论著

某区级医院甲型流感患者临床特征及血常规分析

Clinical characteristics and blood routine analysis of influenza A patients in a district hospital

:104-107
 
目的 分析区级医院甲型流行性感冒患者的临床特征,为基层医院甲型流感的早期诊断及防控工作提供科学依据。方法 对2019年12月广州市番禺区中心医院发热门诊就诊的具有流感样症状的发热患者共628例,进行咽拭子甲型流感病毒核酸检测,收集患者临床资料,包括性别、年龄、体温、症状、血常规,根据核酸检测结果分为阴性组及阳性组,2组结果进行比较。结果 甲型流感病毒核酸检测阳性患者共116例,阳性率为18.5%。阳性组发病年龄以14~19岁所占比例最大,共91例(78.4%)。阳性组平均年龄小于阴性组(P<0.05)。阳性组发病体温以38.1~39 ℃所占比例最大,共47例(46.5%)。阳性者平均体温高于阴性组(P<0.01)。症状方面,阳性组仅鼻塞流涕比例较阴性组高(P<0.05)。阳性组白细胞计数、中性粒细胞绝对值、淋巴细胞绝对值、淋巴细胞百分比均低于阴性组(P<0.01)。结论 2019年冬季甲型流感患者以青少年为主,单纯症状较难区分甲型流感及普通感冒,需结合血常规特别是白细胞计数、中性粒细胞绝对值、淋巴细胞绝对值的降低进行分析。
Objective The clinical characteristics of patients with influenza A in district hospital were analyzed to provide scientific basis for early diagnosis, prevention and control of influenza A in primary hospital. Methods A total of 628 patients with influenza-like symptoms from Guangzhou Panyu Central Hospital in December 2019 were enrolled, and the clinical data was collected, including gender, age, body temperature, symptoms, and blood test results. According to the result of influenza A nucleic acid detection, patients were divided into negative group and positive group, and the clinical data of these two groups were compared. Results A total of 116 patients were positive in influenza A virus nucleic acid detection, which positive rate was 18.5%. In the positive group, patients aged 14-19 accounted for the largest proportion, with 91 patients (78.4%). The mean age of the positive group was significantly lower than that of the negative group (P<0.05). Body temperature ranged from 38.1 to 39 ℃ accounted for the largest proportion in the positive group, with 47 patients (46.5%). The mean body temperature of the positive group was significantly higher than that of the negative group (P<0.01). In terms of symptoms, only the proportion of nasal congestion in positive group was higher than that in negative group (P<0.05). In terms of blood test results, WBC count, neutrophil absolute value, lymphocyte absolute value and lymphocyte percentage in the positive group were significantly lower than those in the negative group (P<0.01). Conclusions The majority of patients with influenza A in the winter of 2019 were teenagers, and it was difficult to distinguish influenza A from the common cold only by symptoms. The differential diagnosis should be carried out in combination with the blood routine analysis, especially the decrease in the white blood cell count, the absolute value of neutrophil and the absolute value of lymphocytes.
论著

中等强度有氧运动联合力量训练的运动干预对老年高尿酸血症患者尿酸、身体机能及生活质量的影响

Effect of moderate intensity aerobic exercise combined with strength training on uric acid level, physical function and quality of life in elderly patients with hyperuricemia

