论著

HER-2联合血清肿瘤标志物检测在胃癌诊断中的临床价值

The value of HER-2 and tumor marker in the diagnosis of gastric cancer

:30-34
 
目的 分析在胃癌诊断中应用人表皮生长因子受体2(HER-2)结合肿瘤标志物检测的意义。方法 回顾性选取2019年6月—2021年6月我院收治的100例胃癌患者作为胃癌组,另选同期收治的60例胃良性肿瘤患者作为胃良性肿瘤组。比较HER-2与多项肿瘤标志物检测的诊断效能等。结果 胃癌组HER-2、糖类抗原(CA)125、CA72-4及CA19-9浓度与阳性表达率高于胃良性肿瘤组(P<0.05)。对于胃癌诊断,免疫组化指标HER-2检测的敏感度为72.00%,正确率为77.00%;多项肿瘤标志物检测的敏感度为77.00%,正确率为80.00%;二者联合检测的敏感度为89.00%,正确率为90.00%;相较于多项肿瘤标志物与HER-2单一检测,二者联合检验的正确率、敏感度更高(P<0.05)。结论 HER-2结合血清肿瘤标志物检验对胃癌的诊断价值较高。
Objective To analyze the significance of human epidermal growth factor receptor 2(HER-2)combined with tumor marker in the diagnosis of gastric cancer.Methods A total of 100 patients with gastric cancer admitted to our hospital from June 2019 to June 2021 were retrospectively selected as the gastric cancer group, and 60 cases of gastric benign tumor admitted to our hospital during the same period were also selected.The diagnostic efficacy of HER-2 was compared with those of multiple tumor markers.Results The concentration and positive expression rate of HER-2, carbohydrate antigen(CA)125, CA72-4 and CA19-9 in gastric cancer group were higher than those in gastric benign tumor group(P<0.05).For the diagnosis of gastric cancer, the sensitivity of the immunohistochemical indicator HER-2 detection was 72.00%, and the accuracy rate was 77.00%.The sensitivity and accuracy of detecting multiple tumor markers were 77.00% and 80.00%, respectively.The sensitivity of the combined detection of the two was 89.00%, and the accuracy was 90.00%.Compared to multiple tumor markers and HER-2 single detection, the combined test of the two had a higher accuracy and sensitivity(P<0.05).Conclusions The detection of HER-2 combined with serum tumor markers has high diagnostic value for gastric cancer.
论著

基于随机森林算法建立甲状腺功能减退患病风险预测模型

Establishing a hypothyroidism risk prediction model based on random forest algorithm

:16-24
 
目的 基于随机森林方法构建甲状腺功能减退(简称甲减)患病风险预测模型。方法 从MIMIC-IV数据库纳入5 735名甲减患者为病例组,4 803名非甲减患者为对照组,基于随机森林模型进行建模。同时利用逻辑回归、贝叶斯正则化神经网络、XGBoost作为比较模型。最后用准确率、F1分数、精确率、召回率、特异性以及AUC值评价四个机器学习模型性能。结果 随机森林模型准确率为0.85,F1分数为0.84,精确率为0.84,召回率为0.84,特异性为0.86,AUC值为0.91。在该模型中,促甲状腺激素、年龄、绝对淋巴细胞计数、血液中红细胞数、中性白细胞、性别、碱性磷酸酶、丙氨酸氨基转移酶、嗜酸性粒细胞绝对计数、尿素氮为甲减患者诊断重要性排前10的指标。结论 采用随机森林方法构建的甲减患病预测模型为甲减的早期诊断有潜在应用价值。
Objective To construct a risk prediction model for hypothyroidism based on the random forest model.Methods A total of 5 735 hypothyroidism patients were included from the MIMIC-IV database as the case group, and 4 803 non-hypothyroidism patients were included as the control group.Random forest models were constructed for both groups, and logistic regression, Bayesian regularized neural network, and XGBoost were used as comparative models.The performance of the four machine learning models was evaluated using accuracy, F1 score, precision, recall, specificity, and AUC value.Results The random forest model had an accuracy of 0.85, an F1 score of 0.84, a precision of 0.84, a recall of 0.84, a specificity of 0.86, and an AUC value of 0.91.In this model, thyroid-stimulating hormone, age, absolute lymphocyte count, red blood cell count in blood, neutrophil, gender, alkaline phosphatase, aspartate aminotransferase, absolute eosinophil count, and blood urea nitrogen were the top 10 indicators for diagnosing hypothyroidism patients.Conclusions The hypothyroidism disease prediction model constructed using the random forest method has potential application value for the early diagnosis of hypothyroidism.
论著

