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目的 合并肺纤维化的慢性阻塞性肺疾病(COPD)是COPD的特殊亚型,患者兼具气流受限与肺组织纤维化病理特征,临床症状更严重、肺功能下降更快,且现有单一治疗方案难以同时改善气流受限与纤维化进展,预后较差。基于此,本研究旨在分析尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD患者的效果及对肺功能的影响,为优化临床治疗方案提供依据。方法 选取2022年3月—2024年12月收治的96例合并肺纤维化的COPD患者,采用前瞻性随机对照研究设计,应用随机数字表法分为试验组与对照组。所有患者均采取常规治疗,对照组48例采取尼达尼布治疗,试验组采取尼达尼布联合格隆溴铵治疗。两组均治疗24周后,比较治疗前后症状评分、肺功能、纤维化指标、炎症指标,并分析两组治疗安全性。结果 治疗后,两组CAT评分、mMRC评分及VAS降低(P<0.05);且与对照组比较,试验组CAT评分、mMRC评分及咳嗽VAS评分较低(P<0.05)。治疗后,两组FVC、FEV1、DLCO及FEV1/FVC比值均较治疗前改善(P<0.05);且与对照组比较,试验组FVC、FEV1、DLCO及FEV1/FVC比值较优(P<0.05)。治疗后,两组血清KL-6、SP-D水平及CT纤维化评分均降低(P<0.05);且与对照组比较,试验组血清KL-6、SP-D水平及CT纤维化评分较低(P<0.05)。治疗后,两组血清IL-6、TNF-α及TGF-β1水平降低(P<0.05);且与对照组比较,试验组血清IL-6、TNF-α及TGF-β1水平较低(P<0.05)。试验组总不良反应发生率为8.33%(4/48),对照组为10.42%(5/48),两组比较差异无统计学意义(P>0.05)。结论 尼达尼布联合格隆溴铵治疗合并肺纤维化的COPD效果良好,可减轻患者临床症状,改善肺功能与肺纤维化,降低机体炎症反应,安全性较高。
Objective To analyze the effects of the combination of nintedanib and glycopyrrolate in treating chronic obstructive pulmonary disease(COPD)patients with associated pulmonary fibrosis and its impact on lung function,providing a basis for optimizing clinical treatment strategies.Methods Ninety-six COPD patients with pulmonary fibrosis admitted from March 2022 to December 2024 were selected,and divided into experimental group and control group using a random number table method.Using a prospective randomized controlled study design,all patients received conventional treatment,with 48 cases in the control group receiving treatment with nintedanib and the experimental group receiving treatment with nintedanib combined with glycopyrrolate bromide.After 24 weeks of treatment in both groups,the symptom scores,lung function,fibrosis indicators,and inflammation indicators were compared before and post-treatment,and the drug safety of the two groups was analyzed.Results Post-treatment,CAT score,mMRC score and VAS decreased in both groups(P<0.05).Compared with the control group,CAT score,mMRC score and cough VAS score were lower in the experimental group(P<0.05).Post-treatment,FVC,FEV1,DLCO and FEV1/FVC ratio of both groups improved compared with that before treatment(P<0.05).Compared with the control group,FVC,FEV1,DLCO and FEV1/FVC ratio of the experimental group were better(P<0.05).Post-treatment,serum KL-6,SP-D levels and CT fibrosis scores of both groups decreased(P<0.05).Compared with the control group,serum KL-6,SP-D levels and CT fibrosis scores of the experimental group were lower(P<0.05).Post-treatment,serum IL-6,TNF-α and TGF-β1 levels in both groups decreased(P<0.05).Compared with the control group,serum IL-6,TNF-α and TGF-β1 levels in the experimental group were lower(P<0.05).The incidence of total adverse reactions in the experimental group was 8.33%(4/48),and that in the control group was 10.42%(5/48).There was no difference between the two groups(P>0.05).Conclusions The combination of nintedanib and glycopyrrolate has a significant effect on the treatment of COPD complicated with pulmonary fibrosis,which can alleviate its clinical symptoms,improve lung function and pulmonary fibrosis,reduce the body’s inflammatory response,which is relatively safe.