:83-86
 
目的 观察中等强度有氧运动联合力量训练对老年高尿酸血症(HUA)尿酸、身体机能及生活质量影响分析。方法 2019年1月—2019年12月在我社区收治的老年HUA患者60例纳入研究,随机数字表法进行分组,选取其中的30例患者实施常规饮食、运动指导为对照组,另30例患者配合中等强度有氧运动联合力量训练为研究组。比较2组患者对干预的依从性,干预前、后的血尿酸水平,身体机能及生活质量评分(WHOQOL-100评分)。结果 2组患者均在干预期内完成训练,依从性优良率比较,差异无统计学意义(P>0.05)。干预前2组患者的血尿酸水平、身体机能比较,差异无统计学意义(P>0.05)。干预后2组患者的血尿酸水平、安静心率较干预前降低,研究组低于对照组,而肺活量则较干预前提升,研究组高于对照组,差异有统计学意义(P<0.05)。干预前2组患者的WHOQOL-100评分比较,差异无统计学意义(P>0.05),干预后2组WHOQOL-100各项评分较干预前提升,研究组高于对照组,差异有统计学意义(P<0.05)。结论 在老年HUA患者的相关指导中,运用中等强度有氧运动联合力量训练的运动干预,可较为明显的降低血清血尿酸水平,降低并平稳安静心率,提升肺活量,提升生活质量,效果理想。
Objective To observe the effect of moderate intensity aerobic exercise combined with strength training on uric acid level, physical function and quality of life in elderly patients with hyperuricemia (HUA). Methods Sixty elderly patients with HUA were treated in our center from January 2019 to December 2019. They were randomly divided into two groups, 30 cases in each group. Among them, 30 cases given routine diet and exercise guidance were included in control group, and the other 30 cases given moderate intensity aerobic exercise combined with strength training on the basis of the control group were included in study group. The compliance, blood uric acid level, physical function and quality of life (WHOQOL-100 scores) before and after the intervention were compared between the two groups. Results Two groups of patients completed the training within the expected time, and there was no significant difference in compliance (P>0.05). Before the intervention, there were no significant differences in blood uric acid level and physical function between the two groups (P>0.05). After the intervention, the serum uric acid level and resting heart rate of the two groups were lower than those before the intervention, and those of the research group were even lower than the control group, while the vital capacity was higher than that before the intervention, and the research group was higher than the control group, those differences were significant (P<0.05). Before the intervention, there was no significant difference in WHOQOL-100 score between the two groups (P>0.05). After the intervention, the scores of WHOQOL-100 in the two groups were higher than those before the intervention, and that in the study group was higher than the control group (P<0.05). Conclusions In the relevant guidance of elderly patients with hyperuricemia (HUA), the application of moderate intensity aerobic exercise combined with strength training can significantly lower the serum uric acid level, reduce and stabilize the resting heart rate, improve the vital capacity and quality of life, with ideal effect.
论著

青春期多囊卵巢综合征患者AMH与25(OH)D3的关联性研究

Study on the relationship between anti-Müllerian hormone and 25(OH)D3 in adolescent patients with polycystic ovary syndrome

:79-82
 
目的 探讨青春期多囊卵巢综合征(PCOS)患者血清抗苗勒管激素(AMH)与25(OH)D3水平的相关性。方法 本研究选择在2019年1月—2020年12月在我院妇科门诊就诊的PCOS青春期女性79名,另选择同期体检的非PCOS健康对照85名。对所有受试者测量身高、体质量,计算体质量指数(BMI)。由诊治医生检查研究对象是否有痤疮、多毛以及月经情况。抽取静脉血检测黄体生成素、卵泡刺激素、总睾酮、硫酸脱氢表雄酮、抗苗勒管激素和 25(OH)D3,将 25(OH)D3分为不足[25(OH)D3<30 ng/mL]和缺乏[25(OH)D3<20 ng/mL]2组,对数据进行比较分析。结果 与健康对照组比较,PCOS组更容易发生月经稀发/闭经,其痤疮发生率较高(P值均<0.05)。体质量指数、AMH值、总睾酮和硫酸脱氢表雄酮的体内检出水平在PCOS组较高,而25(OH)D3在PCOS组较低(P值均<0.05)。PCOS组的AMH与BMI和总睾酮呈正相关关系,与25(OH)D3呈负相关关系(P值均<0.05)。25(OH)D3缺乏组的AMH水平高于25(OH)D3不足组,对照组和PCOS组的25(OH)D3缺乏组的AMH水平均高于25(OH)D3不足组,两两比较其差异有统计学意义(P值均<0.05)。健康对照组的25(OH)D3缺乏率为67.1%(57/85),而PCOS组的25(OH)D3缺乏率为96.2%(76/79),2组比较其差异有统计学意义(χ2=22.68,P<0.001)。结论 青春期多囊卵巢综合征患者体内 25(OH)D3水平与AMH 水平显著相关。AMH 和25(OH)D3可用于评估青春期PCOS发病风险的替代指标。
Objective To explore the correlation between serum anti-Müllerian hormone (AMH) and 25(OH)D3 levels in adolescent patients with polycystic ovary syndrome (PCOS). Methods Seventy-nine adolescent girls with PCOS and 85 non-PCOS healthy controls who walked in the gynecological clinic of our hospital from January 2019 to December 2020 were selected. Height, weight were measured and body mass index (BMI) was calculated.Hirsutism, acne and menstruation were evaluated by doctors on all subjects. Venous blood was drawn to detect levels of luteinizing hormone, follicle stimulating hormone, total testosterone, dehydroepiandrosterone sulfate, AMH and 25(OH)D3, 25(OH)D3 was further divided into insufficient [25(OH)D3<30 ng/mL] and deficient [25(OH)D3<20 ng/mL]level, then all data were compared and analyzed between two groups. Results Compared with the healthy control group, the PCOS group was more prone to have oligomenorrhea or amenorrhea, the incidence of acne was higher in PCOS group than in control group (all P values<0.05). BMI, the levels of AMH, total testosterone and dehydroepiandrosterone sulfate were significantly higher in the PCOS group compared to the control group, while 25(OH)D3 was the opposite (all P values <0.05). AMH in the PCOS group was positively correlated with BMI and level of total testosterone, and negatively correlated with 25(OH)D3 (all P values<0.05). The AMH level in the 25(OH)D3 deficiency group was higher than that in the 25(OH)D3 insufficient group, the AMH levels of the 25(OH)D3 deficient group and control group were higher than that in the 25(OH)D3 insufficient group,the differences were statistically significant (P<0.05). The 25(OH)D3 deficiency rate in the healthy control group was 67.1% (57/85), while the 25(OH)D3 deficiency rate in the PCOS group was 96.2% (76/79). The difference between the two groups was statistically significant (χ2=22.68, P<0.001). Conclusions Serum 25(OH)D3 level was an independent factor significantly associated with AMH level in adolescents with PCOS. AMH and 25(OH)D3 levels may be used as surrogate markers of PCOS risk in adolescents.
论著

