目的：探究咳嗽变异性哮喘（CVA）患者临床治疗方案，明确阿奇霉素、苏黄止咳胶囊联合应用的价值。方法：筛选50例CVA患者（支气管扩张剂治疗无效），时间范围为2018年1月至2019年12月，应用双盲法将其分为观察组（常规治疗+阿奇霉素+苏黄止咳胶囊治疗）和对照组（常规治疗），各25例，对比两组治疗有效率、炎性因子水平及中性粒细胞百分比、咳嗽症状评分、肺功能指标、不良反应发生率。结果：观察组治疗有效率（96%）高于对照组（76%）；与对照组比较，观察组治疗后IL-6、PCT以及中性粒细胞百分比水平更低，观察组咳嗽次数、咳嗽程度、咳嗽性质评分更低，且观察组治疗后FVC、FEV1、PEF水平均高于对照组，差异有统计学意义（P<0.05），治疗前两组上述指标、评分则无明显差异；观察组（16%）和对照组（12%）不良反应发生率无明显差异（P>0.05）。结论：在CVA患者的治疗中，若使用支气管舒张剂治疗无效，可予以患者阿奇霉素联合苏黄止咳胶囊治疗。

目的 分析血清降钙素原(PCT)、C-反应蛋白(CRP)表达水平与慢性阻塞性肺疾病(COPD)患者肺功能的关联性.方法 选取我院2014年9月至2017年7月COPD患者133例,依据肺功能损害程度分组,轻度组46例,中度组37例,重度组29例,极重度组21例,4组均行血清PCT、CRP表达水平检测.比较4组血清PCT、CRP表达水平,分析血清PCT、CRP表达水平与COPD患者肺功能的相关性.结果 经单因素方差分析可知,4组血清PCT、CRP表达水平比较差异有统计学意义(P＜0.05),且极重度组血清PCT、CRP表达水平高于轻、中、重度组,差异有统计学意义(P＜0.05);经Spearman检验可知,血清PCT、CRP表达水平与COPD患者肺功能之问呈负相关(P＜0.05).结论 血清PCT、CRP表达水平与COPD患者肺功能之间呈负相关,临床上应严密监测COPD患者血清PCT、CRP水平变化情况,以预防肺部感染,进而有效保护其肺功能.

Objective Applying nuclear magnetic resonance(NMR)metabolomics approaches to analyze serum metabolic pro-file of patients with LN.Methods Serum samples of twenty-eight paitents with LN,35 patients of SLE without LN were compared with those from 35 healthy people.After preprocessing,all serum samples was detected by 600 Hz NMR spectroscopy.Under multivariate pattern recognition analysis,the differences in endogenous metabolites among the three groups were compared.Results The main differences of metabolites areas were levels of lipid,amino acid ,glucose and creatine.PCA model were capable of distinguishing pa-tients of LN from healthy people in the control group.Conclusion Compared with a single marker,serum metabolites 'fingerprint'based on NMR technology were more expected to become a new method for early diagnosis of LN.

Objective To analyze the effect of health management of risk factors in people with early period of stroke.Methods 896 pre-stroke patients that met the diagnosis criteria were divided into management group(n = 450) and control group(n = 446).Health management was carried out in management group,including lecture on stroke prevention knowledge,rational food guide,maintaining normal weight by regular exercises and keeping psychological balance,etc.Health record was also established by testing blood pressure and blood glucose in follow up survey.While patients in control group were only informed high blood pressure and risk factors of stroke without any prevention measures.Symptomatic treatments were the same in the two groups.The transition from pre-stroke to stroke was compared between the two groups 3 months and 6 months later.Results There was no significant difference in normal rate of blood glucose and blood pressure between the two groups before treatment(P 0.05).3 months after treatment,there was also no significant difference in normal rate of blood glucose and blood pressure between the two groups(P 0.05).6 months after treatment,significant difference was found in the normal rate of blood glucose and blood pressure between the management group and control group(P 0.01).The difference in the incidence of stroke between the two groups was also significant(P 0.01).Conclusion The health management of pre-stroke risk factors can effectively prevent or delay the occurrence of stroke and improve the life quality of pre-stroke patients.

