目的 探讨开展药学服务干预对中老年COPD患者用药时间以及剂量的准确性的影响。方法 选取100名中医科门诊中老年COPD患者,随机分为干预组与对照组,干预组开展参与中医药治疗方案的确立、用药的衡量以及对患者进行用药指导、疾病健康宣教、定期随访等药学服务。对照组不作相关的药学服务干预。结果 干预组服药时间依从性(97.89±1.11)%,剂量准确率(99.95±0.05)%,干预组患者用药依从性比对照组有提高;平均疗程(11.12±2.1)天,比对照组缩短,差异有统计学意义(P<0.05)。结论 药师通过药学服务提高了中老年COPD患者的用药依从性及准确性,从而缩短疗程,值得推广。

Objective To investigate the time of drug use and dose accuracy in middle aged and elderly patients with COPD to develop pharmaceutical care intervention. Methods 100 middle aged and elderly patients with COPD were selected from the department of traditional Chinese medicine, randomly divided into intervention group and control group, the intervention group was developed pharmaceutical care including taking part in setting of therapeutic schedule, pharmaceutical measurement and guide of drug use in patients, health education, regular visit etc. The control group did not have pharmaceutical care intervention. Results The time of taking medicine compliance was (97.89±1.11)% and dose accuracy was(99.95±0.05)% in the intervention group. The intervention group had significantly improved compared with the control group. The course of treatment was(11.12±2.1)days. The average course of treatment was shorter than the control group. The difference was statistically significant (P<0.05). Conclusion Medication compliance of middle aged and elderly patients with COPD is higher by pharmaceutical care from the pharmacists. The course of treatment is shortened. It is worth using widely.

目的 探讨纤维支气管镜吸痰联合镜下注药治疗慢性阻塞性肺疾病(COPD)的应用价值。方法 选择50例确诊慢性阻塞性肺疾病患者,随机分为A、B两组(每组25例),两组患者均予常规治疗,B组在常规治疗的基础上加予每周二次经纤维支气管镜吸痰和镜下注药治疗。通过观察比较2组治疗前后的症状、肺通气功能、动脉血气分析的变化及不良反应来评价疗效。结果 治疗两周后,B组患者的症状、肺通气功能、血气分析以及氧合指数较A组有明显改善,无明显不良反应。结论 纤维支气管镜吸痰联合镜下注药治疗慢性阻塞性肺疾病安全、有效,值得临床推广。

Objective To investigatethe utility of applying bronchoscopy combined with endoscopic injection in patients with chronic obstructive pulmonary disease. Methods 50 patients diagnosed with chronic obstructive pulmonary disease, were randomly divided into A, B groups (n=25,respectively). All the patients received internal routine treatment. Patients in group B received bronchoscopy and endoscopic injection therapy twice a week additionally. The efficacy was evaluated by comparing improvement of symptoms, pulmonary ventilation function and arterial blood gas analysis before and after treatment. The assessment of adverse reactions was also included. Results After two weeks of treatment, the patients in group B had been improved more significantly than the patients in group A, no significant adverse reactions were found. Conclusion It's safe and effective using bronchoscopy combined with endoscopic injection therapy for chronic obstructive pulmonary disease.

目的 探究自我管理干预对慢性阻塞性肺疾病(COPD) 稳定期患者的临床疗效影响。方法 选取2013年6月—2014年6月我院诊断的COPD稳定期患者90例,随机分为对照组(45例)和观察组(45例)。对照组只给予常规治疗,观察组在常规治疗基础上给予自我管理干预,包括健康教育和康复训练,之后通过比较两组患者肺功能、6MWD、生活质量问卷(SGRQ)评分、急性发病频率、依从性等方面的变化来探讨自我管理干预对COPD治疗的临床意义。结果 观察组患者肺功能和6MWD较对照组有改善,观察组的SGRQ得分、急性加重频率显著低于对照组,而其依从性比例明显高于对照组,两组间差异在统计学上均有意义(P<0.05)。结论 加强COPD稳定期自我管理干预能够改善COPD的预后,值得在临床上进行应用。

目的 回顾分析慢性阻塞性肺疾病急性加重期并或不并肺部结核感染在感染及营养方面指标的差异性,明确结核感染对AECOPD的影响。方法 选取2013年7月—2015年6月因急性发作入住我院的COPD患者105例,根据GOLD 2011对COPD的诊断标准及卫生部2008年制定的肺结核诊断标准将其分为无结核组、稳定期组、好转期组及进展期四组。分别在入院时测定患者白细胞计数、中性粒细胞比率、总淋巴细胞计数、淋巴细胞比值、红细胞沉降率、血红蛋白浓度、血清白蛋白及C反应蛋白及体重指数。结果 各组感染指标比较,WBC、CRP两指标差异不显著(P>0.05),而无结核组相较于其他三组,NEUT%更高(F=4.004,P=0.010)、LY%及ESR更低(F/P分别为3.668/0.015和20.197/0.000);各组营养指标比较,合并有肺结核的三组,其Hb、ALB及BMI均比无结核组低,达到统计学差异(P<0.05),而TLC在各组间无差异(F=0.858,P=0.466)。结论 合并有结核感染的AECOPD患者更容易出血贫血(Hb降低)、低蛋白血症(ALB降低)、低体重(BMI降低)、中性粒细胞含量偏低(NEUT%降低)而血沉(ESR)、淋巴细胞比率(LY%)升高的情况,对出现此类情况的AECOPD患者应进行结核感染相关检查。