目的 分析舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁患者的效果。方法 选择2023年1月—2025年1月平顶山市第一人民医院收治的86例冠心病介入术后患者,随机分为对照组(43例)、舒肝解郁胶囊组(43例),均进行常规治疗及体外反搏治疗,舒肝解郁胶囊组加用舒肝解郁胶囊,测量并比较两组患者治疗前后心肺功能,评估患者焦虑和抑郁情绪、临床疗效及生活质量。结果 治疗后舒肝解郁胶囊组左心室射血分数(LVEF)和最大摄氧量(VO2max)均显著高于对照组(P<0.05);治疗后舒肝解郁胶囊组汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分均低于对照组(P<0.05);舒肝解郁胶囊组总有效率高于对照组(P<0.05);治疗后舒肝解郁胶囊组生活质量综合评定问卷(GQOLI-74)各维度评分均显著高于对照组(P<0.05)。结论 舒肝解郁胶囊联合体外反搏治疗冠心病介入术后焦虑抑郁效果显著,可减轻患者负面情绪,改善其心肺功能及生活质量。
Objective To analyze the effect of Shugan Jieyu Capsule combined with external counterpulsation in the treatment of anxiety and depression in patients with coronary artery disease after percutaneous coronary intervention(PCI).Methods From January 2023 to January 2025,86 patients with coronary heart disease who had undergone PCI in our hospital were enrolled and randomly divided into a control group(43 cases) and a Shugan Jieyu Capsule group(43 cases).All patients received conventional treatment and external counterpulsation.The Shugan Jieyu Capsule group was given Shugan Jieyu Capsule in addition.Cardiopulmonary function was measured and compared before and after treatment between the two groups,and anxiety and depression,clinical efficacy,and quality of life were evaluated.Results After treatment,the left ventricular ejection fraction(LVEF) and maximum oxygen uptake(VO2max) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).The Hamilton Anxiety Rating Scale(HAMA) and Hamilton Depression Rating Scale(HAMD) scores in the Shugan Jieyu Capsule group were significantly lower than those in the control group(P<0.05).The total effective rate in the Shugan Jieyu Capsule group was significantly higher than that in the control group(P<0.05).After treatment,the scores on all dimensions of the General Quality of Life Assessment Questionnaire-74(GQOLI-74) in the Shugan Jieyu Capsule group were significantly higher than those in the control group(P<0.05).Conclusions Shugan Jieyu Capsule combined with external counterpulsation is effective in treating anxiety and depression after PCI,alleviating negative emotions and improving cardiopulmonary function and quality of life.
肺癌作为全球恶性肿瘤中发病率和死亡率较高的一种,手术是其主要治疗手段。然而,肺切除手术常引起肺功能下降,影响患者术后功能恢复及生活质量。准确预测术后肺功能对制定个体化手术方案、降低并发症风险及改善患者预后具有重要意义。目前,研究者已开发出多种结合临床指标、影像学参数及生物标志物的预测模型,用于评估肺癌患者术后肺功能变化。然而,现有模型在准确性、特异性、标准化及临床推广方面仍存在诸多挑战。本文系统综述肺癌术后肺功能的影响因素,并对现有预测模型进行总结与评价,以期为患者术前评估、手术方案选择及术后管理提供参考,进而为改善治疗效果与患者生活质量提供理论依据。
Lung cancer is a kind of malignant tumor with high morbidity and mortality in the world,and surgery is the main treatment.However,pneumonectomy is often accompanied by the loss of lung function,which seriously affects the recovery of lung function and the quality of life.Accurate prediction of postoperative pulmonary function is of great significance for formulating individualized surgical plans,reducing the risk of complications and improving the prognosis of patients.At present,researchers have developed a variety of predictive models that combine clinical indicators,imaging parameters,and biomarkers to evaluate postoperative lung function changes in patients with lung cancer.However,there are still many challenges in the accuracy,specificity,standardization and clinical promotion of existing models.This paper systematically reviews the influencing factors of lung function after lung cancer surgery,and summarizes and evaluates the existing prediction models,in order to provide a reference for preoperative evaluation,surgical plan selection and postoperative management of patients,and then provide theoretical basis for improving treatment effect and quality of life of patients.