家庭睡眠习惯调查在孤独症患儿睡眠评估中的信效度研究

Reliability and validity of the family sleep habits inventory in the sleep assessment among children with autism spectrum disorder

:70-73
 
目的 检验家庭睡眠习惯调查(FISH)在评估孤独症谱系障碍(ASD)患儿睡眠评估中的信度和效度。方法 随机抽取在清远市妇幼保健院儿童语言行为科干预的199例2~6岁ASD共患睡眠障碍患儿,其照顾者同时完成FISH和儿童睡眠习惯问卷(CSHQ),2周后再次同时完成上述两个问卷,以检验FISH的信度和效度。结果 验证性因素分析的结果表明,五因素模型拟合良好(χ2=79.05,df=44,χ2/df=1.80, P<0.001,SRMR=0.06,GFI=0.94,IFI=0.89,RMSEA=0.06),总量表及各分量表有较高的内部一致性信度(0.71~0.77)和重测信度(0.79~0.88)。FISH的白天习惯分别与CSHQ的入睡延迟、夜醒呈负相关,入睡前习惯分别与CSHQ的睡眠抵触、睡眠焦虑、白天睡眠呈负相关,睡眠常规分别与CSHQ的睡眠抵触、入睡延迟、睡眠焦虑呈负相关,睡前父母行为分别与CSHQ的睡眠抵触、睡眠焦虑呈负相关,总分与CSHQ总分呈负相关,差异均有统计学意义(P<0.05)。结论 FISH具有较好的信度和效度,可作为ASD患儿睡眠习惯的评估工具。
Objective To test the reliability and validity of the famity inveritory of sleep habits(FISH) in the sleep assessment among children with autism spectrum disorder (ASD). Methods A random sample of 199 children with ASD and sleep disorders intervened in the Children's Language and Behavior Department of Maternal and Child Health Hospital of Qingyuan City were selected, their caregivers completed the FISH and the children's sleep habit questionnaire(CSHQ) at the same time, and completed the above two questionnaires again 2 weeks later to test the reliability and validity of the FISH. Results The results of confirmatory factor analysis showed that the five-factor model fits well (χ2=79.05, df=44, χ2/df=1.80, P<0.001, SRMR=0.06, GFI=0.94, IFI =0.89, RMSEA=0.06), the total scale and each subscale had high internal consistent reliability (0.71~0.77) and test-retest reliability (0.79~0.88). The daytime habits of FISH were negatively correlated with sleep delay and waking up at night of CSHQ respectively, the habits before sleep of FISH were negatively correlated with sleep conflict, sleep anxiety and daytime sleep of CSHQ respectively, the sleep routine of FISH was negatively correlated with sleep conflict, sleep delay and sleep anxiety of CSHQ respectively, the parents' behavior before sleep of FISH was negatively correlated with sleep conflict and sleep anxiety of CSHQ respectively, and the total score of FISH was negatively correlated with CSHQ, with statistically significant differences (P<0.05). Conclusions The FISH had good reliability and validity, and can be used as an assessment tool for children with ASD.
论著

