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INTRODUCCIÓN. Para el tratamiento farmacoterapéutico de enfermedades respi-ratorias, el uso de herramientas para abordar la vía inhalatoria es de elección por su mayor eficacia y menos efectos secundarios; registrar su adhesión y prevalencia es importante. OBJETIVO. Determinar el nivel y la prevalencia de adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Cróni-ca. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 215 y muestra de 121 Historias Clínicas. Se aplicó el Test de Adhesión a Inhaladores, que consistió en dos cuestionarios complementarios: el de 10 ítems, que valoró el nivel de adhesión, y el de 12 que identificó el tipo de incumplimiento en pacientes de Consulta Externa de la Unidad Técnica de Neumología del Hospital de Especialidades Carlos Andrade Marín, periodo julio 2018 - enero 2019. La tabulación y análisis de datos se realizó con el programa Excel. RESULTADOS. La prevalencia de mala adhesión en asmáticos fue de 83,33% y en Enfermedad Pulmonar Obstructiva Crónica 13,33%. En cuanto al sexo, la prevalencia de mala adhesión fue de 15,28% en hombres y de 40,82% en mujeres, con una p<0,05. No se encontró diferencia significativa respecto a los niveles de instrucción. CONCLUSIÓN. La prevalencia de mala adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Crónica fue alta sobre todo en los asmáticos.
INTRODUCTION. For respiratory diseases and their pharmacotherapeutic treatment, the use of tools to address the inhalation route is chosen due to its greater efficacy and fewer secondary effects; then record the adherence and prevalence is important. OBJECTIVE. To determine both level and prevalence of adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease. MATE-RIALS AND METHODS. Cross-sectional analytical study. Population of 215 and sam-ple of 121 patients. The Inhaler Adherence Test was applied, which consisted of two complementary questionnaires: a 10-item questionnaire, which assessed the level of adherence, and a 12-item questionnaire that identified the type of non-compliance in patients of the Pneumology Technical Unit of the Hospital de Especialidades Carlos Andrade Marín, period July 2018 - January 2019. The tabulation and data analysis was performed with Microsoft Excel program. RESULTS. The prevalence of poor ad-herence in asthmatics was 83.33% and in Chronic Obstructive Pulmonary Disease was 13.3%. Regarding gender, the prevalence of poor adherence was 15.28% in men and 40.82% in women, with a p <0.05. No significant differences were found regarding the levels of instruction. CONCLUSION. The prevalence of poor adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease was high, especially in asthmatics
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Respiratory Tract Diseases , Asthma , Nebulizers and Vaporizers , Pulmonary Medicine , Pulmonary Disease, Chronic Obstructive , Treatment Adherence and Compliance , Respiratory Therapy , Bronchodilator Agents , Medication Therapy Management , Medication Adherence , Dry Powder InhalersABSTRACT
Objective To explore the relationship between quality of life and knowledge,beliefs,behavioral,pulmonary function outcomes in stable-stage patients with chronic obsturctive pulmonary disease (COPD).Methods Using the general data questionnaire,COPD assessment test (CAT),knowledge,attitude and behavior questionnaire to investigate 93 stable-stage COPD patients in urban and rural areas,and measure the level of forced expiratory volume in one second (FEV1％).Results CAT total score was (22.56 ± 6.40) points which was in severe level;knowledge,beliefs,behavior total score was (41.94 ± 8.20) points,and FEV1％ was (59.81 ± 7.64) ％.The CAT was negatively correlated with knowledge,beliefs,behavior total score and two dimensions of beliefs,behavior and FEV1％,r values were-0.262,-0.288,-0.217,-0.256 respectively,P ＜ 0.05.Conclusions The COPD patients in stable-stage have a high level of CAT.Targeted invention should be combined with the status of the knowledge,beliefs and behavior to improve the level of air flow,and quality of life of patients.