目的 探讨肥胖与肺功能参数的相关性。方法 将90例接受肺功能检查的患者依据体质指数(BMI)分为肥胖组(BMI≥25 kg/m2,n=50)和正常体质量组(18.5 kg/m2<BMI≤24.9 kg/m2,n=40),比较两组各项肺功能参数的差异,包括肺通气功能的参数如[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、1秒率(FEV1/FVC)、最大呼气流量(PEF)]以及反映小气道功能的参数[50%最大呼气流量(MEF50),25%最大呼气流量(MEF25)];比较肥胖组不同性别间上述肺功能参数的差异及其与腰围(WC)与BMI的相关性。结果 肥胖组FVC、FEV1、FEV1/FVC、MEF50、MEF25低于正常体质量组(P<0.01);肥胖组中男性FVC及FEV1低于女性(P<0.01)。相关分析结果显示,肥胖组中WC与BMI均与肺功能多个参数呈负相关趋势,其中WC的负相关趋势更突出,且与FVC呈负相关关系(P<0.05)。结论 肥胖影响反映肺功能的多个参数,表现为肺通气功能和小气道功能多个指标水平降低,且肥胖男性更甚;在肥胖人群中,相较于BMI,WC与FVC的关系更密切。
Objective To investigate the correlation between obesity and pulmonary function parameters.Methods Ninety patients undergoing pulmonary function testing were categorized into an obese group(BMI≥25 kg/m2,n=50)and a normal-weight group(18.5 kg/m2< BMI≤24.9 kg/m2,n=40).Differences in pulmonary function parameters were compared between groups,including ventilatory parameters(forced vital capacity[FVC],forced expiratory volume in 1 second[FEV1],FEV1/FVC ratio,peak expiratory flow[PEF]) and parameters reflecting small airway function(maximum expiratory flow at 50% of forced expiratory volume[MEF50],and 25% maximum expiratory flow[MEF25]).Differences in these pulmonary function parameters between genders within the obese group and their correlations with waist circumference(WC)and BMI were also assessed.Results FVC,FEV1,FEV1/FVC,MEF50,and MEF25 were significantly lower in the obese group compared to the normal-weight group(P<0.01).Among obese subjects,male FVC and FEV1 were significantly lower than female values(P<0.01).Correlation analysis revealed negative correlations of WC and BMI with multiple pulmonary function parameters in the obese group,with WC exhibiting a more pronounced negative correlation and a significant negative relationship with FVC(P<0.05).Conclusions Obesity impacts multiple parameters reflecting lung function,manifesting as reduced levels of several indicators of pulmonary ventilation and small airway function,with male obese individuals exhibiting greater impairment.Within the obese population,WC correlates more closely with FVC than BMI.