血清PCT联合AG检测对脓毒症患者预后的预测价值

Predictive value of serum PCT combined with AG detection on the prognosis of patients with sepsis

:66-69
 
目的 探究血清降钙素原(PCT)联合阴离子隙(AG)检测在脓毒症患者预后中预测价值。方法 选取2019年1月—2021年1月于我院治疗117例毒症患者作为研究对象,根据入院治疗28 d的预后情况,分为存活组(78例)和死亡组(39例),对比2组患者一般资料,采用多因素分析其高危因素,应用ROC曲线确定曲线下面积,评估血清PCT联合AG检测对该类患者预后的预测价值。结果 2组患者一般资料对比,年龄、中性粒细胞计数、血清C反应蛋白(CRP)、PCT、AG、APACHEⅡ评分差异有统计学意义(P<0.05);年龄、CRP、PCT、AG水平是该类死亡的危险因素;ROC曲线分析结果显示,血清PCT曲线下面积为0.737,最佳截断值为9.595;AG曲线下面积为0.791,最佳截断值为21.695;血清PCT联合AG检测曲线下面积为0.933,最佳截断值为1.3442。结论 血清PCT联合AG检测对脓毒症患者预后具有较高的预测价值。
Objective To investigate the predictive value of serum procalcitonin (PCT) combined with anion gap (AG) detection on the prognosis of patients with sepsis. Methods One hundred and seventeen patients with sepsis treated in our hospital from January 2019 to January 2021 were selected as study subjects and divided into survival group (78 patients) and death group (39 patients) according to their prognosis at 28 d of admission. The general data of the two groups was compared, multi-factor Logistic analysis of high-risk factors of sepsis patients was performed, area under the ROC curve was applied to assess the predictive value of serum PCT combined AG detection on the prognosis of sepsis patients. Results After comparing the general data of the two groups, the differences in age, neutrophil count, C-reactive protein (CRP), PCT, AG and APACHE II scores were statistically significant (P<0.05); multi-factor Logistic regression analysis showed that age, CRP, PCT and AG levels were risk factors for death in sepsis patients; the results of ROC curve analysis showed that the area under the curve of serum PCT was 0.737, with an optimal cut-off value of 9.595; the area under the AG curve was 0.791, with an optimal cut-off value of 21.695;the area under the curve of serum PCT combined with AG was 0.933, and the optimal cut-off value was 1.3442. Conclusions Serum PCT combined with AG assay had a high predictive value for the prognosis of patients with sepsis.
论著

基于中国PIM标准分析老年精神疾病住院患者潜在不适当用药现状

Analysis of potentially inappropriate medication in elderly psychiatric inpatients based on criteria of potentially inappropriate medication for the elderly in China

:57-61
 
目的 调查分析老年精神疾病住院患者潜在不适当用药(PIM)现状。方法 回顾分析2021年3月老年住院患者临床诊断、用药情况等资料,依据2017年版《中国老年人潜在不适当用药判断标准》分析处方PIM情况。结果 125例研究对象中,平均年龄(73.31±7.87)岁,平均用药(6.62±2.68)种。101例(80.80%)患者存在140项PIM,81例(64.80%)患者使用了A级警示药物共103项,33例(40.74%)患者使用了B级警示药物共37项;高风险药物39项(27.86%),低风险药物101项(72.14%);PIM发生率排名前3位的药物是奥氮平、利培酮、劳拉西泮;12例患者存在4项与疾病状态相关的PIM。结论 该院PIM发生率偏高,医生和药师应加大力度降低PIM比例,减少不良反应,提高用药安全,促进合理用药。
Objective To investigate the current status of potentially inappropriate medications (PIM) for elderly inpatients with mental illness in a psychiatric hospital. Methods Based on the 2017 edition of “Judgment Standards for Potentially Inappropriate Medications for the Elderly in China”, we retrospectively analyzed the PIM by investigating the clinical diagnosis and medication status of 125 elderly psychiatric inpatients in March 2021. Results Among 125 subjects, the average age was (73.31±7.87) years, and the average medication was (6.62±2.68). There were 101 patients (80.80%) had 140 items of PIM, 81 patients (64.80%) used a total of 103 items of A-level warning drugs, 33 patients (40.74%) used a total of 37 items of B-level warning drugs; there were 39 high-risk drugs(27.86%), 101 low-risk drugs (72.14%); the drugs with top three PIM incidence were olanzapine, risperidone and lorazepam; 12 patients had 4 PIMs related to the disease state. Conclusions The incidence of PIM in this hospital is relatively high. Doctors and pharmacists should be advised to increase their efforts to reduce the proportion of PIM, reduce the incidence of adverse reactions, improve medication safety, and promote rational drug usage.
论著