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Objective To explore the relationship between osteoporosis and serum total type Ⅰ amino terminal extension of the peptide,vitamin D3 and smoking index in the patients with chronic obstructive pulmonary disease (COPD).Methods One hundred and fifty patients with COPD (test group) and 150 healthy people (control group) were selected.The total type Ⅰ amino terminal extension of the peptide was measured by electrochemical luminescence,and enzyme-linked immunoassay was adopted to determine the vitamin D3.The 150 patients with COPD were divided into slight group (45 cases),moderate group (52 cases) and severe group (53 cases) according to the severity of COPD.In 150 patients with COPD,120 patients with smoking were divided into 3 groups according to smoking index:A group smoking index ＜ 360,36 cases;B group smoking index 360-400,34 cases;and C group smoking index 401-560,50 cases.The levels of serum total type Ⅰ amino terminal extension of the peptide and vitamin D3 were compared and correlation was analyzed.Results The vitamin D3 and the total type Ⅰ amino terminal extension of the peptide levels in test group were significandy lower than those in control group:(35.37 ± 12.11) mg/L vs.(45.88 ± 12.55) mg/L and (38.16 ± 11.12) mg/L vs.(45.23 ± 12.33) mg/L,and there were statistical differences (t =2.74 and 4.64,P＜ 0.01).The levels of vitamin D3 and the total type Ⅰ amino terminal extension of the peptide in slight,moderate and severe group were decreased in turn,and the levels of total type Ⅰ amino terminal extension of the peptide and the vitamin D3 were positively associated with the severity of COPD (r =0.185 and 0.257,P ＜ 0.05).The levels of vitamin D3 and total type Ⅰ amino terminal extension of the peptide in A,B and C group were decreased in turn,and the levels of total type Ⅰ amino terminal extension of the peptide and the vitamin D3 were positively associated with smoking index (r =0.159 and 0.172,P ＜ 0.05).Conclusion COPD patients are easier to suffer from osteoporosis compared with healthy population,and the serum vitamin D3 and total type Ⅰ amino terminal extension of the peptide can forecast the osteoporosis in COPD patients.
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Objective To compare the efficacy of three solutions used in the patients who suffered chronic obstructive pulmonary diseases (COPD ) when combined with oral fungal infection,and to find the most suitable one. Methods Using randomized controlled trial method, 98 patients who suffered COPD complicated with fungal infection were randomly divided into three groups. Method 1, using 0.5% povidone for the oral care. Method 2, making 200 million U of nystatin powder dissolved in 2.5% NaHCO3 for the oral care.Method 3, gave oral care with 2.5% NaHCO3 first, then put 200 million U of nystatin powder into 20 ml glycerol and covered the oral spots with them. Three groups were observed in the effect of oral fungal infection and the feedback from patients and nurses. Results In the analysis of the white spots sharply disappeared or pharyngeal swab smear turned negative, method 1 and method 3 had no statistical difference, P>0.05, but method 2 and method 3 had statistical significance, t=3.892, P 0.05. The time made solution of method 1 occupied 41.7% of method 3, and the time made solution of method 2 occupied 54.4%of method 3, while there was no statistical significance in total time of three groups (P>0.05). Conclusions The oral care with 0.5% povidone had good effect on the patients who suffered COPD complicated with oral fungal infection,with good comfort,and most nurses saving time. Nystatin powder dissolved in 2.5% NaHCO3 worked later than nystatin powder dissolved in glycerol.
