ABSTRACT
Objective To observe the effect and the influence on PCT,CRP in the treatment of patients with acute exacerbation pulmonary disease by Budesonide and ipratropium bromide.Methods 80 patients with acute exacerbation pulmonary disease were randomly divided into 40 cases of the control group and 40 cases of the observa-tion group,the two groups were given routine treatment,the control group then had been given ipratropium bromide for 7d,and the observation group had been given Budesonide and ipratropium bromide for 7d,the blood gas indicators (PaO2 ,PCO2 ),pulmonary function (FEV1 ,PEF,FEV1 /FVC),dyspnoea and exercise tolerance score,serum PCT levels,serum CRP levels and clinical efficacy were compared,Adverse reactions were recorded.Results (1 )the PaO2 ,FEV1 ,PEF,FEV1 /FVC of the observation group and the control group after treatment were (70.7 ±2.3)mmHg and (62.5 ±3.0)mmHg,(2.15 ±0.63)L and (1.76 ±0.56)L,(3.49 ±0.82)L/s and (3.06 ±0.75)L/s, (68.52 ±6.53)% and (60.14 ±6.03)%,These indicators were significantly higher than those before treatment,all P <0.05,the PCO2 ,PCT,CRP were (51.4 ±1.7)mmHg and (56.6 ±2.3)mmHg,(1.75 ±1.20)μg/L and (2.58 ± 1.17)μg/L,(10.25 ±6.77)mg/L and (19.07 ±5.75)mg/L,These indicators were significantly lower than those before treatment,all P <0.05,the PaO2 ,FEV1 ,PEF,FEV1 /FVC of the observation group were significantly higher than those of the control group,the PCO2 ,PCT,CRP were significantly lower than those of the control group,all P <0.05;(2)The dyspnoea and exercise tolerance score of the observation group and the control group after treatment was significantly lower than those before treatment,the dyspnoea and exercise tolerance score of the observation group was significantly lower than those of the control group;(3)The clinical total effective rate of the observation group was 90%,which was higher than 65% of the control group(χ2 =7.312,P <0.05).Conclusion The method containing Budesonide and ipratropium bromide Inhalation has exact effect,and can effectively improve respiratory function, which is an effective treatment of choice for acute exacerbation of COPD.
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Objective To discuss the clinical characteristics of elderly patients with acute pulmonary embolism in common circumstance of primary hospital in order to improve the quality of diagnosis and treatment of such patients.Methods Retrospective analysis was made on case records of acute pulmonary embolism patients older than 60 years.Results Among 41 cases of acute pulmonary embolism,21 cases (51.2％) have co-exiting lower extremity deep vein thrombosis (DVT).The risk factors of pulmonary embolism include:hypertension (23 cases,51.2％) ;malignant tumor (12 cases,21.3％) ;operation with time of anesthesia longer than 30 minutes (11 cases,26.8％) ;immobilization (11 cases,26.8％) ;diabetes mellitus (10 cases,24.4％) ;hyperlipidemia (9 cases,22.0％) ;obesity (8 cases,19.5％) ; prolonged atrial fibrillation (6 cases,16.6％).The major symptoms include:dyspnea (36 cases,87.8％) ; cough (11 cases,26.8％) ; chest pain (8 cases,19.5％) ; syncope (6 cases,14.6％) ; palpitation (5 cases,12.2％) ; hemoptysis (5 cases,12.2％) ; agitation (2 cases,4.9％).Common signs include:cyanosis (38 cases,92.7 ％) ; tachypnea (34 cases,82.9％) ; tachycardia (34 cases,82.9 ％) ; asymmetrical swelling of lower extremities (13 cases,31.7 ％) ; hypotension (7 cases,17.1％).Common finding of the patient's blood gas analysis is hypoxemia (39 cases,95.1％) and hypocapnemia (20 cases,48.8％).Common findings of chest X-ray are infiltration of the lungs and small amounts of pleural effusion.15 (36.6％) patients with DVT have both risk factors and typical clinical symptoms.Common findings of EKG were sinus tachycardia.Definite diagnosis of pulmonary embolism was made by CTPA (computed tomography pulmonary angiography) in 22 cases(53.7％).37 (90.2％) patients with PE (pulmonary thrombo-embolism) underwent anticoagulant therapy,4 (9.8％) patients underwent anticoagulant plus thrombolysis.The motility of this group was 19.5％.Conclusion The most common risk factors of elderly PE patients are chronic illness (most commonly COPD,hypertension,hyperlipidemia),malignant tumor,operation and immobilization.No clinical sign and laboratory test have high specificity.CTPA is the main way to make definite diagnosis.Anticoagulant is the primary therapy in elderly patients with PE,which is safe and efficacious.Thrombolysis of large area PE in elderly patients with risk factors of bleeding should be cautious.Excessive thrombolysis should be avoided.
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Objective: To observe the effect of vitamin A and iron supplementation on iron status during pregnancy. Methods: 167 pregnant women aged 21～33 years in the second trimester were recruited and randomly allocated to four groups: placebo; vitamin A (1.1 mg/d); iron(60 mg elemental iron); vitamin A and iron, for 10 weeks. Results:The incidences of vitamin A deficiency, anemia and iron depletion were 0.6%,7.8% and 6.2% in the second trimester respectively. Serum VA level was not changed in three supplemented groups but decreased in placebo group. Hemoglobin in all groups before and after supplementation was in normal range, with no significant differences. The improvement in serum ferritin, free erythrocyte proporphyrin and transferrin saturation was better in the group supplemented with VA+Fe than VA or Fe alone. Conclusion: The simultaneous supplementation of vitamin A and iron is better in improvement of iron status than supplementation of vitamin A or iron alone during pregnancy. Improvement of iron status by simultaneous supplementation of pregnant women with vitamin A and iron was better than supplementation with iron or vitamin A alone.