Objective To create their own sexual health risk factors in the conduct of health management,analysis of its pre-diabetes at the impact of the crowd.Ways of community residents will be healthy in line with pre-diabetes diagnosis of 386 cases were randomly divided,one of the management group of 193 cases,193 cases of the control group.Methods Unit to implement the health management,including knowledge of diabetes prevention seminars,guiding its reasonable diet,maintain normal body weight,avoiding overweight and obesity.Moderate exercise,maintaining a healthy lifestyle,such as psychological balance.And set up personal health files,regular monitoring of blood glucose,to conduct follow-up management.Inform the control group only impaired fasting glucose or impaired glucose tolerance,that belong to its current pre-diabetes.Comparison of 3 months,6 months later,the management group and control group pre-diabetes and overt diabetic vesting happened.Results The results of the implementation of health management measures 3 months later,the management group and control group for impaired fasting glucose returned to normal the number of people there was no significant difference(χ2=0.05,P=0.86),impaired glucose tolerance returned to normal the number of differences no statistical significance(X = 0.82,P=0.14),to the number of overt diabetes is also no significant difference(χ2=0.92,P=0.31);the implementation of intervention measures 6 months later,the two groups of impaired fasting glucose returned to normal and impaired glucose tolerance returned to normal the number of differences have statistical significance(χ2=15.62,27.68;both P0.01),but to overt diabetes the number was no significant difference(χ2=3.12,P=0.06).Conclusion On pre-diabetes population of the risk factors of self-health management,which can effectively prevent or delay diabetes,improve quality of life.

Objective To Analysis on effectiveness of hypertension self-management model and hypertension classification management model on blood pressure control and management for Labor Workers with hypertension.Methods 105 Labor Workers with hypertension were recruited randomly from the Community Health Service Center of Shenzhen Grand Industrial Zone as self-management group,and another 102 patients with hypertension selected from the outpatient service department of internal medicine in Pingshan Hospital as classification management group.The control of blood pressure and survey of questionnaire after continuous treatment for 6 month.Results The subjects in the self-management group showed greater improvement in management condition.The rate of blood pressure control in each Group increased to 51.4%,37.2%,respectively(self-management group inreased 29.5%,another group increased 17.6%),and the difference had statistics significance.Conclusion The community-based hypertension self-management model is more effective on the improvement of blood pressure control and management than the hypertension classification management model in labor workers patients.

我们2006-06/2006-12在深圳市大工业区对劳务工高血压患者实施高血压自我管理项目,收集参加者的意见和建议,对该项目的效果进行定性评估.

目的 观察复方雷尼替丁、莫沙比利联合应用治疗胃食管反流病的效果.方法 选择胃食管反流病患者155例,随机分2组:治疗组78例,口服复方雷尼替丁和莫沙比利治疗;对照组77例,口服盐酸雷尼替丁治疗,4周为1疗程.结果 治疗组总有效率为96.2%,对照组总有效率为84.4%,2组总有效率比较,差异有统计学意义(χ2=6.11,P＜0.05).结论 复方雷尼替丁与莫沙比利联合应用治疗胃食管反流病有效率明显高于单独使用盐酸雷尼替丁.

Objective:To observe the effects of simvastatin on atherosclerotic plaque of carotid and blood lipid level of patients with transient ischemic attack(TlA) and clinical efficacy.Methods:Sixty-six cases of patients having carotid atherosclerosis and TIA were randomly divided into trial group and control group.Trial group took simvastatin with aspirin orally for six months,the control group only aspirin orally.The ultrasonic examination of carotid artery intima and media thickness(IMT),atherosclerosis area and determination of blood lipid levels before and after treatment for both groups.The cerebral vascular incident rates were compared within six months between two groups.Results:After treatment trial group significantly decreased the levels of blood cholesterol,low-density lipoprotein and triglyceride levels and increased high-density lipoprotein level significantly(all P0.01).The ultrasonic examination showed thinning of carotid IMT and reducing of plaque area significantly compared with the control group(P0.05).The cerebral vascular incident rates were 9.09 % and 21.21 % for trial group and control group respectively.There was no significant difference between the two groups(P0.05).Conclusion:Simvastatin can not only adjust lipids level,but also has th effects of anti-lipid oxidation,protecting vascular endothelium and can eliminate or stabilize carotid atherosclerotic plaque of the patients with TIA.