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Objective To compare the efficacy and safety of long-term treatment (48 weeks) with tiotropium bromide (5 μg) via Respimat(R) with placebo in patients with chronic obstructive pulmonary disease (COPD).Methods A total of 338 patients were randomized in this double-blind,placebo controlled,parallel study.All patients received either tiotropium bromide or placebo.Tiotropium bromide solution 5 μg (2 × 2.5 μg/puff) or matching placebo was delivered via Respimat(R) at a dosage of once daily for 48 weeks.Co-primary endpoints were trough forced expiratory volume in one second (FEV1) and the time to first exacerbation.Results Statistically significant improvements of both trough FEV1 and trough forced vital capacity (FVC) in the tiotropium group were achieved at weeks 4,24,and 48 compared with those in the placebo group(P ＜ 0.000 1).Tiotropium treatment delayed the time to first exacerbation.The time was 157 days in the tiotropium group and 85 days in the placebo group.A statistically significant difference (P =0.002 7) in favor of tiotropium was also observed.The total numbers of exacerbation during treatment were 90 and 128 in the tiotropium and placebo groups,respectively.The Poisson regression analysis gave a mean exacerbation rate per patient year exposure of 0.67 in the tiotropium group compared to 0.98 in the placebo group with a rate ratio of 0.69 (95％ CI O.50-0.93,P =0.016 4).A much larger improvement from baseline in St.George's respiratory questionnaire (SGRQ) total score was observed for the tiotropium group than in the placebo group(P =0.036 7),SGRQ symptom and activity scores of patients in the tiotropium group were also superior to those of patients receiving placebo.The drugs-related adverse events in the tiotropium and placebo groups were 12 cases and 11 cases,respectively.Conclusions Tiotropium significantly improved lung function and quality of life,delayed the time to first exacerbation,reduced the number of exacerbation.Overall,tiotropium was well tolerated.
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Objective To investigate the clinical effect of long-term home non-invasive assisted ventilation in stable chronic obstructive pulmonary disease (COPD) combined with type Ⅱ respiratory failure.Methods Seventy-eight patients with stable COPD combined with type Ⅱ respiratory failure were divided into treatment group (26 cases) and control group (52 cases).Patients in control group were given conventional treatment,including inhaled salmeterol/fluticasone plus long-term home oxygen therapy (LTOT).Patients in treatment group on the basis of conventional treatment were given non-invasive assisted ventilation therapy for 6-8 hours a day,and the course was 12 months.Blood gas analysis index [pH,arterial blood carbon dioxide partial pressure (PaCO2),arterial blood oxygen partial pressure (PaO2)],pulmonary function index [forced expiratory volume in 1 second (FEV1),FEV1 percentage of expected value (FEV1％)],6 min walk test (6-MWT) distance,St George's respiratory questionnaire (SGRQ) and acute episodes.Results After 12 months'follow-up,there was no endotracheal intubation and dead patients in treatment group.Five patients had acute trachea intubation and invasive mechanical ventilation,and 1 case died in the control group.The index of pulmonary function (FEV1,FEV1％) in two groups after treatment was improved compared with that before treatment (P＜ 0.05).But FEV1 and FEV1％ over the same period in treatment group after treatment was higher than that in control group (P ＜ 0.05).The blood gas analysis indicators (pH,PaCO2,PaO2) in treatment group after treatment were improved compared with that before treatment (P ＜0.05).PaO2 in control group after treatment was improved,compared with that before treatment (P＜ 0.05),but there was no significant difference in control group in pH and PaCO2 levels before and after treatment (P ＞0.05).After treatment 6-MWT distance,and SGRQ scores were improved,compared with that before treatment (P ＜ 0.05),6-MWT from the same period in treatment group after treatment was higher than that in control group,and SGRQ scores was lower than that in control group during this period (P ＜ 0.05).There was significant difference in average acute episodes between treatment group and control group [(0.84 ± 0.16) times vs.(1.49 ± 0.78) times,t =-3.65,P ＜ 0.05].Conclusion Home non-invasive assisted ventilation treatment can improve blood gas analysis and pulmonary function in patients of COPD combined with type Ⅱ respiratory failure of stationary phase,increase exercise tolerance,improve the quality of life,and reduce the number of acute episodes and intubation rate.