CT征象在预测亚实性肺腺癌结节侵袭风险中的价值

Value of CT signs in predicting the risk of invasion of subsolid lung adenocarcinoma nodules

:46-51
 
目的 探讨亚实性肺腺癌结节CT征象在预测侵袭风险中的价值。方法 选取经胸部CT检查发现并经病理证实为肺腺癌的亚实性结节共76个病灶,病灶分为侵袭前组与侵袭组2组,分析结节CT征象,行统计学分析,明确亚实性肺腺癌结节侵袭性的预测因素。结果 侵袭前组(包括原位腺癌、微浸润性腺癌)共31例;侵袭组[浸润性腺癌(IAC)]共45例。2组在最大平均直径、结节平均CT值、结节形状、分叶、毛刺、胸膜牵拉征、有无实性成分、肿瘤微血管CT成像征间比较差异有统计学意义(P<0.05),而在空泡征、空气支气管征方面比较差异无统计学意义(P>0.05)。结节最大直径预测浸润性腺癌侵袭性界值为13.63 mm,敏感度、特异度分别为68.9%、96.8%,AUC为0.885;平均CT值预测IAC侵袭性界值为-528 HU,敏感度、特异度分别为84.4%、83.9%,AUC为0.867。回归分析显示病灶最大平均直径(OR=2.015、P=0.01)可以作为浸润性肺腺癌结节的独立预测因子。结论 亚实性肺腺癌结节侵袭前组和侵袭组在最大直径、平均CT值、形状、分叶、毛刺、微血管征存在差异;结节的最大平均直径是IAC的独立预测因子。
Objective To investigate the value of CT signs in predicting the risk of invasion of subsolid lung adenocarcinoma nodules.Methods A total of 76 subsolid pulmonary adenocarcinoma nodules detected by chest CT and pathologically confirmed were selected,and the lesions were divided into pre-invasion group and invasion group.CT signs of nodules were analyzed and statistical analysis was performed to determine the predictive factors of invasion of subsolid pulmonary adenocarcinoma nodules.Results There were 31 cases in the pre-invasion group(including adenocarcinoma in situ and minimally invasive adenocarcinoma)and 45 cases ininvasion group[invasive adenocarcinoma(IAC)].There were significant differences in maximum mean diameter,mean CT value of nodule,nodule shape,lobule,burr,pleural stretch sign,solid component and microvascular CT imaging signs between the two groups(P<0.05),but there were no significant differences in vacuole sign and air bronchial sign between the two groups(P>0.05).The maximum diameter of nodules predicted the invasion boundary of invasive adenocarcinoma was 13.63 mm,the sensitivity and specificity were 68.9% and 96.8%,respectively,and the AUC was 0.885.The mean CT value predicted the invasive boundary of IAC was -528 HU,the sensitivity and specificity were 84.4% and 83.9%,respectively,and the AUC was 0.867.Regression analysis showed that the maximum mean lesion diameter(OR=2.015,P=0.01)was an independent predictor of infiltrating lung adenocarcinoma nodules.Conclusions There were differences in the maximum diameter,mean CT value,shape,lobed,burr and microvascular signs between the pre-invasion group and the invasion group.The maximum mean diameter of nodules was an independent predictor of IAC.
论著

不同贫血类型患者铁蛋白水平、甲状腺功能检测结果对比分析

Comparative analysis of ferritin level and thyroid function in patients with different types of anemia

