ABSTRACT
Objective To explore the risk factors and targeted therapy for fungus infection in acute exacerbation of chronic obstructive pulmonary disease (COPD) pulmonary.Methods 83 acute exacerbations of COPD patients with pulmonary fungus infection were selected as the observation object(COPD fungal infection group),according to the time sequence of random month by month in acute exacerbations of COPD no secondary fungal infection of the 80 patients hospitalized patients as control group,analysis of risk factors lead to fungal infection.Results Two groups in age,live ICU time,antibiotic use time,hormone use time,albumin level mechanical ventilation people with diabetes mellitus,merger,as cor pulmonale had statistically significant differences (P ＜ 0.05) ; The conditional Logistic multiariate analysis,age,ICU patients live time,antibiotics use time,hormone use time,albumin level was acute exacerbations of COPD factors such as pulmonary fungus infection independent risk factors(P ＜0.01) ;Fungus infection were combined with antimycotic,cured 69 cases (83.13％) improved 12 cases (14.46％),there was no change in 1 case(1.20％),death 1 case (1.20％).Conclusion Patients older age,live long,long time ICU antibiotics and hormones and the low level of albumin is acute exacerbations of COPD pulmonary fungus infection independent risk factors,timely diagnosis and prognosis of patients with antifungal treatment is good.
ABSTRACT
Objective To explore the change of plasma D-dimer (DD),lactate dehydrogenase isoenzyme 3 (LDH3),tissue plasminogen activator (t-PA) in the early stage of acute pulmonary embolism and their clinical significance.Methods Forty-six patients with acute pulmonary embolism of early stage (pulmonary embolism group) and 50 cases of normal person (control group) were enrolled in this study.The patients in pulmonary embolism group were divided into low-risk(18 patients),middle-risk(15 patients) and higher-risk (13 patients).The levels of DD,LDH3 and t-PA were detected and compared.Results The levels of DD,LDH3 and t-PA in pulmonary embolism group were (2.95 ± 0.73) mg/L,(421.42 ± 63.29)U/L and (0.85 ±0.02) U/L,and significantly higher than those in control group [(0.03 ±0.01) mg/L,(198.17 ± 23.37) U/L and (0.59 ± 0.02) U/L] (P ＜ 0.05).The levels of DD,LDH3 and t-PA in low-risk patients [(1.49 ± 0.04) mg/L,(315.47 ± 38.24) U/L and (0.63 ± 0.01) U/L] were significantly lower than those in middle-risk patients [(2.22 ±0.27) mg/L,(382.41 ±54.36) U/L and (0.79 ±0.02) U/L] and higher-risk patients [(3.38 ± 0.98) mg/L,(583.93 ± 117.21) U/L and (0.92 ± 0.03) U/L] (P ＜ 0.05).The levels of LDH3 and t-PA in middle-risk patients were significantly lower than those in higher-risk patients (P ＜ 0.05).After treatment,the levels of DD,LDH3 and t-PA were significantly decreased [(2.95 ± 0.73)mg/L vs.(1.03 ±0.11) mg/L,(421.42 ±63.29) U/L vs.(223.24 ±25.04) U/L,(0.85 ±0.02) U/L vs.(0.62 ± 0.02) U/L] (P ＜ 0.05).Conclusions The levels of DD,LDH3 and t-PA in the early stage of acute pulmonary embolism are increased significantly,and with the remission of the patient's condition,the levels of DD,LDH3 and t-PA are decreased.United detection conduces to the diagnosis of acute pulmonary embolism.