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We observed 38 patients' breath frequency after different oxygen therapy according to their visit sequences and tolerance conditions.All patients with chronic obstructive pulmonary.disease (COPD) plus carbon dioxide retention from April 2008 to June 2011 were recruited at our hospital.Twentythree patients who could maintain SpO2≥92％ through inspiring O2 at ≤3.5 L/min were assigned into the first group.And another 15 subjects whose SpO2 could not reach 92％ at the same oxygen flow for 5 hours were assigned into the second group.The second group received an elevated oxygen flow until their SpO2 attained 92％ or so.But the maximal rate did not exceed 8 L/min even if SpO2 was below 92％.The state was maintained for 5 hours.Paired t-test showed PaO2 became elevated and PaCO2 decreased significantly on onset and termination of low oxygen flow in both groups.But the frequency of the second group's breaths per minute (BPM) had no significant differences.After elevating oxygen flow,the second group's BPM and PaCO2 on onset and termination were (19.4 ± 3.4) and (18.1 ± 2.6) perminute (P =0.038),(55.0 ±8.1) and (52.0 ±7.9) mm Hg (1 mm Hg =0.133 kPa) (P =0.030) respectively and the results showed significant decreases.But SpO2 was elevated [(85.8 ± 4.1) and (90.7 ± 2.4) mm Hg (P =0.000)].
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ObjectiveTo explore the application of finasteride during ipratropium bromide treatment in the elderly with chronic obstructive pulmonary disease. Methods The 263 patients who were hospitalized for chronic obstructive pulmonary disease (COPD) and treated with ipratropium bromide (aged 63-89 years) in Cadre Wards of Ji Shui Tan Hospital from Jan.2006 to Jan.2011 were reviewed.They were divided by gender and combination of benign prostatic hyperplasia (BPH) and treatment of finasteride.The duration of ipratropium bromide treatment,time to dysuria and the severe degree of dysuria were evaluated.Results None of the female patients suffered from difficult urination or discontinued impratropium bromide for abnormal urination,while there were 23.3％ cases with difficult urination,5.8％ catheterization and 3.4％ discontinued bromide in male patients.More patients suffered from catheterization and bromide discontinuance in prostatic hyperplasia group (8.0 ％ and 4.7 ％ ) as compared with non-prostatic hyperplasia group (P＜ 0.05).The occurrence of urethral catheterization for dysuria or ipratropium bromide discontinuance obviously decreased 40％ and 30％,respectively,after finasteride treatment (P＜0.01). Conclusions The COPD patients complicated with BPH should be treated with finasteride to prevent the occurrence of abnormal urination and urinary retention during the treatment of ipratropium bromide.
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Objective To study and compare the effect of different ventilation modes in chronic obstructive pulmonary diseases (COPD) combined with respiratory failure. Methods Fifty patients with COPD combined with respiratory failure were divided into group A and group B with 25 cases each by random digits table,and they were treated with invasive positive pressure ventilation. Then the two groups were respectively treated with synchronized intermittent mandutory ventilation (SIMV) + pressure suppert ventilation (PSV) and PSV + positive end-expiratory pressure (PEEP) after appearing the pulmonaryinfection-control- window. And the time of mechanical ventilation, length of hospital stay, reintubation rate, complication rate and serum interleukin (IL)-8,high Sensitiveity c-reactive protein (hs-CRP), IL-4 and interferon (IFN)- γ of the two groups before and after the treatment was analyzed and compared. Results The time of mechanical ventilation and length of hospital stay in group B was shorter than that in group A [(11.8 ± 2.3), (16.8 ± 3.2) d vs. (20.3 ± 2.0), (28.8 ± 4.1) d], and the reintubation rate and complication rate was lower than that in group A [8%(2/25), 8%(2/25) vs. 24%(6/25), 24%(6/25)]. The levels of serum IL-8, hs-CRP, IL-4 and IFN- 7 were lower in group B than those in group A (P ＜ 0.05). Conclusion The effect of nasal mask inhaled oxygen early given to COPD combined with respiratory failure is better, and it should be paid attention to.