超低频经颅磁刺激联合艾司唑仑对失眠症患者睡眠脑电图参数及血清神经营养因子表达的作用

Effects of infra-low frequency transcranial magnetic stimulation combined with estazolam on sleep EEG parameters and serum neurotrophic factors expression in patients with insomnia

:32-37
 
目的 探讨超低频经颅磁刺激(ILF-TMS)联合艾司唑仑对失眠症患者睡眠脑电图参数及血清神经营养因子表达的影响。方法 选取2018年8月—2020年4月我院失眠症患者114例,随机数字表法分为研究组(n=57)、对照组(n=57)。对照组予以艾司唑仑联合ILF-TMS假性刺激,研究组予以艾司唑仑联合ILF-TMS真性刺激,均治疗1个月。对比2组疗效与治疗前、治疗1个月后睡眠进程参数(总睡眠时间、入睡时间、睡眠效率、觉醒时间)、睡眠结构(非快速眼动睡眠期、快速动眼睡眠期)、匹兹堡睡眠质量量表(PSQI)评分、失眠严重程度指数量表(ISI)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、血清神经营养因子[胶质细胞源性神经营养因子(GDNF)、脑源性神经营养因子(BDNF)]水平。结果 (1)疗效:研究组治疗1个月后总有效率高于对照组(P<0.05);(2)睡眠进程参数:治疗1个月后研究组总睡眠时间、睡眠效率高于对照组,入睡时间、觉醒时间短于对照组(P<0.05);(3)睡眠结构:治疗1个月后研究组Ⅲ期、Ⅱ期、非快速眼动睡眠期高于对照组,Ⅰ期睡眠期低于对照组(P<0.05);(4)PSQI、ISI评分:治疗1个月后研究组PSQI、ISI评分低于对照组(P<0.05);(5)SAS、SDS评分:治疗1个月后研究组SAS、SDS评分低于对照组(P<0.05);(6)血清神经营养因子:治疗1个月后研究组血清GDNF、BDNF水平高于对照组(P<0.05)。结论 ILF-TMS联合艾司唑仑治疗失眠症效果确切,可上调血清神经营养因子表达,改善睡眠脑电图参数,提高睡眠质量,控制焦虑、抑郁症状。
Objective To investigate the effects of infra-low frequency transcranial magnetic stimulation (ILF-TMS) combined with estazolam on sleep EEG parameters and serum neurotrophic factors expression in patients with insomnia. Methods One hundred and fourteen patients with insomnia in our hospital from August 2018 to April 2020 were divided into study group (n=57) and control group (n=57) by random number table method. The control group was treated with estazolam combined with pseudo ILF-TMS stimulation, and the study group was treated with estazolam combined with real ILF-TMS stimulation, all of which were treated for 1 month. Comparing curative effect of two groups before and 1 month after treatment, and sleep process parameters (total sleep time, falling asleep time, sleep efficiency, waking time), the structure of the sleep stages (stage Ⅲ, Ⅱ, Ⅰ, rapid eye movement sleep), Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), self-rating anxiety scale (SAS) score, self-rating depression scale (SDS) score, serum neurotrophic factors (GDNF, BDNF) levels. Results (1) Efficacy: the total effective rate of the study group was higher than that of the control group after 1 month of treatment (P<0.05). (2) Sleep process parameters: after 1 month of treatment, the total sleep time and sleep efficiency in the study group were higher than those in the control group, and the falling asleep time and waking time were shorter than those in the control group (P<0.05). (3) Sleep structure: after 1 month of treatment, compared to the control group, the study group had more in stageⅢ, Ⅱ, rapid eye movement sleep, and less in stage Ⅰsleep(P<0.05). (4) PSQI and ISI scores: after 1 month of treatment, PSQI and ISI scores of the study group were lower than those of the control group (P<0.05). (5) SAS and SDS scores: after 1 month of treatment, SAS and SDS scores in the study group were lower than those in the control group (P<0.05). (6) Serum neurotrophic factors: after 1 month of treatment, serum GDNF and BDNF levels in the study group were higher than those in the control group (P<0.05). Conclusions ILF-TMS combined with estazolam is an effective treatment of insomnia. It can up-regulate the expression of serum neurotrophic factors, improve the parameters of sleep EEG, improve sleep quality, and control the symptoms of anxiety and depression.
论著

