本文選題：慢性阻塞性肺疾病 + 紅細(xì)胞分布寬度��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：【研究背景】目前慢性阻塞性肺疾病是嚴(yán)重威脅人類生命安全的第五大死亡原因,患病率高、就診率低,具有較高致殘和致死率。慢性阻塞性肺疾病以氣流受限為特征,可以預(yù)防和治療,與炎癥反應(yīng)有關(guān)。慢性阻塞性肺病對(duì)患者的影響可波及全身,肺功能僅能評(píng)價(jià)慢性阻塞性肺病患者肺部疾病進(jìn)展的嚴(yán)重程度,但對(duì)于患者綜合情況及預(yù)后的評(píng)估有很大的局限性。紅細(xì)胞形態(tài)不僅反映血液系統(tǒng)疾病,也可反映機(jī)體的慢性炎癥狀態(tài)、全身營(yíng)養(yǎng)狀況、以及無(wú)效的紅細(xì)胞生成。紅細(xì)胞分布寬度(RDW)是客觀表示紅細(xì)胞形態(tài)學(xué)變化的指標(biāo)。BODE指數(shù)綜合了包括臨床癥狀、營(yíng)養(yǎng)狀態(tài)、運(yùn)動(dòng)能力和肺功能的相關(guān)參數(shù),可以綜合評(píng)價(jià)慢性阻塞性肺病患者的綜合情況并對(duì)預(yù)后有提示意義�！灸康摹刻接懠t細(xì)胞分布寬度與慢性阻塞性肺病患者BODE指數(shù)及病情嚴(yán)重程度間的相關(guān)性。【方法】1研究對(duì)象選擇:選取2015年12月至2016年12月期間于山西醫(yī)科大學(xué)第二醫(yī)院就診的慢性阻塞性肺病患者的病歷進(jìn)行研究。2指標(biāo)分析:記錄并統(tǒng)計(jì)其人口統(tǒng)計(jì)學(xué)特征,包括性別、GOLD分級(jí)、吸煙情況、合并癥及BODE指數(shù)等。統(tǒng)計(jì)分析紅細(xì)胞分布寬度與GOLD分級(jí)、功能參數(shù)、人口統(tǒng)計(jì)學(xué)參數(shù)等的相關(guān)性。對(duì)比分析不同RDW水平的患者的一般情況。3統(tǒng)計(jì)學(xué)分析:使用SPSS 19.0軟件包對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,采用KolmogorovSmirov正態(tài)檢驗(yàn)數(shù)據(jù)是否符合正態(tài)分布,計(jì)量資料采用均數(shù)±標(biāo)準(zhǔn)差((?)±s)表示,組間比較采用獨(dú)立樣本t檢驗(yàn),多組間比較采用方差分析。計(jì)數(shù)資料以百分比表示,采用χ~2檢驗(yàn)。RDW與BODE指數(shù)的相關(guān)性采用Pearson相關(guān)分析。影響B(tài)ODE指數(shù)的因素納入多因素Logistic回歸分析。P0.05認(rèn)為差異或相關(guān)性有統(tǒng)計(jì)學(xué)意義�！窘Y(jié)果】1所選取的研究對(duì)象男性占88%,女性占12%,GOLD分級(jí)集中分布在2、3級(jí),,64%的患者有心源性疾病、糖尿病及其他并發(fā)癥,所有患者的BODE指數(shù)均在0~10;2 GOLD分級(jí)1~4級(jí)患者的RDW差異有統(tǒng)計(jì)學(xué)意義(F=4.773,P=0.04),RDW隨著GOLD分級(jí)升高而逐漸增大;3兩組患者的年齡、FEV1、%FEV1、FVC、FVC%、FEV1/FVC、PEF、%FEF25/75、開始吸煙時(shí)間、BMI、6MWT、氧飽和度、BODE指數(shù)等均有顯著差異(P0.05);和REW≤14.3的患者相比,RDW14.3的患者年齡、BODE指數(shù)顯著增大(P0.05);FEV1、%FEV1、FVC、FVC%、FEV1/FVC、PEF、%FEF25/75、開始吸煙時(shí)間、BMI、6MWT、氧飽和度顯著下降(P0.05);4 RDW與年齡、BODE指數(shù)、GOLD分級(jí)呈顯著正相關(guān)(P0.05);RDW與6MWT、%FEV1、FVC%、FEV1/FVC、PEF%、%FEF 25/75、氧飽和度、BMI呈顯著負(fù)相關(guān)(P0.05)�！窘Y(jié)論】1 COPD患者多為男性、吸煙者、患有心源性疾病、糖尿病及其他并發(fā)癥者、BODE指數(shù)在0~10;2 RDW與GOLD分級(jí)2、3級(jí)的患者呈顯著正相關(guān);3年齡、FEV1、%FEV1、FVC、FVC%、FEV1/FVC、PEF、%FEF 25/75、開始吸煙時(shí)間、BMI、6MWT、氧飽和度、BODE指數(shù)均可影響RDW大小;4 RDW與年齡、BODE指數(shù)、GOLD分級(jí)呈顯著正相關(guān);與6MWT、%FEV1、FVC%、FEV1/FVC、PEF%、%FEF 25/75、氧飽和度、BMI呈顯著負(fù)相關(guān)。
[Abstract]:Background at present, chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death, which is a serious threat to human life. Chronic obstructive pulmonary disease, characterized by airflow limitation, can be prevented and treated, and associated with inflammation. The influence of chronic obstructive pulmonary disease (COPD) on patients can affect the whole body. Pulmonary function can only evaluate the severity of pulmonary disease in patients