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.
抗生素在哮喘当中的应用一直备受争议。近年的研究主要集中于大环内酯类抗生素(Macrolides)的非抗菌效应，已有研究发现l4元环和l5元环的大环内酯类抗生素具有类激素样抗炎活性[1]。作为新一代大环内酯类衍生物的泰利霉素(Telithromycin)由于其独特的抗细菌耐药性，一问世便受到广泛关注，而近期公布的TELICAST试验(The Telithromycin，Chlamydophila，and Asthma Trial)中关于其在哮喘急性加重疗效方面的结果更是令人振奋。该试验发现，对已确诊的哮喘急性加重期患者，在指南推荐的常规治疗基础上加用为期10 d的泰利霉素口服(800 mg／d)，可使哮喘症状评分明显下降，肺功能指标改善，但其发挥疗效的机制尚不十分清楚[2]。
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
目的:了解阻塞性睡眠呼吸暂停综合症(OSAHS)患者夜间心律失常的发生情况、常见类型及相关因素。方法:对67例睡眠打鼾患者同步进行动态心电图及多导睡眠图监测。以呼吸暂停指数及夜间最低氧饱和度将研究对象进行分组,比较分析夜间心律失常发生率及发生类型并进一步分析夜间心律失常的相关因素。结果:OSAS组的夜间心律失常发生率显著高于单纯鼾症患者。随着OSAS加重,呼吸暂停低通气指数逐渐增大,夜间氧饱和度下降越明显,心律失常发生率升高,发生时间延长、恶性程度增加,尤其以缓慢型心律失常的发生率增多。结论:OSAHS患者夜间心律失常的发生率及严重程度与OSAHS严重程度呈正相关,夜间心律失常的诱发与呼吸暂停低通气指数及低氧血症密切相关。应重视夜间心律失常患者合并存在的OSAHS的诊治。