负性调节细胞CD4+CD25+T及其相关细胞因子在COPD患者外周血中的表达与合并细菌感染的相关性研究

Correlation between expressions of negative regulatory cell CD4+CD25+T and its related cytokines in peripheral blood and bacterial infection of COPD patients

:13-17
 
目的 探讨负性调节细胞CD4+CD25+T及其相关细胞因子在慢性阻塞性肺病(COPD)患者外周血中的表达与合并细菌感染的相关性。方法 纳入2018年1月—2019年12月间收治的66例COPD患者作为研究对象,其中急性加重期COPD患者(AECOPD)36例、稳定期患者30例,并纳入同期体检健康者30例作为对照组。对所有纳入的研究对象外周血标本中的CD4+CD25+T调节性T细胞及其相关细胞因子[白介素-4(IL-4)、白介素-10(IL-10)、干扰素-γ(IFN-γ)]表达水平进行检测,分析相关指标水平与COPD是否合并细菌感染的关系,及预测细菌感染的效能。结果 AECOPD和稳定期COPD患者CD4+、CD4+CD25+、IFN-γ/IL-4水平均低于对照组(P<0.05),IL-4、IL-10水均高于对照组(P<0.05);AECOPD患者IFN-γ水平高于对照组(P<0.05);AECOPD患者CD4+、CD4+CD25+水平低于稳定期COPD患者(P<0.05),IL-4、IL-10、IFN-γ均高于稳定期COPD患者(P<0.05);CD4+、CD4+CD25+水平与IL4、IFN-γ均呈负相关关系(P<0.05),CD4+水平与IL-10呈负相关关系(P<0.05);COPD合并感染者CD4+水平低于未合并感染者(P<0.05),IL-4、IFN-γ水平均高于未合并感染者(P<0.05);COPD合并革兰氏阴性菌感染者CD4+CD25+水平低于未合并感染者(P<0.05),IL-10水平均高于未合并感染者(P<0.05);CD4+、IL-4、IL-10、IFN-γ均是预测COPD患者合并细菌感染的有效指标(P<0.05),其中IL-4和IFN-γ效能较高。结论 CD4+、CD4+CD25+Treg细胞及其相关细胞因子参与COPD发生发展和患者细菌感染,监测其水平变化有利于为临床诊治提供信息。
Objective To investigate the correlation between the expressions of negative regulatory cell CD4+CD25+T and its related cytokines in peripheral blood and bacterial infection of patients with chronic obstructive pulmonary disease (COPD). Methods Sixty-six COPD patients admitted between January 2018 and December 2019 were included as the research subjects, including 36 patients with acute exacerbation of COPD (AECOPD) and 30 patients with stable COPD. Another 30 healthy people undergoing physical examination during the same period were included in control group. The expression levels of CD4+CD25+ regulatory T cell and its related cytokines [interleukin-4 (IL-4), interleukin-10 (IL-10), interferon-γ (IFN-γ)] in the peripheral blood samples were detected among the included subjects. The relationship between levels of related indicators and presence or absence of bacterial infection in COPD and the efficacy of predicting infection were analyzed. Results The levels of CD4+, CD4+CD25+ and IFN-γ/IL-4 in patients with AECOPD and patients with stable COPD were lower than those in control group (P<0.05), while the levels of IL-4 and IL-10 were higher than those in control group (P<0.05). The IFN-γ level of AECOPD patients was higher than that of control group (P<0.05). The levels of CD4+ and CD4+CD25+of AECOPD patients were lower than those of stable COPD patients (P<0.05), while the levels of IL-4, IL-10 and IFN-γ were all higher than those of stable COPD patients (P<0.05). The levels of CD4+ and CD4+CD25+were negatively correlated with IL-4 and IFN-γ (P<0.05), and the CD4+level was negatively correlated with IL-10 (P<0.05). The CD4+ level in COPD patients with infection was lower than that in patients without infection (P<0.05), while the levels of IL-4 and IFN-γ were higher than those in patients without infection (P<0.05). The CD4+CD25+level of COPD patients with Gram-negative bacteria infection was lower than that of patients without infection (P<0.05), while the IL-10 level was higher than that of patients without infection (P<0.05). CD4+, IL-4, IL-10 and IFN-γ were effective indicators in predicting bacterial infection in COPD patients (P<0.05), and IL-4 and IFN-γ had higher efficacy. Conclusions CD4+, CD4+CD25+ T cell and related cytokines are involved in the occurrence and development of COPD and bacterial infection in patients. Monitoring changes of those levels is helpful to provide information for clinical diagnosis and treatment.
临床诊疗