目的 研究老年慢性阻塞性肺病(COPD)患者血清IL-33水平与其病程分期的相关性。方法 选择60例老年COPD患者作为观察组,按病程分期分为稳定期组和急性加重组,另选择15例非COPD老年患者作为对照组;分别检测血清IL-33水平。结果 各组组间比较结果显示,AECOPD组和COPD稳定期组的血清IL-33水平均高于对照组(P<0.05),其中,AECOPD组的比COPD稳定期组的更高(P<0.05)。结论 血清IL-33水平在老年COPD患者中增高,急性加重期更明显,提示IL-33在老年人COPD发生、发展中可能起重要作用。

Objective To have relevant research between serum IL-33 level and the stage of disease in elderly patients with chronic obstructive pulmonary disease(COPD). Methods 60 elderly patients with COPD were selected as the observation group, who were divided into stable COPD group and AECOPD group. The other 15 patients with non-COPD were selected as the control group. The serum IL-33 levels were detected respectively. Results The comparison results between the groups showed that the serum IL-33 levels in the AECOPD group and the stable COPD group were higher than those in the control group(P<0.05), which was higher in the AECOPD group than in the COPD group(P<0.05). Conclusion Serum IL-33 levels were increased in elderly patients with COPD, the increase in acute exacerbation was more obvious, suggesting that IL-33 may play an important role in the occurrence and development of COPD in the elderly.

目的 分析呼吸康复治疗对农村地区慢性阻塞性肺疾病(COPD)稳定期患者BODE评分系统的影响。方法 将我院收治的60例COPD稳定期患者作为研究对象,随机分为对照组与观察组,每组30例。对照组常规治疗,观察组则给予呼吸康复治疗方案。比较两组患者治疗前后BOBE评分系统的变化。结果 治疗后,观察组BMI、FEV1%、MMRC分级、6MWD分别为(22.4±1.1)kg/m²,(68.6±3.6)%,(1.3±0.2)级,(256.3±36.3)m,BODE指数评分降低至(3.4±1.0)分,ADL为(78.2±6.4)分,QOL为(67.8±2.6)分,与对照组相比差异有统计学意义(P<0.05);且观察组炎性因子水平下降幅度高于对照组(P<0.05)。结论 在农村地区COPD稳定期患者的临床治疗中,采用呼吸康复治疗方案,患者BODE评分系统指标改善显著,值得推广。

Objective To analyze the influence of respiratory rehabilitation treatment on BODE coring system of patients with chronic obstructive pulmonary disease (COPD) in stable phase in rural areas. Methods 60 patients with COPD in stable phase admitted into the hospital were selected as the research object and were randomly divided into control group and observation group with 30 cases in each. The control group received conventional treatment while the observation group received respiratory rehabilitation treatment. The changes of BOBE coring system in the two groups before and after the treatment were compared. Results After the treatment, BMI, FEV1% MMRC classification and 6MWD of the observation group were (22.4±1.1) kg/m², (68.6±3.6)%, (1.3±0.2) and (256.3±36.3) m respectively. The BODE index score decreased to (3.4±1.0), ADL (78.2±6.4), and QOL (67.8 + 2.6).compared with those of the control group, the difference was statistically significant (P< 0.05). And the decline level of inflammatory factors in the observation group was significantly higher than that of the control group (P<0.05). Conclusion In the clinical treatment of patients with COPD in stable phase in rural areas, respiratory rehabilitation treatment were adopted, the improvement of BOBE coring system indexes is significant. It is worthy to be popularized.

      目的 探讨老年营养风险指数（GNRI）与慢性阻塞性肺疾病者急性加重期患者预后的相关性。方法 选择贵州省六盘水水旷医院2019年1月—2022年1月收治的COPD急性加重期患者，根据GNRI值，分为正常营养组（GNRI＞98）和营养不良组（GNRI≤98），应用生存曲线和Cox比例风险回归评估营养状况与死亡率之间的关联。结果 共纳入198例COPD急性加重期患者，正常营养组90例，营养不良组108例，营养不良发生率为54.5%；Kaplan-Meier曲线表明，营养不良组的全因累积死亡率更高（58.3% vs 35.0%，P＜0.001）。Cox比例风险回归分析显示在未校正模型中，HR为2.31（1.25~4.28），P＜0.001。在完全校正模型中，HR为2.48（1.37~4.51），P=0.005，提示与正常营养状况相比，营养不良与全因死亡风险升高相关。结论  GNRI低是COPD患者急性加重期全因死亡的独立危险因素。

      Objective  To investigate the correlation between elderly nutritional risk index（GNRI）and prognosis of patients with AECOPD．Methods  Patients with AECOPD admitted to our hospital from January 2019 to January 2022 were selected and divided into normal nutrition group（GNRI＞98）and malnutrition group（GNRI≤98）according to GNRI value．Survival curve and Cox regression were used to evaluate the association between nutritional status and mortality．Results  A total of 198 patients with AECOPD were included in this study．According to GNRI scores，90 patients were in the normal nutrition group and 108 were in the malnutrition group，with malnutrition incidence of 54.5%．The Kaplan-Meier curve showed that the cumulative all-cause mortality was higher in the malnutrition group（58.3% vs 35%，P＜0.001）．Cox proportional hazard  regression analysis showed that HR in the uncorrected model was 2.31（1.25-4.28），P＜0.001．In the fully corrected model，HR was 2.4（1.37-4.51）and P=0.005，suggesting that malnutrition was associated with a significantly higher risk of all-cause mortalitycompared with normal nutritional status．Conclusions  Low GNRI is an independent risk factor for all-cause death in AECOPD patients．