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Objective To investigate awareness of definition, diagnostic criteria, severity classification and standard diagnosis and treatment for chronic obstructive pulmonary disease (COPD) among primary-care physicians at the grassroots in urban and suburban Shanghai.Methods In total, 298 physicians were surveyed by unified questionnaire for COPD-related knowledge in two secondary-care general hospitals (one in urban and suburban areas each ) and 12 community primary-care centers (four in urban and eight in suburban areas) in Shanghai.One hundred and fifteen physicians in two urban hospitals and one suburban hospital were trained professionally and then evaluated for its effectiveness.Results Awareness of diagnostic criteria of COPD was only 22.4% (35/156), 25.6% ( 10/39), 4.3 % (3/69)and 26.5% (9/34) among physicians in urban primary-care hospitals, urban secondary-care hospitals,suburban primary-care hospitals and suburban secondary-care hospitals, respectively.Their awareness of knowledge about use of anti-cholinergic agents was 13.5 % (21/156), 35.9 % ( 14/39), naught (0/69),and 14.7 % ( 5/34 ), respectively.Only 0.67 % of them ( 2/298 ) knew about severity classification of COPD.Awareness of definition and diagnostic criteria for COPD in the physicians increased to 72.2 % ( 83/115) after training from 18.2% (21/115) before it, and their awareness of severity classification for COPD increased to 45.2% (52/115) after training from 0.8 % (1/115) before it.Conclusions Awareness of COPD-related knowledge, especially of standard diagnosis and treatment for COPD, was poor in primary-care physicians at the grassroots in Shanghai, so it is necessary to strengthen training for them in COPD-related knowledge, including pulmonary function tests.
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Objective To investigate the effect of physician guidance on cigarette cessation in current smokers with chronic obstructive pulmonary disease(COPD).Methods Cigarette cessation education and routine telephone follow-up was provided for 70 COPD patients.Pulmonary function and exhaled carbon monoxide level were detected every 3 months.Results After 6 months' follow-up,28 participants(40.00%) successfully quitted cigarette smoking.Seventeen subjects (24.28%) experienced relapse,with mean cessation time(3.08±0.33) months.Once receiving physician guidance,5 re-attempted to quit cigarette smoking,and 12 reduced tobacco consumption. Sixteen subjects(22.86%) did not quit smoking,although the mean cigarette consumption per day was decreased by 60%.Nine participants (12.86%) showed no change in smoking habit. Conclusion Physician guidance could impreve the rate of cigarette cessation in COPD patients.Intensive intervention may be correlated with successful smoking cessation.
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Objective To evaluate perception and awareness of disease knowledge in patients with chronic obstructive pulmonary disease (COPD) in rural area of Xuzhou City. Methods Perception and awareness of COPD, including its nature, control, medication use, impact on their quality of life, experience of its acute exacerbation, and so on, in 392 patients with COPD were evaluated with self-designed ad hoc questionnaire. Proportion and percentage were used in statistical analysis. Results According to the GLOD standards, 58 of 392 patients with COPD could be classified as stage Ⅰ (14. 8%), 164 as stage Ⅱ (41.8%), 103 as stage Ⅲ (26.3%) and 67 as stage Ⅳ (17.1%), respectively. Only 14 patients (3.6%) had heard COPD, but all of them did not know the definition of COPD and its acute exacerbation. Lung function tests and health education had never been performed for all these patients. One hundred and twenty-six patients (32. 1%) did not understand that smoking is a risk factor for COPD, 343 patients (87. 5%) had never heard that COPD could be prevented and controlled. Only 95 patients (24. 2%) did regular physical exercises. Seventy-six patients (19. 4%) in stable stage did not take theophylline regularly, and none of them took inhalers or nebulizer drugs regularly or temporally, or oxygen therapy and pulmonary rehabilitation at home. During acute exacerbation, 261 patients (66.6%) could take theophyUine or analogous drugs and antibiotics. One hundred and five patients (26. 8%) were admitted to hospital during the past year due to respiratory symptoms. Physical activities were restrained in 224 patients (57.1%), 91 patients (23. 2%) had a little bit feeling of depression sometimes and social communication was impacted in 232 patients (59. 2%). Conclusions Patients with COPD in rural Xuzhan, Jiangsu province were poor in knowledge of COPD, and their treatment during stable stage and acute exacerbation did not meet the standards. COPD had significant impact on their daily life, and education and management for the patients should be strengthened.