:29-34
 
目的 探讨不同贫血类型患者铁蛋白水平、甲状腺功能检测结果对比分析。方法 前瞻性选取2018年11月—2021年11月我院收治的240例贫血患者作为研究对象。将患者分为小细胞低色素性贫血组(n=75),正细胞性贫血组(n=100)和大细胞性贫血组(n=65)。检查患者甲状腺功能[甲状腺素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)]和铁蛋白(SF)表达水平。采用Spearman检验进行相关性分析;采用Logistics回归模型进行回归分析。结果 3组患者红细胞(RBC)、血红蛋白(Hb)、平均红细胞容积(MCV)、红细胞平均血红蛋白浓度(MCHC)、平均红细胞血红蛋白含量(MCH)、血清肌酐(Scr)间存在差异(P<0.05);大细胞性贫血组TSH、FT3和SF低于正细胞性贫血组和小细胞低色素性贫血组(P<0.05),而FT4高于正细胞性贫血组和小细胞低色素性贫血组(P<0.05);贫血类型与TSH、FT4、FT3和SF呈正相关(P<0.05);多因素Logistics回归分析结果显示,TSH、FT4、FT3和SF在3个模型中均为独立危险因素(P<0.05)。结论 不同贫血类型患者间甲状腺功能和铁蛋白表达水平存在显著差异,大细胞性贫血组TSH、FT3和SF低于正细胞性贫血组和小细胞低色素性贫血组,而FT4更高,甲状腺功能指标和铁蛋白均是各种类型贫血发生的危险因素。
Objective To explore the comparative analysis of ferritin level and thyroid function detection results in patients with different types of anemia.Methods A total of 240 anemia patients admitted to our hospital from November 2018 to November 2021 were prospectively selected as research objects.The patients were divided into microcytic hypochromic anemia group(n=75),normocytic anemia group(n=100),and macrocytic anemia group(n=65).The expression levels of thyroid function[thyroxine(TSH),free triiodothyronine(FT3),free thyroxine(FT4)]and ferritin(SF)were examined.Correlation analysis was performed by Sperman test.The logistic regression model was adopted for regression analysis.Results There were significant differences in red blood cell,hemoglobin,mean corpuscular volume,mean corpuscular hemoglobin concentration,mean corpuscular hemoglobin content and serum creatinine among three groups(P<0.05).TSH,FT3 and SF in macrocytic anemia group were significantly lower than those in normocytic anemia group and microcytic hypochromic anemia group(P<0.05),while FT4 was significantly higher than that in normocytic anemia group and microcytic hypochromic anemia group(P<0.05).The type of anemia was positively correlated with TSH,FT4,FT3 and SF(P<0.05).The results of multi-factor logistics regression analysis showed that TSH,FT4,FT3 and SF were independent risk factors in the three models(P<0.05).Conclusions There were significant differences in thyroid function and ferritin expression levels among patients with different types of anemia.Macrocytic anemia group TSH,FT3 and SF were lower than those in normocytic anemia group and microcytic hypochromic anemia group,while FT4 was higher.Both thyroid function indexes and ferritin were risk factors for various types of anemia.
论著

河源市源城区2 468例儿童呼吸道感染病原体核酸检测结果分析

Analysis of nucleic acid detection results of respiratory tract infection pathogens in 2 468 children in Yuancheng District of Heyuan City

