Objective To investigate the effects of immune—enhancing enteral nutritioin therapy on the inflammatory reaction and immune function in the rats of ventilation-induced lung injury．Methods Fourty rats were divided into four groups(EN1、EN2、SEN1、SEN2，n=10)．All groups were performed mechanic ventilation and fed isocaloric enteral nutrition．EN1 group：tidal Volume(VT) =8 mL／kg，traditional enteral nutrition；EN2 group：VT=40 mL／kg，traditional enteral nutrition；SEN1 group：VT：8 mL／kg，immune-enhancing enteral immunonutrition；SEN2 group：VT=40 mL／kg，immune-enhancing enteral immunonutrition．Lymphocyte subsets，TNF-α，IL-6 and contents of arachidonic acid(AA)were determined at different time point(0，4，24，72 h after ventilation)．Results The levels of CD3+，CD4+，CD4+／CD8+ in SEN2 group were lower(Plt;0.05)than in EN1，EN2 and SEN1 group after 24，72 h of ventilation．The serum concentrations of TNF-α，IL-6 and AA were significantly lower in EN2 than in other three groups(P lt;0.05)．Conclusion Immune-enhancing enteral nutrition feeding prior to machanie ventilatioin can alleriate the damage of immunological function and reduce infl ammotory responses
抗生素在哮喘當中的應用一直備受爭議。近年的研究主要集中于大環內酯類抗生素(Macrolides)的非抗菌效應，已有研究發現l4元環和l5元環的大環內酯類抗生素具有類激素樣抗炎活性[1]。作為新一代大環內酯類衍生物的泰利霉素(Telithromycin)由于其獨特的抗細菌耐藥性，一問世便受到廣泛關注，而近期公布的TELICAST試驗(The Telithromycin，Chlamydophila，and Asthma Trial)中關于其在哮喘急性加重療效方面的結果更是令人振奮。該試驗發現，對已確診的哮喘急性加重期患者，在指南推薦的常規治療基礎上加用為期10 d的泰利霉素口服(800 mg／d)，可使哮喘癥狀評分明顯下降，肺功能指標改善，但其發揮療效的機制尚不十分清楚[2]。
ObjectiveTo assess the fatigue in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyze the factors caused fatigue and the relationship between quality of life (QOL) and fatigue. MethodsOne hundred and sixty-nine patients with OSAHS and 78 subjects without OSAHS diagnosed by polysomnography (PSG) between December 2010 and March 2011 in West China Hospital were recruited in the study. Fatigue was assessed by using multidimensional fatigue inventory (MFI), excessive daytime sleepiness by Epworth sleepiness scale(ESS), QOL by functional outcomes of sleep questionnaire (FOSQ). ResultsFatigue in the patients with OSAHS was more severe than that of the controls (51.06±13.39 vs. 44.82±9.81, P < 0.001), but no difference was revealed in the patients with different degree of OSAHS. Fatigue was positively correlated with ESS score(r=0.210), total sleep time intervals(r=0.156), and the ratio of time of SpO2 below 90% in total sleep time(r=0.153)(P < 0.05), and was negatively correlated with the average oxygen saturation(r=-0.171, P < 0.05) and all subscales of FOSQ(P < 0.01). ConclusionsFatigue in patients with OSAHS is more severe than that of controls. Fatigue can significantly reduce QOL, and the impact is greater than that of excessive daytime sleepiness.
Objective To investigate the implication of oxidation protein product ( advanced oxidation protein product, AOPP) , an index of oxidative stress in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 47 patients with OSAHS and 48 normal controls were enrolled. The concentration of AOPP was measured by spextrophotometry after ameliorated, while superoxide ( SOD) , malonaldehyde ( MDA) , glutathione peroxidase ( GSH-PX) in morning blood samples were detected by Xanthine oxidase test. Results ( 1) Plasma AOPP and MDA were significantly elevated in OSAHS compared with those in control group ( both P lt;0. 01) . Plasma SOD and GSH-PX were significantly lower in OSAHS compared with those in control group ( both P lt;0. 01) . There were significant differences in the plasma AOPP, MDA, SODand GSH-PX among different severity of OSAHS ( all P lt; 0. 01) . Plasma AOPP and MDA were increased and SOD and GSH-PX were gradually decreased with the progression of OSAHS. ( 2) Plasma AOPP correlated well with MDA, SOD and GSH-PX, moreover, AOPP was positively correlated with apnea hyponea index or lowest oxygen saturation. Conclusion AOPP is an alternative index reflecting both oxidative streess and tissue injury in patients with OSAHS.
目的:了解阻塞性睡眠呼吸暫停綜合癥(OSAHS)患者夜間心律失常的發生情況、常見類型及相關因素。方法:對67例睡眠打鼾患者同步進行動態心電圖及多導睡眠圖監測。以呼吸暫停指數及夜間最低氧飽和度將研究對象進行分組,比較分析夜間心律失常發生率及發生類型并進一步分析夜間心律失常的相關因素。結果:OSAS組的夜間心律失常發生率顯著高于單純鼾癥患者。隨著OSAS加重,呼吸暫停低通氣指數逐漸增大,夜間氧飽和度下降越明顯,心律失常發生率升高,發生時間延長、惡性程度增加,尤其以緩慢型心律失常的發生率增多。結論:OSAHS患者夜間心律失常的發生率及嚴重程度與OSAHS嚴重程度呈正相關,夜間心律失常的誘發與呼吸暫停低通氣指數及低氧血癥密切相關。應重視夜間心律失常患者合并存在的OSAHS的診治。