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Objective The aim of this study is to evaluate clinical application of BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index in patients with chronic obstructive pulmonary disease (COPD). Methods Forty patients with stable COPD in Xuanwu Hospital of Beijing during September 2003 to December 2007, were recruited in the study, including 25 men and 15 women, aged 38 to 85 years (with a mean of 62 ± 13 years). BODE index was measured for each patient, one year and three years after recruitment, respectively. Severity of COPD, including number and duration of episodes, length of each hospital stay and times of hospitalization due to acute exacerbation of COPD (AECOPD), were recorded. All data were statistically analyzed with SPSS 13.0 software for windows. Results ①There was a remarkable difference in COPD severity between patients with BODE score equal to or greater than five and these with less than five (P <0.01 ). ①BODE score inversely correlated with forced expired volume at the first second ( FEV1 ) in COPD patients (P < 0.01 for those with BODE score equal to or greater than five and P <0.05 for these with BODE score less than five, respectively). ③BODE score positively correlated with number and duration of acute exacerbation, length of hospital stay and times of hospitalization due to AECOPD (P <0. 01 for those with BODE score equal to or greater than five and P < 0. 05 for those with BODE score less than five, respectively). For patients with COPD, their BODE score in the first year positively correlated with that in the third year ( r = 0.834, P < 0.01 ). Conclusions BODE index is a better indicator to evaluate their condition severity in patients with COPD.
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Objective To evaluate the value of serum procalcitonin(PCT)on antibiotics use in treatment of acute exacerbations of chronic obstructive pulmonary disease( AECOPD). Method From May 2004 to December 2006, a total of 235 patients requiring hospitalization for AECOPD were randomly assigned into two groups: standard therapy group(group A, n = 117)and PCT-guided group(group B, n = 118) .PCT levels of all patients were measured after hospital admission by an amplified cryptate emission technology assay. On the base of similarly normal treatment, group A received antibiotics according to the attending physicians,and group B were treated with antibiotics according to serum PCT levels:antibiotic treatment was applied with PCT level ≥0.25 ng/ml and was discouraged with PCT level ＜0.25 ng/ml. Length of hospitalization,clinical efficacy,costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality,rate of exacerbation and rehospitalization within 1 year were observed. Analyses were performed by t test, Mann-Whitney U test or χ2 test. Results Clinical efficacy, hospital mortality, length of hospitalization, rate of exacerbation and rehospitalization within 1 year were similar in two groups (P =0.635,0.768,0.884,0.747,0.727) ;costs of antibiotics and hospitalization,rate of antibiotics use of PCT-guided group were lower than that of standard therapy group( P = 0.029,0.036,0.014). Conclusions PCT could be used in treatment of AECOPD for antibiotic use after hospital admission,which may reduce antibiotic use and lower costs of antibiotic and hospitalization.
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Objective To evaluate the predicting value of serum procaleitonin (PCT) in treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in elderly patients. Methods A total of 267 elderly patients requiring hospitalization for AECOPD were randomly assigned into 2 groups: standard therapy group (standard group, n= 135) and PCT-guided group(PCT group, n= 132). Standard group received antibiotics according to the guideline of attending physicians and PCT group were treated with antibiotics according to serum PCT levels.Length of hospitalization, clinical efficacy, costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were observed. Results Length of hospitalization, clinical efficacy, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were similar in 2 groups(all P＞0.05);costs of hospitalization and antibiotics, rate of antibiotics use of PCT group[10 882 (3808-16 651)yuan, 6934 (2390-10 660)yuan, 76.5%] were lower than those of standard group[13 637(4650-19 730)yuan, 8589(3144-12 117)yuan, 87.4%] (all P＜0.05). Conclusions PCT guidance offers an advantage over standard therapy in reducing antibiotic use and in lowering the costs of hospitalization in treatment of AECOPD in elderly patients.