目的 分析改良经脊柱内椎间孔镜系统技术(TESSYS)对腰椎间盘突出症患者疼痛及功能的影响,以期分析该术式优劣,丰富该研究领域。方法 回顾性选取2022年10月—2024年10月医院治疗的80例腰椎间盘突出症患者作为研究对象,根据治疗方式的不同划分为观察组(TESSYS技术治疗)和对照组(经皮椎间孔镜髓核摘除术治疗),每组各40例。观察两组患者疗效、手术时间、术中出血量、住院时间、透视次数、切口长度等情况。比较两组患者术前、术后6 h、术后1天、术后1周、术后1个月VAS评分情况,比较两组患者术前及术后1个月腰椎功能情况,包括Oswestry功能障碍指数(ODI)、腰椎曲度、腰背肌后伸活动度。比较两组患者术前及术后24 h的血清超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平。结果 观察组患者疗效优于对照组(Z=-3.737,P<0.001)。交互效应下,两组疼痛因不同术式而随着时间增加而有所不同(P<0.05);时点效应下,观察组、对照组各组均随着时点增加疼痛随之减少(P<0.05);组间效应下,干预前、干预后1个月两组差异不明显,但是观察组疼痛干预后6 h(Z=-2.831,P=0.005)、干预后1天(Z=-3.253,P=0.001)低于对照组。术后1个月,观察组患者的ODI(Z=-4.804,P<0.001)低于对照组,而腰椎曲度(Z=-6.218,P<0.001)、腰背肌后伸活动度(Z=-7.014,P=0.001)高于对照组。术后24 h后,观察组患者的hs-CRP(Z=-5.671,P<0.001)、IL-6(Z=-3.262,P<0.001)低于对照组。结论 TESSYS相较于经皮椎间孔镜髓核摘除术在治疗腰椎间盘突出症时具有显著优势,可提高疗效,减少出血量,减轻疼痛,减少炎症反应,加快腰椎功能康复,缩短住院时间。
Objective The effect of modified transforaminal endoscopic spine system(TESSYS) on pain and function in patients with lumbar disc herniation was analyzed,so as to analyze the advantages and disadvantages of this procedure and enrich the research field.Methods Retrospectively,80 patients with lumbar disc herniation treated in the hospital from October 2022 to October 2024 were selected as the study subjects.These patients were divided into two groups based on their treatment methods:the observation group(treated with TESSYS technology)and the control group(treated with percutaneous endoscopic discectomy).Each group consisted of 40 patients.The study evaluated the treatment efficacy,surgical duration,intraoperative bleeding volume,hospital stay fluoroscopy frequency,and incision length for both groups.Additionally,we compared the VAS scores of both groups before surgery,six hours post-surgery,one day post-surgery,one week post-surgery,and one month post-surgery.We also compared the lumbar function of both groups before surgery and 1 month post-surgery,including the Oswestry Functional Index(ODI),lumbar lordosis,and lumbar back muscle extension activity.Furthermore,we compared the serum levels of high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)in both groups before and 24 hours after surgery.Results The therapeutic effect of the observation group was better than that of the control group(Z=-3.737,P<0.001).Under the interaction effect,the pain of the two groups varied with time due to different surgical procedures(P<0.05).Under the time effect,both the observation group and the control group showed a decrease trend in pain as the time to treatment increased(P<0.05).Under the inter group effect,there was no significant difference between the two groups before and 1 month after intervention,but the pain in the observation group was less than that in the control group at 6 hours after intervention(Z=-2.831,P=0.005)and 1 day after intervention(Z=-3.253,P=0.001).One month after surgery,the ODI(Z=-4.804,P<0.001)of the observation group patients was lower than that of the control group,while the lumbar curvature(Z=-6.218,P<0.001)and lumbar back muscle extension activity(Z=-7.014,P=0.001)were higher than those of the control group.Twenty-four hours after surgery,the hs-CRP(Z=-5.671,P<0.001)and IL-6(Z=-3.262,P<0.001)levels in the observation group were lower than those in the control group.Conclusions The improved percutaneous transforaminal endoscopic technique has significant advantages over percutaneous transforaminal discectomy in the treatment of lumbar disc herniation.It can improve efficacy,reduce bleeding,alleviate pain,reduce inflammatory reactions,accelerate lumbar functional recovery,and shorten hospitalization time.