:17-21
 
目的 分析不同年龄、不同季节河源市源城区呼吸道感染的病原学情况,指导临床用药。方法 回顾性研究2020年3月—2022年2月2 468例呼吸道感染的住院患儿,取咽部分泌物送广州达安临床检验中心进行呼吸道核酸六项检测并分析结果。包括:肺炎链球菌(Sp)、呼吸道合胞病毒(RSV)、卡他莫拉菌(MC)、流感嗜血杆菌(Hi)、肺炎支原体(LP)、腺病毒(ADV)。结果 (1)2 468例患儿的标本中阳性率52.8%,其中RSV最高,其他依次为Sp、Hi、MC、MP、ADV。而混合感染仅次于RSV。(2)婴儿组和幼儿组以RSV感染为主,在学龄前组和学龄组儿童中,以Sp感染为主,各病原体的混合感染组合很多,一种细菌合并一种病毒多见。(3)秋冬季是河源市源城区呼吸道感染的高发季节,RSV是秋冬季呼吸道感染最主要的病原体。结论 秋冬季节为河源市源城区呼吸道感染的高发季节,RSV为该季节的主要病原体。RSV也是婴幼儿组感染的主要致病菌,随着年龄增大,细菌感染导致的呼吸道疾病逐渐占优势。混合感染在各年龄组中均占比较高,值得临床诊疗的重视。
Objective To analyze the etiology of respiratory tract infection in Yuancheng District of Heyuan City ,which was in different ages and seasons,and to provide guidance of clinical drug usage.Methods Cases of 2 468 hospitalized children with respiratory tract infection from March 2020 to February 2022 were analyzed.The secretion from pharynx was collected and sent to Guangzhou Da’an Clinical Examination Center for six respiratory nucleic acid tests and then the results were analyzed,including Streptococcus pneumoniae(Sp),respiratory syncytial virus(RSV),Moraxella catarrhalis(MC),Haemophilus influenzae(Hi),Mycoplasma pneumonia(MP),adenovirus(ADV).Results The positive rate of 2 468 hospitalized children with respiratory tract infection was 52.8%,of which the highest was RSV,followed by Sp,Hi,MC,MP,ADV.Meanwhile the mixed infection rate was second to RSV.RSV infection was the main infection in infant group and early-aged children group,while in preschool group and school-aged group,Sp infection was the main infection.There were many mixed infection of pathogen,and one bacteria combined with one virus was more common.Respiratory tract infection had high incidence in autumn and winter in Yuancheng District of Heyuan City,RSV was the major pathogen.Conclusions Autumn and winter were the seasons with high respiratory tract infection incidence in Yuancheng District of Heyuan City,and RSV was the main pathogen in these two seasons.RSV was also the main pathogen of infant group infection.But with the increase of children’s age,bacterial infection became the main reason of respiratory tract diseases.Mixed infection accounts for a high proportion in all age groups,which should be valued in clinical diagnosis and treatment.
论著

血清ADPN、CA125及AMH检测在PCOS中的临床分析

Clinical diagnostic value of serum ADPN,CA125 and AMH levels in polycystic ovary syndrome

:79-83
 
目的 探讨血清脂联素(ADPN)、糖类抗原125(CA125)及抗苗勒管激素(AMH)水平检测在多囊卵巢综合征(PCOS)中的临床诊断价值。方法 选取2022年1月—2022年9月在东莞市中医院经鹿特丹诊断标准确诊的100例PCOS患者作为PCOS组;PCOS组通过测定患者体质量指数(BMI)是否大于28 kg/m2分为肥胖组和非肥胖组;测定患者的睾酮水平的高低是否大于80 ng/dL分为高雄激素组和非高雄激素组。另选身体健康、年龄与PCOS组相近的100名健康女性作为对照组。分别测定PCOS组和对照组的ADPN、CA125以及AMH,分析血清ADPN、CA125、AMH在PCOS患者中的检测价值。结果 POCS组的BMI、AMH、CA125、睾酮、ADPN与健康组比较差异均有统计学意义(P<0.05)。与对照组比较,PCOS组的BMI、AMH、CA125、睾酮水平升高、ADPN水平降低。PCOS患者的CA125与AMH水平呈正相关(P<0.05),ADPN与AMH无关(P>0.05)。结论 PCOS 患者血清CA125和AMH水平升高,ADPN水平降低。
Objective To explore the clinical diagnostic value of serum adiponectin(ADPN),carbohydrate antigen 125(CA125)and anti-Mullerian hormone(AMH)levels in polycystic ovary syndrome(PCOS).Method A total of 100 patients confirmed with PCOS in Dongguan Traditional Chinese Medicine Hospital from January 2022 to September 2022 were selected as the study subjects.All patients were diagnosed with PCOS according to the 2003 Rotterdam diagnostic criteria,and served as the PCOS group.The PCOS group was divided into obese and non obese group by measuring the patient’s body mass index(BMI)whether was greater than 28 kg/m2.A high androgen group and a non high androgen group were determined by whether the patient’s testosterone level is greater than 80 ng/dL.A hundred healthy women of similar age were selected as the healthy control group.The levels of ADPN,CA125 and AMH were measured in the experimental and control group,and their detection value were analyzed.Results BMI,AMH,CA125,testosterone and ADPN in the POCS group were statistically different compared to the healthy group(P<0.05).Compared with the PCOS group,the control group showed a significant increase in BMI,AMH,CA125 and testosterone levels,while the PCOS group showed a decrease in ADPN level.There was a positive correlation between CA125 and AMH in patients with PCOS,while there was no correlation between ADPN and AMH.Conclusions The levels of serum CA125 and AMH in PCOS patients significantly increased,while the level of ADPN decreased.The three indicators have good diagnostic value in PCOS and are worth promoting.
论著