Objective To investigate the relationship between the early renal failure of hypertensive blood and urine β2-microglobulin(β2-MG).Methods β2-MG in blood urine was determined with radioimmunoassay in 58 hypertensives and 32 matched normal subjects respectively,and compared between the groups.Results Higher plasma level of β2-MG were observed in patients with hppertensive than in normal(P<0.05);The higher urine level of β2-MG were observed in patients with hypertensive than in mrmal(P<0.05).Conclusion The early renal failure of hypertentsive is closely associated with the β2-MG in blood and urine.Measurement of β2-MG in blood and urine can be used as a sensitive index for the diagnosis of changes of hypertensive renal function.

随着社区医疗的广泛开展,很多老年人会首先选择去社区医疗中心就诊.现将我院近年来收治的老年人心血管病在社区诊断中有代表性的失误举例分析如下,以期吸取经验教训,提高社区全科医生的诊断水平.

Objective To analyze the chronic complications of type 2 diabets mellitus(T2DM) and their related factors in Pingshan district and provide a basis for health education and prphylactico-therpeutic measure.Methods Seventy-eight cases of T2DM were selected at random in Pingshan district and a correlation analysis was made of the survey of their chronic complication and risk factors.Results The course of T2DM,high blood pressure,and high blood glucose were correlated with pathologic change of great vessel and the course of T2DM,family history,and obesity correlated with pathologic change of micrangium,so they were the independent risk factors,and the course of T2DM in particular.Conclusion T2DM and its chronic complications are the result of multifactorial causes which act in conjunction,so we must develop the health education of diabeles and strengthen large-scale prevention and treatment.

目的 探讨老年(≥75岁)急性心肌梗死患者静脉溶栓的疗效及安全性. 方法 将62例老年急性心肌梗死患者随机分为溶栓组和常规治疗组;溶栓组32例,采用尿激酶静脉溶栓加皮下注射小剂量低分子肝素钙.常规治疗组30例.除不用尿激酶及小剂量低分子肝素钙外,其余治疗均与溶栓组相同.结果 冠状动脉再通率溶栓组为65.6%(21/32),常规治疗组为16.7%(5/30),两组比较差异具有显著性(P<0.05);溶栓组病死率6.3%(2/32),而常规治疗组病死率为23.3%(7/30),两组比较具有显著差异性(P<0.05);两组无严重出血并发症,出血并发症比较差异无显著性(P>0.05). 结论 尿激酶静脉溶栓治疗老年急性心肌梗死可以提高冠状动脉再通率,降低死亡率和改善预后,是可行性治疗措施.

高血压病治疗的药物选择是临床医生需要综合考虑的问题,现将我院应用美托洛尔控释片对中青年高血压病进行治疗的观察结果和体会总结如下.

目的探讨室性心动过速(室速)的动态心电图特征及临床意义。方法对1000例24 h动态心电图监测中检出的32例室速进行分析。结果室速发作范围1~29阵,频率为76~210次/min,其中30例(93.7%)为短阵室速,20例(62.5%)发生在睡眠中,23例(71.9%)发作时无症状。分析表明室性期前收缩的提前指数和易损指数对恶性心律失常的预测不敏感;室速发作时的症状与频率、频度及持续时间有关,9例有症状者室速频率为(146.3±24.3)次/min,23例无症状者室速频率为(117.7±27.5)次/min,差异有统计学意义(P<0.01)。结论大多数室速预后良好,而有心肌缺血、心力衰竭及其他严重并发症则预后不良。