目的 探讨多组分运动训练对老年慢性阻塞性肺疾病(COPD)稳定期病人骨骼肌功能的影响。方法 前瞻性选择2022年10月—2024年10月90例COPD稳定期患者,采用抽签法随机分为观察组与对照组,对照组45例采取常规运动干预,观察组45例在对照组基础上增加多组分运动训练。干预前、干预后3个月比较两组患者四肢骨骼肌含量,四肢肌群力量,运动耐力与肺功能,生活质量。结果 干预后,两组上肢、下肢骨骼肌含量均略增加,观察组高于对照组(P<0.05);干预后,两组膝伸肌、膝屈肌、肘伸肌、肘屈肌肌群力量均增加,观察组高于对照组(P<0.05);干预后,两组6 min步行试验、用力肺活量及第一秒用力呼气量均升高,观察组高于对照组(P<0.05);干预后,两组圣乔治呼吸问卷各维度分数及总分均降低,观察组低于对照组(P<0.05)。结论 针对老年COPD稳定期患者采取多组分运动训练可提升患者四肢骨骼肌含量与四肢肌群力量,改善患者运动耐力与肺功能,减轻COPD及骨骼肌功能障碍对患者生活质量造成的负面影响。
Objective To explore the effect of multi-component exercise training on skeletal muscle function in elderly patients with stable chronic obstructive pulmonary disease(COPD).Methods From October 2022 to October 2024,90 stable COPD patients were prospectively selected and randomly divided into an observation group and a control group using a lottery method.The control group consisted of 45 patients who received routine exercise care,while the observation group consisted of 45 patients who received multi-component exercise training in addition to the routine care.Skeletal muscle content,muscle group strength,exercise endurance,lung function,and quality of life between two groups of patients were compared before and three months after intervention.Results After intervention,the skeletal muscle content of both upper and lower extremities slightly increased in both groups,with the observation group being higher than the control group(P<0.05).After intervention,the strength of the knee extensor,knee flexor,elbow extensor,and elbow flexor muscle groups increased in both groups,with the observation group had better results than the control group(P<0.05).After intervention,both groups showed an increase in six-minute walking test,forced vital capacity,and forced expiratory volume in first second,with the observation group had better results than the control group(P<0.05).After intervention,the scores of each dimension and total score of the SGRQ in both groups decreased,and the observation group had lower scores than the control group(P<0.05).Conclusions Multi-component exercise training for stable elderly COPD patients can improve the skeletal muscle content and muscle strength of the extremities,enhance exercise endurance and lung function,and alleviate the negative impact of COPD and skeletal muscle dysfunction on patients’quality of life.
目的 本研究旨在探讨不同俯卧位通气(PPV)时间对重症肺炎合并胃肠功能障碍患者肠内营养耐受性的影响。方法 选择2020年7月—2023年7月在天津市人民医院重症监护病房(MICU)治疗的80例重症肺炎合并胃肠功能障碍患者为研究对象, 按每日PPV时间分为长时组(≥12 h, n=40)和短时组(<12 h, n=40)。比较两组患者一般资料、氧合指数、胃肠功能指标[腹内压、血清促胃液素(GAS)和血管活性肠肽(VIP)]、肠内营养达标率、胃肠并发症率等。结果 短时组治疗后, 1 d、3 d、5 d氧合指数为(189.93±33.72)、(247.53±63.01)、(325.03±58.11)mmHg,高于长时组的(161.63±36.88)、(191.83±57.65)、(267.95±46.25)mmHg,均P<0.05; 胃残留量为(29.00±7.92)、(19.75±4.45)、(11.00±1.87) mL低于长时组的(75.03±23.29)、(53.13±11.99)、(21.70±5.52) mL, 均P<0.05。短时组治疗后腹内压[(8.53±2.05)mmHg vs (9.75±2.05) mmHg]、VIP水平[(61.14±7.63) vs (67.49±4.43) pg/mL]低于长时组,GAS水平[(65.02±8.84) vs (54.22±9.21)pg/mL]升高(均P<0.05)。短时组总胃肠并发症发生率(7.50%)低于长时组(25.00%), P=0.034。结论 对于重症肺炎合并胃肠功能障碍患者,每日PPV时间≤12 h可改善氧合并降低胃肠并发症风险, 可能与减轻腹压、调节胃肠激素分泌及提升肠内营养耐受性相关。
