis (IPF) and connective tissue disease associated with fibrotic interstitial lung disease (CTD-fILD). Methods We retrospectively reviewed 25 patients with AE-CTD-fILD and 26 patients with AE-IPF, and Kaplan-Merier was used to analyze the survival of the two groups of patients. The impact of age,gender, smoking,WBC,CRP,ESR and tumor markers on acute exacerbation death were performed by Cox regression analysis. Results The AE-IPF patients had a higher proportion of men,age and smoking,and a lower ESR compared with AE-CTD-fILD patients(24/26 vs 10/25,P<0.001;63.77±9.97 vs 58.00±10.32,P=0.048;16/26 vs 9/25,P=0.02;28.07±29.45 vs 64.35±40.34,P=0.002 ). 11 cases of 26 patients with AE-IPF and 5 cases of 25 patients with AE-CTD-fILD died within 90 days, Log-rank tests showed patients with CTD-fILD had similar mortality rate compared with IPF patients after AE(42.3% vs 20%,P=0.073). The WBC count was negatively correlated with survival and the independent predictors for patients with AE-IPF and AE-CTD-fILD after adjusting for other clinical variates in Cox regression models(HR=1.305,P=0.001;HR=1.529,P=0.009). CA15-3 may be a risk factor for death of AE-IPF patients(HR=1.015,P=0.005). Conclusion AE-CTD-fILD and AE-IPF were associated with similar poor short-term survival, WBC count and plasma CA15-3 may be the independent survival predictors respectively for patients with acute exacerbation of pulmonary fibrosis in short term.

目的 探讨慢性阻塞性肺疾病急性期加重期(AECOPD)患者血清降钙素原(PCT)、白介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平变化及与肺功能的相关性。方法 选择121例COPD急性加重期患者为实验组研究对象,选取同期体检的80例稳定期COPD患者为对照组,比较两组患者血清PCT、IL-6、hs-CRP的差别,并对三者与COPD患者肺功能的相关性进行探讨。结果 实验组患者IL-6、hs-CRP水平显著高于对照组(P＜0.05)。实验组FEV1值、FEV1%显著低于对照组(P＜0.05)。Pearson分析显示,实验组hs-CRP与肺功能指标FEV1%呈负相关关系(r=-1.51,P=0.048)。结论 AECOPD患者的血清炎症因子水平明显高于COPD稳定期患者,血清炎症因子与慢阻肺患者肺功能损伤密切相关。

目的 观察氟伐他汀联合环磷腺苷葡胺治疗慢性肺心病急性加重期的临床疗效。方法 将我院收治的74例慢性肺心病急性加重期病人,使用随机数字表法分为联合用药组与对照组,每组各37例。对照组单独使用环磷腺苷葡胺,联合用药组在对照组的基础上加服氟伐他汀。两组疗程均为7周。观察比较两组患者治疗前后的NO,ET-1,CRP,PaO₂水平以及治疗效果。结果 经7周疗程治疗后,对照组有效率为64.86%,联合用药组94.59%。两组间比较,差异有统计学意义(P<0.05)。两组NO,ET-1,CRP,PaO₂水平比较,联合用药组均优于对照组,差异有统计学意义(P<0.05)。结论 氟伐他汀联合环磷腺苷葡胺治疗慢性肺心病急性加重期的临床疗效更为显著,值得临床推广。

Objective To observe the clinical efficacy of combined treatment of Fluvastatin combined with Meglumine Adenosine Cyclophosphate on acute exacerbation of chronic pulmonary heart disease. Methods 74 patients with acute exacerbation of chronic pulmonary heart disease were randomly divided into combined treatment group and control group. The control group was treated by Meglumine Adenosine Cyclophosphate for 7 weeks.The combined treatment group was treated by Meglumine Adenosine Cyclophosphate and Fluvastatin for 7 weeks. The clinical efficacy and the score of NO,CRP,ET-1,PaO₂ were assessed before and after the treatment. Results After 7 weeks treatment, the total clinical efficacy rate was 64.86% in the control group and 94.59% in the combined treatment group. The differences between them has statistically significant(P<0.05). The score of NO,ET-1,CRP,PaO₂ in combined treatment group were significantly improved compared to control group (P<0.05). Conclusion The clinical efficacy of Fluvastatin combined with Meglumine Adenosine Cyclophosphate on acute exacerbation of chronic pulmonary heart disease is more efficient. It is worth to develop clinically.

目的 评估灯盏花素联合自血穴位注射疗法治疗慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效。方法 对照组使用常规治疗方法,治疗组加用灯盏花素联合自血穴位注射疗法。所有入组患者在入院和出院当天进行圣乔治呼吸问卷(SGRQ)评分和COPD评估测试(CAT)评分,使用统计软件比较两组的SGRQ总评分、CAT评分和住院天数。结果 SGRQ总评分、CAT评分和住院天数有正相关关系;和对照组相比较,治疗组SGRQ总评分在治疗前后没有差异, CAT评分在治疗前后有差异,治疗组的住院天数减少。结论 SGRQ总评分、CAT评分能够反映AECOPD病情,CAT评分更加适合评估AECOPD短期病情变化,灯盏花素联合自血穴位注射疗法治疗AECOPD具有临床疗效。

Objective It was evaluated the clinical effect of the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with Breviscapine combined with self-blood acupoint injection therapy. Methods Routine treatment methods were used in the controlled group. Breviscapine and the self-blood acupoint injection therapy were added into the treatment group. St George's respiratory questionnaire (SGRQ) and chronic obstructive pulmonary disease assessment test (CAT) were done in all enrolled patients. And the total score of SGRQ, the score of CAT and the length of stay in hospital were assessed. Results There were positive relationships between the total score of SGRQ, the score of CAT and the length of stay in hospital.compared with the controlled group, before and after the treatment, significant difference was not observed with the overall score of SGRQ in the treatment group, but was observed with the score of CAT in the treatment group, and stay time in hospital in the treatment group was declined obviously. Conclusion The total score of SGRQ and the score of CAT could reflect the conditions of AECOPD, and the latter was more suitable for the evaluation of the condition change in short period. The clinical effects were obvious in the treatment of AECOPD with Breviscapine combined with self-blood acupoint injection therapy.