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Objective To report the management of single allograft lung transplantation in 4 cases of COPD. Methods Four COPD cases receiving lung transplantation were analyzed respectively. There was diffuse emphysema in double lung in one case and in the remaining 3 cases severe diffuse emphysema that mixed together partially to be bulla but not to the 1/3 of the thoracic cavity. All the cases received the corpse donor. One case with diffuse emphysema received the single-right lung transplantation, one case received simultaneous single-lung transplantation and lung volume reduction and the remaining 2 cases received LVRS 47 days and 28 days after single-left lung transplantation respectively. The inductive treatment with the daclizumab or antithymocyte globulin (ATG) was done and the rejection was prevented with the Tacrolimus, mycophenolate and prednisone. Results The operations were successful in the 4 cases. One case had the acute rejection 5 days after operation and reco- vered after intensive treatment with Methylprednisolone. Two cases discharged successfully and lived to today and the first case lived more than 2 years. Two cases died 74 days and 77 days after lung transplantation respectively. Conclusion In late stage COPD, single allograft lung transplantation is an effective treatment to the bilateral emphysema patients and the lung volume reduction should be done simultaneously to the patients with the bullae that may be ruptured.
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Objective To evaluate the respiratory mechanics and inflammatory status in elderly patients with stable chronic obstructive pulmonary diseases (COPD).Methods The arterial blood gases (ABGs),respiratory drive and its derivatives,mechanics of respiratory muscles,resistance and compliance of airway,interleukin-8 (IL-8)and interferon-?(IFN-?)were measured in 42 cases withstable COPD and 40 subjects of normal control.Results The elderly patients with stable COPD had great changes in the following parameters while compared with the control group:peak inspiratory pressure(PIMAX) [(4.48?2.11)vs(6.10?2.91)kPa],maximum expiratory pressure (PEMAX)[(6.30?3.20)vs(9.15?93.30)kPa],0.1s mouth occlusion pressure(P_(0.1)) with its correction index,airway resistance,compliance,ABGs,the levels of IL-8[(218.46?91.14) vs (161.84?14.40)ng/L]and IFN-?[(2435.82?639.92)vs(1652.40?95.08)ng/L],which might aggravate the progress of COPD consistently.Conclusions The elderly patiends with stable COPD has marked changes in respiratory drive,airway resistance,and airway compliance,respiratory mechanic and inflammatory status.The intervention should be performed in the elderly stable COPD patients.
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Objective To study PFSDQ-M in evaluating meal-induced hypoxemia in patients with chronic obstructive pulmonary disease.Methods PFSDQ-M scores were collected from 63 COPD patients;49 of them were performed spirometry and meal-related SpO2 monitoring.On the basis of different lung function parameters,data analysis was used to assess the relationship between PFSDQ-M and meal-induced hypoxemia.Results The SpO2 fluctuation during eating period was of significant difference in COPD patients with 3 respective levels of pulmonary function parameters (P
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Objective:To observe the role of Zhike Qingfei Oral Liquid in treatment of the airway inflammation of chronic obstructive pulmonary diseases(COPD).Methods:50 cases with COPD at stable stage were divided into a treatment group and a control group,25 cases in each.Patients in both groups were treated with conventional therapy,including oxygen therapy,cardiactonic diuresis and relieving cough and asthma,etc.Zhike Qingfei Oral Liquid was added to the patients,of the treatment group,20ml each time,3 times each day,for 6 weeks.Clinical scores,pulmonary function,cell count and classification,interleukin-8(IL-8)and tumor necrosis Factor-?(TNF-?)in the sputum before and after treatment were investigated.Results:In the treatment group.the clinical score,FEV_1 and FEV_1/FVC(%)improved significantly(P
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0.05), respectively. ICU stay time was shorter in protocol-directed group than in non-protocol-directed group (20?11 vs. 44?33 days, P