ABSTRACT
Objective To investigate the changes and clinical significance of the plasma cytokines and endothelium function in patients with chronic pulmonary heart failure disease at high altitude area.Methods Plasma levels of tumor necrosisfactor-alpha(TNF-?),interleukin-6(IL-6),endothelin-1(ET-1) were measured in 278 chronic pulmonary heart patients with various degrees of heart failure and in 48 healthy controls.Left ventricular ejection fraction(LVEF),Right ventricular ejection fraction(RVEF) and Pulmonary(PASP) were examined with echocardiography.Results Plasma levels of TNF-?,IL-6,ET-1 were elevated in patients of functional classes Ⅱto Ⅳ as compared with age-matched control subjects and were progressively elvated with the decreasing functional status of the patients.The levels of TNF-?,IL-6,ET-1 respectively were positively correlated with PASP but negtively correlated with LVEF and RVEF(P
ABSTRACT
Objective To study the relationship between malnutrition and respiratory muscle strengthas well as the effect of diet supplement on respiratory muscle strength in elderlypatients with chronic cor pulmonale in high altitude areas(HAECCP). Methods 46 patients with HAECCP not in exacerbation were divided into two groups, namely, diet supplement group (23 cases) and control group (23 cases). The caloric intake was increased by 45%-50% in the diet supplement group. Ten parameters with regard to body weight, muscle strength and respiratory function were measured in all the patients. These parameters included percentage of ideal body weight (%IBW), triceps skinfold thickness(TSF), midarm muscle circumference (MAMC), maximal inspiratory pressure(PImax), maximal expiratory pressure (PEmax),maximal transdiaphragmatic pressure(Pdimax),forced expiratory volume in 1 second (FEV_1) ,expressed as percentage predicted (FEV_1%), ratio of FEV_1 to forced vital capacity (FEV_1/FVC), partial pressure of arterial O_2 (PaO_2) and partial pressure of alveolar CO_2(PaCO_2). All the parameters were measured again after 4 weeks. Results There was no significant differece between the parameters in the two groups before the treatment. After 4 weeks of treatment, there was significant improvement in %IBW, serum albumin (Alb), TSF, MAMC, PImax,PEmax,Pdimax in the diet supplement group, indicating the effect of increased nutrition on body weight and respiratory muscle strength. However, no significant difference was found in the parameters of pulmonary function and blood gas analysis after diet supplement. NO change was observed in the parameters of the controls after 4 weeks. Conclusions In stable patients with HAECCP not in exacerbation, the strength of respiratory muscle decreased as a result of malnutrition. After diet supplement, the strength of respiratory muscle increased with accompanying improvement in nutritional status.