子宫瘢痕的超声弹性成像结合厚度分析对剖宫产后再妊娠产妇子宫破裂的预测应用

Application of ultrasound elasticity imaging combined with thickness analysis for prediction of uterine rupture in pregnant women after cesarean section

:40-45
 
目的 探讨子宫瘢痕的超声弹性成像结合厚度分析对剖宫产后再妊娠产妇子宫破裂的预测应用。方法 选择2020年1月—2021年12月在中山市中医院分娩的剖宫产术后再次妊娠经阴道分娩(VBAC)产妇作为研究对象。根据纳入和排除标准,共纳入子宫破裂的VBAC产妇32例、非子宫破裂的VBAC产妇90例。通过住院病历信息系统查询研究对象的基本信息及其在妊娠晚期(≥37周)用B超对研究对象行子宫瘢痕厚度和弹性的测量结果,采用受试者工作特征曲线(ROC)曲线分析子宫瘢痕厚度和弹性SI值对子宫破裂的预测作用。结果 子宫破裂组中年龄>35岁、妊娠>2次、与上次剖宫产间隔<2年、新生儿体质量≥3 kg、单层缝合者的比例高于非子宫破裂组(P<0.05)。122例产妇子宫瘢痕厚度的均值为(3.42±0.49)mm,SI的均值为(2.57±0.45)。ROC曲线分析结果显示:子宫瘢痕厚度单独预测子宫破裂的曲线下面积(AUC)为0.805(95%CI:0.730~0.880,P<0.05),cut off值为3.05 mm,灵敏度为0.726,特异度为0.910,约登指数为0.636;子宫瘢痕SI单独预测子宫破裂的AUC为0.730(95%CI:0.635~0.824,P<0.05),cut off值为2.11,灵敏度为0.767,特异度为0.781,约登指数为0.548;子宫瘢痕厚度联合预测子宫破裂的AUC为0.874(95%CI:0.812~0.937,P<0.01),灵敏度为0.875,特异度为0.811,约登指数为0.686。子宫瘢痕厚度结合子宫瘢痕SI值预测子宫破裂的AUC高于单独使用子宫瘢痕厚度(Z=7.611,P=0.041)和子宫瘢痕SI值(Z=25.864,P=0.025)。结论 子宫瘢痕的超声弹性成像SI值联合子宫厚度可有效提高超声对于VBAC产妇子宫破裂的预测效能,具有一定的应用意义。
Objective To study the application of ultrasound elasticity imaging combined thickness analysis of uterine scar in predicting uterine rupture in women pregnant after cesarean section.Methods Pregnant women with vaginal birth after cesarean(VBAC)from January 2020 to December 2021 in Zhongshan Hospital of Traditional Chinese Medicine were selected as the research subjects.A total of 32 VBAC parturients with uterine rupture and 90 VBAC parturients without uterine rupture were included according to the inclusion and exclusion criteria.The basic information of the subjects was queried through the medical record information system of the hospital.In the third trimester(≥37 weeks),the thickness and elasticity of uterine scar were measured by ultrasound,and the predictive effect of uterine scar thickness and elastic SI value on uterine rupture was analyzed by ROC curve.Results Chi-square test showed that the incidence of uterine rupture was higher in patients with age>35 years,pregnancy>2 times,interval from last cesarean section<2 years,newborn weight≥3kg,and the proportion of uterine rupture in single suture was higher than that in double suture(P<0.05).The mean uterine scar thickness of 122 subjects was(3.42±0.49)mm,and the mean SI was(2.57±0.45).The area under curve(AUC)of uterine scar thickness alone for predicting uterine rupture was 0.805(95%CI:0.730-0.880,P<0.05),the cut off value was 3.05 mm,the sensitivity was 0.726,the specificity was 0.910,and the Youden coefficient was 0.636 by ROC curve analysis.The AUC of uterine scar SI alone for predicting uterine rupture was 0.730(95%CI:0.635-0.824,P<0.05),the cut off value was 2.11,the sensitivity was 0.767,the specificity was 0.781,and the Youden coefficient was 0.548 by ROC curve analysis.The AUC of uterine scar thickness combination for predicting uterine rupture was 0.874(95%CI:0.812-0.937,P<0.01),the sensitivity was 0.875,the specificity was 0.811,and the Youden coefficient was 0.686 by ROC curve analysis.The AUC predicted by uterine scar thickness combined with uterine scar SI value was higher than that predicted by uterine scar thickness alone(Z=7.611,P=0.041)and uterine scar SI value(Z=25.864,P=0.025).Conclusions Elastic SI value of ultrasound imaging of uterine scar combined with uterine thickness can effectively improve the prediction efficiency of ultrasound for VBAC maternal uterine rupture,which has certain application significance,but further demonstration is still needed.
临床诊疗

