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Objective:To investigate the correlation between serum adiponectin (APN) and inflammatory markers, nutritional status and severe acute exacerbation in late stage in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:One hundred and sixty-three male patients with AECOPD from July 2017 to April 2019 in Wusong Hospital of Baoshan District, Shanghai City were selected. The patients were divided into low APN group (serum APN ≤ 102.38 μg/L, 97 cases) and high APN group (serum APN>102.38 μg/L, 66 cases). The interleukin (IL)-6, IL-8, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hemoglobin, albumin, prealbumin, body mass index (BMI) and number of severe acute exacerbation in 1 year′ follow-up were compared between 2 groups, and the correlation between APN and inflammatory markers, nutritional status and number of severe acute exacerbation were analyzed.Results:The BMI, hemoglobin, prealbumin and albumin in low APN group were significantly higher than those in high APN group: (23.20 ± 3.26) kg/m 2 vs. (20.77 ± 3.78) kg/m 2, (133.23 ± 17.13) g/L vs. (125.68 ± 20.83) g/L, (185.36 ± 57.60) g/L vs. (148.83 ± 64.79) g/L, (37.09 ± 4.06) g/L vs. (33.77 ± 5.86) g/L, and there were statistical differences ( P<0.01 or<0.05); there were no statistical differences in total protein, IL-6, IL-8, CRP and ESR between 2 groups ( P>0.05). APN showed negative correlation with BMI, hemoglobin, albumin and prealbumin ( r = -0.42, -0.28, -0.33 and -0.31; P<0.01); there was no correlation with IL-6, IL-8, ESR and CRP ( P>0.05). The rate of 4 times of severe acute exacerbation in 1 year′ follow-up in low APN group was significantly lower than that in high APN group: 8.25% (8/97) vs. 22.73% (15/66), and there was statistical difference ( χ2 = 6.79, P<0.05). Conclusions:The AECOPD patients with low APN have better nutritional status and less exacerbation. Serum APN can be used as a predictive index of severe acute exacerbation in AECOPD patients
Résumé
Objective To analyze the thyroid hormone levels before and after treatment in the patients with chronic obstructive pulmonary disease in acute exacerbation stage (AECOPD) with respiratory failure.Methods In 40 cases of elderly AECOPD patients with respiratory failure,the thyroid hormone levels before and after the treatment were measured.At the same time,the thyroid hormone levels in another 40 agematched healthy volunteers were determined.Results In elderly AECOPD patients,serum T3,FT3,T4 and FT4were significantly lower than that of the control group:T3 ( [ 1.23 ± 0.25 ] nmol/L vs.[ 1.70 ± 0.29 ] nmol/L,t =3.97,P＜0.01),FT3( [3.27 ±0.59] pmol/L vs.[4.48 ±0.95] pmol/L,t =6.09,P ＜0.01),T4 ([ 109.3 ±17.73 ] nmol/L vs.[ 116.01 ± 18.72 ] nmol/L,t =6.94,P ＜0.01 ),FT4( [ 15.11 ±2.37] pmol/L vs.[ 17.62 ±0.35 ] pmol/L,t =7.23,P ＜ 0.01 ) ; While in the elderly AECOPD patients with respiratory failure,the T3,FT3,T4 and FT4 were lower than those patients without respiratory failure:T3 ( [ 1.08 ± 0.10 ] nmol/L vs.[ 1.35 ±0.26 ] nmol/L,t =4.02,P ＜ 0.01 ),FT3 ( [ 2.89 ± 0.41 ] pmol/L vs.[ 3.59 ± 0.53 ] pmol/L,t =4.58,P ＜0.01 ),T4 ([96.54 ± 14.34] nmol/L vs.[ 115.20 ± 26.10] nmol/L,t =2.71,P ＜ 0.01 ),FT4 ( [ 14.05 ±2.05 ] pmol/L vs.[ 17.11 ± 1.55 ] pmol/L,t =5.37,P ＜ 0.01 ).In elderly AECOPD patients,the post-treatment T3,FT3 and T4 levels were elevated compared with that before treatment.The difference was statistically significant:T3 ( [ 1.43 ± 0.29 ] nmol/L vs.[ 1.25 ± 0.25 ] nmol/L,t =2.93,P ＜ 0.01 ),FT3 ( [ 3.61 ± 0.49 ]pmol/L vs.[3.26 ± 0.60] pmol/L,t =2.73,P ＜ 0.01 ),T4 ( [ 114.31 ± 10.99] nmol/L vs.[ 110.28 ± 16.91 ]nmol/L,t =4.58.P ＜0.01).Conclusion In elderly AECOPD patients,the T3,FT3,T4 and FT4 levels are reduced and those in AECOPD patients with respiratory failure were decreased even more.Supportive treatment is able to enhance the thyroid hormone levels and improve the patients' condition.Therefore,the level of thyroid hormone in elderly AECOPD patients is useful to predict the patient's condition and prognosis.
Résumé
Both the sleep apnea scale of sleep disorders questionnaire (SA-SDQ) and the Epworth sleepiness scale (ESS) were used to evaluate 25 patients with snoring and 125 patients with obstructive sleep apnea hypoventilation syndrome ( OSAHS), and scores were calculated and compared to the results of polysomnography ( PSG). Results showed that there was significant difference in scores of ESS and SA-SDQ, apnea hyponea index (AHI) and the minimal saturation of blood oxygen (LSpO2) at night between patients with OSAHS and those with snoring (P ＜ 0.05). Score of both ESS and SA-SDQ significantly correlated with AHI ( r = 0. 78 and r = 0. 66, respectively, P ＜ 0. 01 ) , i. e. , more severe of the condition, higher the scores. Score of ESS is highly consistent with clinical presentations in patients with OSAHS and can be used as preliminary screening for its diagnosis, however, use of SA-SDQ score is limited in diagnosing OSAHS due to its lower consistency.