with chronic obstructive pulmonary disease (COPD), but it has great limitations in the evaluation of patients' comprehensive condition and prognosis. Erythrocyte morphology not only reflects the disease of the blood system, but also reflects the chronic inflammatory state of the body, the nutritional status of the whole body, and the ineffective erythropoiesis. Red blood cell distribution width (RDW) is an objective indicator of red blood cell morphological changes. The bode index synthesizes the related parameters including clinical symptoms, nutritional status, motor ability and lung function. [objective] to investigate the correlation between erythrocyte distribution width, bode index and severity of chronic obstructive pulmonary disease (COPD). [ Methods: 1 the study subjects were selected from the second Hospital of Shanxi Medical University from December 2015 to December 2016. The medical records of patients with chronic obstructive pulmonary disease (COPD) from December 2015 to December 2016 were analyzed. These include gender gold grade, smoking status, complications and bode index. The correlation between red blood cell distribution width and gold grade, functional parameters and demographic parameters was analyzed statistically. Comparing and analyzing the general situation of patients with different RDW levels. 3 statistical analysis: the data were analyzed by SPSS 19.0 software package. Kolmogorov Smirov normal test data were used to test whether the data accorded with normal distribution. The measurement data were expressed as mean 鹵standard deviation (?) 鹵s). Independent sample t test was used for group comparison and ANOVA was used for multi-group comparison. The count data were expressed as percentage, and Pearson correlation analysis was used to analyze the correlation between RDW and bode index by 蠂 ~ 2 test. The factors influencing bode index were included in multivariate logistic regression analysis. P05 suggested that the difference or correlation was statistically significant. [results] 1 the selected subjects were 88 males and 12 females who had cardiogenic diseases in 64% of the patients with grade 2 or 3 grade gold. Diabetes and other complications, There was a significant difference in RDW in all patients at 0 / 10 / 2 gold grade / grade 1 / 4 (F = 4.773 / P0. 04). The age of FEV1, V1FVCCFVCV, F2575, BMI6MWTT, oxygen saturation and BODE index increased gradually with the increase of gold grade in all patients. There was significant difference (P0.05); the age and BODE index of patients with RDW14.3 increased significantly compared with those of patients with REW 鈮，

本文編號(hào)：2069475