基于倾向性评分匹配分析系统免疫炎症指数对早、中期肝细胞癌术后早期复发的预测价值

:83-89
 
目的 分析早、中期肝细胞癌(HCC)切除术后早期(≤2年)复发的危险因素并探讨术前系统免疫炎症指数(SII)对早、中期HCC术后早期复发的预测价值。方法 回顾性研究2017年10月—2020年10月于我院接受肝癌根治性切除术的238例早中期HCC患者,收集基线资料,通过1∶1倾向性评分匹配(PSM)均衡组间协变量获取早期复发组及未复发组各69例;单因素和多因素Logistic回归分析影响术后早期HCC复发的相关因素,构建列线图模型,临床决策曲线(DCA)评估列线图预测模型在临床的应用效果;受试者操作特征(ROC)曲线评价预测效能,根据最高约登指数确定截断点。结果 单因素及多因素Logistic回归分析结果均提示微血管侵犯(MVI)及术前系统免疫炎症指数(SII)高水平是术后早期复发的独立危险因素;列线图模型有较好的预测效能;ROC曲线计算出SII最佳临界值为696.85×109/L。结论 术前高水平SII可能对预测HCC患者术后早期复发具有潜在价值。
论著

呼出气一氧化氮测定在指导慢性阻塞性肺疾病急性加重患者使用全身激素的价值

Value of exhaled nitric oxide measurement in guiding the use of systemic glucocorticoid in patients with acute exacerbation of chronic obstructive pulmonary disease

:58-62
 
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.
临床诊疗

血清NSE及aEEG动态变化早期预测窒息新生儿脑损伤的意义

:100-104
 
目的 探究血清神经元特异性烯醇化酶(NSE)、振幅整合脑电图(aEEG)动态变化对早期预测窒息新生儿脑损伤的临床意义。方法 选择2022年3月–2023年3月在我院新生儿重症监护室接受治疗的窒息新生儿作为研究对象。按窒息程度分组:轻度窒息30例为A组,重度窒息30例为B组,无窒息的30例足月儿为C组。记录A、B、C组患儿出生后的血清NSE及aEEG,包括出生后24 h、3 d、7 d的血清NSE,出生后6 h、3 d、7 d的aEEG,了解血清NSE及aEEG变化。结果 B组在出生后24 h、3 d、7 d的血清NSE高于A组、C组,组间比较差异有统计学意义(P<0.05)。出生后6 h、3 d、7 d,aEEG背景活动、睡眠觉醒周期、痫性活动和窒息程度紧密相关。结论 血清NSE、aEEG可作为窒息新生儿脑损伤的监测,对于早期预测脑损伤极具临床应用价值。
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