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 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
ObjectiveTo explore the value of procalcitonin-to-albumin (PAR) in patients with acute respiratory distress syndrome (ARDS).MethodsA retrospective study was carried on patients diagnosed with ARDS from December 2016 to March 2018. The receiver-operating characteristics (ROC) curve was used to identify the cutoff value of PAR. The association of PAR and 28-day mortality was evaluated using univariate and multivariable Cox regression.ResultsIn the final analysis, there were a total of 255 patients included. Of whom 164 (64.3%) was male, 91 (35.7%) was female and the mean age was 52.1±14.5 years old. The 28-day mortality of all the patients was 32.9% (n=84). ROC curve revealed that the cutoff value of PAR was 0.039 (specificity: 0.714, sensitivity: 0.702) and area under the curve was 0.793 (95%CI: 0.735 - 0.850, P<0.001). The following variables were considered for multivariable adjustment: age, body mass index, pneumonia, aspiration, sepsis, surgery, PaO2/FiO2, red blood cell counts and PAR (P<0.01 in univariate analysis). After multivariable analysis, only age (HR: 1.033, 95%CI: 1.009 - 1.059, P=0.008), PaO2/FiO2 (HR: 0.992, 95%CI: 0.985 - 1.000, P=0.044) and PAR (HR: 4.899, 95%CI: 2.148 - 11.174, P<0.001) remained independently associated with 28-day mortality (P<0.05).ConclusionHigh PAR predicts a poor outcome in ARDS patients, therefore it appears to be a prognostic biomarker of outcomes in patients with ARDS.