Objective To explore the effect of different duration of prone position ventilation(PPV)on enteral nutritional tolerance in patients with severe pneumonia combined with gastrointestinal dysfunction.Methods A total of 80 patients with severe pneumonia complicated by gastrointestinal dysfunction were treated in the Medical Intensive Care Unit(MICU)of a hospital from July 2020 to July 2023, and were selected as the research subjects.They were divided into the long-duration group(≥12 hours, n=40)and the short-duration group(<12 hours, n=40)according to the daily duration of PPV.The general data, oxygenation index, gastrointestinal function indicators(intra-abdominal pressure, serum gastrin[GAS] and vasoactive intestinal peptide[VIP]), enteral nutrition achievement rate, and gastrointestinal complications of the two groups were compared.Results The oxygenation index of the short-duration group at 1 d, 3 d,a nd 5 d after treatment([189.93±33.72], [247.53±63.01], and[325.03±58.11] mmHg, respectively)was significantly higher than that of the long-duration group([161.63±36.88], [191.83±57.65], and[267.95±46.25] mmHg,respectively, all P<0.05).The gastric residual volume of the short-duration group([29.00±7.92], [19.75±4.45], and[11.00±1.87] mL, respectively)was significantly lower than that of the long-duration group([75.03±23.29], [53.13±11.99], and[21.70±5.52] mL, respectively, all P<0.05).The intra-abdominal pressure([8.53±2.05] vs [9.75±2.05] mmHg)and VIP level([61.14±7.63] vs [67.49±4.43] pg/mL)of the short-duration group after treatment were significantly lower than those of the long-duration group, while the GAS level([65.02±8.84] vs [54.22±9.21] pg/mL)was significantly higher(all P<0.05).The total incidence of gastrointestinal complications in the short-duration group(7.50%)was significantly lower than that in the long-duration group(25.00%, P=0.034).Conclusions For patients with severe pneumonia complicated by gastrointestinal dysfunction, a daily duration of PPV within 12 hours can improve oxygenation and reduce the risk of gastrointestinal complications, which may be related to the reduction of intra-abdominal pressure, regulation of gastrointestinal hormone secretion, and improvement of enteral nutrition tolerance.
目的 观察桂枝加芍药汤个体化干预治疗儿童功能性腹痛的临床疗效。方法 选取2023年100名在广东省妇幼保健院门急诊就诊确诊为儿童功能性腹痛患儿。100名儿童随机分为两组,益生菌组50名、益生菌+中药个体化干预组50名。连续治疗1周。记录两组患儿卧立位心率、卧立位血压、Rutter 儿童行为量表和中医临床症状的改善情况。结果 益生菌+中药个体化干预组患儿治疗后卧立位心率和Rutter儿童行为量表中N行为评分比益生菌组下降,中医临床症状评分的有效率优于益生菌组。结论 桂枝加芍药汤个性化干预治疗儿童功能性腹痛疗效显著。
Objective To observe the clinical efficacy of individualized intervention with Guizhi plus Shaoyao Decoction in children with functional abdominal pain disorders(FAPDs).Methods A total of 100 children diagnosed with FAPDs at the outpatient and emergency departments of Guangdong Women and Children Hospital were selected.These children were randomly divided into two groups:the probiotics group(50 cases)and the probiotics+traditional Chinese medicine individualized intervention group(50 cases).Both groups received continuous treatment for 1 week.Parameters including supine/upright heart rates,supine/upright blood pressure,Rutter Children’s Behavior Questionnaire,and improvements in traditional Chinese clinical symptom scores were recorded.Results The probiotics+traditional Chinese medicine individualized intervention group exhibited significantly greater reductions in supine/upright heart rates and N-behavior scores compared to the probiotics group.The effective rate of Chinese clinical symptom scores was also significantly higher in the individualized intervention group.Conclusions Individualized intervention of Guizhi plus Shaoyao Decoction has a remarkable efficacy in treating FAPDs in children.
