本文選題：肺功能檢測(cè) + 饑餓　； 參考：《山西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的 回顧性研究“3.28”王家?guī)X透水事故獲救工人肺通氣功能及小氣道功能檢查結(jié)果,分析影響肺功能的因素及其與血清電解質(zhì)變化的關(guān)系,探討?zhàn)囸I狀態(tài)下肺功能改變的機(jī)制及饑餓后再進(jìn)食補(bǔ)充電解質(zhì)作用。 方法 入選46例“3.28”王家?guī)X礦山透水事件的獲救工人為實(shí)驗(yàn)組,51例健康體檢者為對(duì)照組,兩組年齡、性別、身高、體重均匹配。收集所有患者入院1-3天的靜脈血液樣本,進(jìn)行電解質(zhì)、膽紅素、尿酸、前蛋白濃度、C反應(yīng)蛋白、纖維蛋原等指標(biāo)的測(cè)定。所有患者在入院后第6-8天行肺功能檢查,采用實(shí)測(cè)值占預(yù)測(cè)值百分比來(lái)表示結(jié)果。采用SPSS16.0統(tǒng)計(jì)學(xué)軟件建立數(shù)據(jù)庫(kù),將上述研究指標(biāo)錄入數(shù)據(jù)庫(kù)并進(jìn)行統(tǒng)計(jì)學(xué)分析：①對(duì)實(shí)驗(yàn)組和對(duì)照組肺功能檢測(cè)結(jié)果進(jìn)行比較。②小氣道功能改變的影響因素分析：因變量為實(shí)驗(yàn)組小氣道功能,自變量為吸煙史、電解質(zhì)、上呼吸道感染、血尿酸、血膽紅素、前白蛋白、C反應(yīng)蛋白、纖維蛋白原。③相關(guān)性分析：分析血清電解質(zhì)與小氣道功能的相關(guān)性。 結(jié)果 1.兩組肺功能檢測(cè)結(jié)果肺功能檢測(cè)結(jié)果中,實(shí)驗(yàn)組肺功能各項(xiàng)指標(biāo)與對(duì)照組相比均降低。其中FVC、FEV1、FEV1/FVC值低于對(duì)照組(t=2.903,2.401,3.325,均P0.05),PEF、FEF25值顯著低于對(duì)照組(t=8.692,9.912,均P0.001),差異有統(tǒng)計(jì)學(xué)意義。小氣道功能檢測(cè)結(jié)果中,實(shí)驗(yàn)組與對(duì)照組相比,小氣道功能FEF50、FEF75、MMEF明顯低于對(duì)照組(t=7.529,t=7.181,t=7.707,均P0.001),差異有統(tǒng)計(jì)學(xué)意義。FEF50與FEF75異常率較高,小氣道功能異常29(46)例,兩組間異常率差異有統(tǒng)計(jì)學(xué)意義。 2.影響因素本研究調(diào)查了8個(gè)影響因素,共有5個(gè)因素進(jìn)入回歸方程：吸煙史、電解質(zhì)紊亂、上呼吸道感染為危險(xiǎn)因素。排除其他因素的混雜作用外,危險(xiǎn)性分別增加19.844、14.861、28.925倍。高尿酸血癥,高膽紅素血癥為保護(hù)因素。排除其他因素的混雜作用外,危險(xiǎn)性分別是對(duì)照組的6.2%與2.3%。 3.血清電解質(zhì)與小氣道功能變化的相關(guān)性血清鉀、鈉、鈣的濃度與小氣道功能的變化無(wú)相關(guān)性；血清磷、鎂濃度的變化分別與FEF50、FEF75有線性回歸關(guān)系,由標(biāo)準(zhǔn)化回歸系數(shù)可以看出,鎂對(duì)FEF50、FEF75的影響最大(r=0.887,r=0.879,均p0.001)。 結(jié)論 1.饑餓、脫水狀態(tài)可影響肺通氣功能,以小氣道功能降低較為明顯,FEF50與FEF75是判斷小氣道功能的敏感指標(biāo)。 2.電解質(zhì)紊亂及上呼吸道感染是引起小氣道病變的危險(xiǎn)因素。 3.合理補(bǔ)充電解質(zhì),特別是血清磷、鎂對(duì)饑餓所致肺功能紊亂有重要的臨床意義。 4.饑餓、脫水狀態(tài)下血清膽紅素及尿酸升高可能是機(jī)體的一種保護(hù)性適應(yīng)反應(yīng)。
[Abstract]:Purpose The pulmonary ventilation function and small airway function of the workers rescued from the "3.28" Wangjialing water permeation accident were studied retrospectively. The factors affecting the pulmonary function and the relationship between the pulmonary function and the changes of serum electrolytes were analyzed. To investigate the mechanism of lung function change in starvation and the role of supplementation of electrolytes after starvation. Method A total of 46 rescued workers in Wangjialing mine were selected as control group. The two groups were matched in age, sex, height and weight. Venous blood samples of all patients were collected for the determination of electrolyte, bilirubin, uric acid, proprotein concentration, C-reactive protein and fibrinogen. Lung function tests were performed on the 6-8 th day after admission, and the results were expressed as a percentage of the predicted values. SPSS16.0 statistical software was used to establish the database. The results of lung function test in experimental group and control group were compared with that of control group. 2 factors influencing the change of small airway function were analyzed: dependent variable was small airway function in experimental group. The independent variables were smoking history, electrolyte, upper respiratory tract infection, serum uric acid, serum bilirubin, prealbumin C-reactive protein and fibrinogen. 3. The correlation between serum electrolyte and small airway function was analyzed. Result 1. Compared with the control group, the indexes of pulmonary function in the experimental group were lower than those in the control group. The FVC value of FEV1 / FEV1 / FVC was lower than that of the control group (2.903 / 2.401 / 3.325), and the FEF25 value was significantly lower than that of the control group (P0.05, P = 8.692or 9.912, respectively), and the difference was statistically significant. In the small airway function test results, compared with the control group, the MMEF of small airway function FEF50 / FEF75 was significantly lower in the experimental group than that in the control group (P 0.001), and the difference was statistically significant. The abnormal rate of FEF50 and FEF75 was higher in the experimental group than that in the control group. The small airway function was abnormal in 2946 cases. There was significant difference in abnormal rate between the two groups. 2. In this study, 8 influential factors were investigated. Five factors entered the regression equation: smoking history, electrolyte disturbance, upper respiratory tract infection as risk factors. Excluding the mixed effects of other factors, the risk increased by 19.844 ~ 14.861U 28.925 times, respectively. Hyperuricemia and hyperbilirubinemia were protective factors. Excluding the mixed effect of other factors, the risk was 6.2% and 2.3% of the control group, respectively. 3. Correlation between serum electrolytes and small airway function concentration of serum potassium, sodium and calcium have no correlation with changes of small airway function, serum phosphorus and magnesium concentrations have linear regression relationship with FEF50 and FEF75, which can be seen from the standardized regression coefficient. The effect of magnesium on FEF50 and FEF75 was the most significant (P 0.001). Conclusion 1. Starvation and dehydration can affect pulmonary ventilation function. FEF50 and FEF75 are sensitive indexes to judge small airway function. 2. Electrolyte disturbance and upper respiratory tract infection are risk factors for small airway disease. 3. The reasonable supplement of electrolytes, especially serum phosphorus and magnesium, has important clinical significance for the lung dysfunction caused by starvation. 4. Elevated serum bilirubin and uric acid may be a protective adaptive response to starvation and dehydration.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R563

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本文編號(hào)：1902502