曲普瑞林联合腹腔镜下卵巢囊肿剥除术对卵巢子宫内膜异位囊肿患者术后血清性激素水平及妊娠率的影响

Effect of triprirelin combined with laparoscopic ovarian cyst stripping on serum sex hormone levels and pregnancy rate in patients with ovarian endometriosis cyst after operation

:140-143
 
目的 分析曲普瑞林联合腹腔镜下卵巢囊肿剥除术治疗卵巢子宫内膜异位囊肿(OEC)患者的效果。方法 选取我院2019年1月—2020年5月期间收治的OEC患者108例,采用随机抽签法分成研究组与对照组,各54例。对照组行腹腔镜下卵巢囊肿剥除术治疗,研究组基于对照组加用曲普瑞林治疗,统计对比2组疗效、妊娠率以及术前、术后6个月、1年血清性激素水平[卵泡刺激素(FSH)、黄体生成素(LH)、抗苗勒管激素(AMH)]、血清高迁移率组蛋白B1(HMGB1)、视黄醇结合蛋白4(RBP4)、糖类抗原125(CA125)水平。结果 研究组治疗总有效率92.59%高于对照组75.93%(P<0.05);术后6个月、1年研究组LH、FSH低于对照组,AMH高于对照组(P<0.05);术后6个月、1年研究组CA125、RBP4、HMGB1低于对照组(P<0.05);研究组妊娠率59.26%高于对照组29.63%(P<0.05)。结论 曲普瑞林联合腹腔镜下卵巢囊肿剥除术治疗OEC患者时,可改善性激素水平,提高妊娠率,降低血清CA125、RBP4、HMGB1水平。
临床诊疗

吸入和静脉麻醉对老年冠心病患者术后不良心血管事件的影响

Effects of inhalation and intravenous anesthesia on postoperative adverse cardiovascular events in elderly patients with coronary heart disease

:133-135
 
目的 探究不同麻醉方式对患有冠心病的老年患者外科介入不良心血管事件作用的对比。方法 选取2020年1月—2021年1月,我院确诊的冠心病患者,且无心脏外科干预手术80 例,随机分为研究干预组(n=40)和空白对照组(n=40),研究组采用2%的七氟醚,对照组用丙泊酚联合瑞芬太尼,维持麻醉血浆靶浓度在3.0~6.0 mg/L 之间,方式为静脉泵注;分析2组病人外科术后负性心脏情况控制影响; 结果 研究组和对照组患者的肌酸激酶存在差异,同时心脏肌钙蛋白T的高低也存在差异(P均<0.05);研究组在术后的负性心血管情况发病率均低于空白对照组,其中研究组的心源性猝死、心律紊乱不齐和心脏源性的休克等的病变率要远低于对照组,统计学差异存在意义(P均<0.05);而其中研究组的心力衰竭与对照组相比,差异不具有统计学意义(P>0.05)。结论 相比于静脉麻醉,吸入式麻醉能够趋好性降低非心脏手术术后负性心脏相关风险的发生率,该研究对于临床实践有一定的参考意义和实践可操作性,可以考虑普及推广。
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