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(rs=0.820,P<0.001;rs=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(rs=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 (rs=0.870,P<0.001).Stratified by group,both the control and experimental groups showed a positive correlation between EOS% and IL-5 level (rs=0.820,P<0.001;rs=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 探讨断指再植患者采用微波理疗联合康复训练的影响。方法 回顾性选取2022年1月—2023年12月于福州市第二总医院进行断指再植的患者,采用康复训练的50例患者纳入对照组,采用微波理疗联合康复训练的51例患者纳入观察组,对比两组干预1个月后的毛细血管反应情况、感知恢复情况、疼痛评分、手指功能及日常生活能力情况。结果 干预1个月后, 观察组患指的温度[(28.43±5.86)℃ vs (26.15±5.39)℃,t=2.025,P<0.001]、毛细血管反应[(9.76±2.63)cm/s vs(7.36±2.23)cm/s,t=4.922,P=0.046,]高于对照组(P<0.05);观察组的英国医学研究委员会感觉评分[(15.79±3.75)分 vs(11.88±3.13)分,t=5.660,P<0.001]高于对照组;观察组第2周[(3.72±0.88)分 vs(4.39±0.92)分,t=3.721,P<0.001]、4周后[(2.67±0.32)分 vs(3.03±0.52)分,t=4.169,P=0.001]的视觉模拟量表(VAS)评分低于对照组(P<0.05);观察组的密歇根手功能量表(MHQ)评分[(61.05±10.68)分 vs(52.58±10.21)分,t=4.054,P<0.001]高于对照组(P<0.05);观察组的生活质量综合评定表(GQLI-74)评分[(320.16±55.25)分 vs(270.85±50.06)分,t=4.677,P<0.001]高于对照组(P<0.05);观察组的Barthel指数[(75.71±12.84)分 vs(68.58±12.23)分,t=2.843,P=0.005]高于对照组(P<0.05)。结论 微波理疗联合康复训练能够提高断指再植患者的手指功能,减轻患者疼痛,改善日常生活质量。
Objective To explore the effect of microwave physiotherapy combined with rehabilitation training on finger function and daily living ability of patients with severed finger replantation.Methods Patients who underwent replantation of severed fingers in our hospital from January 2022 to December 2023 were selected retrospectively.Fifty patients who received rehabilitation training were included in the control group,51 patients who were intervened by microwave physiotherapy combined with rehabilitation training were included in the observation group.The blood circulation,sensory recovery,pain score,finger function and daily living ability of the two groups were compared.Results The temperature([28.43±5.86]℃ vs [26.15±5.39]℃,t=2.025,P<0.001) and capillary reaction([9.76±2.63]cm/s vs [7.36±2.23]cm/s,t=4.922,P=0.046) of the affected fingers in the observation group were higher(P<0.05).The sensory score([15.79±3.75] vs [11.88±3.13],t=5.660,P<0.001)of the observation group was higher than that of the control group(P<0.05).The visual analogue scale(VAS)scores of the observation group at the second week([3.72±0.88] vs [4.39±0.92],t=3.721,P<0.001) and four weeks later([2.67±0.32]vs [3.03±0.52],t=4.169,P=0.001)were lower than those of the control group(P<0.05).The score of Michigan Hand Outcome Questionnair(MHQ)([61.05±10.68] vs [52.58±10.21],t=4.054,P<0.001) in the observation group was higher(P<0.05).The GQLI-74 score([320.16±55.25] vs [270.85±50.06]) and Barthel index([75.71±12.84] vs[68.58±12.23],t=2.843,P=0.005)in the observation group were higher(P<0.05).Conclusions Microwave physiotherapy combined with rehabilitation training can improve the finger function,relieve the pain and improve the quality of daily life of patients with severed fingers.