血管内皮细胞生长因子对肝癌细胞钙粘附蛋白表达的影响

目的 研究血管内皮细胞生长因子(VEGF)对肝癌HepG2细胞同质性粘附作用和钙粘附蛋白(E-cadherin)的影响.方法 采用3H-TdR掺入试验测定VEGF对肝癌HepG2细胞同质性粘附作用,激光扫描共聚焦显微镜检测VEGF对肝癌细胞E-cadherin表达作用.结果 1 ng/ml、5 ng/ml VEGF诱导HepG2细胞60 min、90 min 3H-TdR掺入实验(dpm/min)分别为1 758.67±289.46、1 380.03±328.55和3 124.3±2 262.14、2 245.6±273.24,10 ng/ml VEGF诱导HepG2细胞60min、90 min、120 min3 H-TdR掺入实验分别为1 232.32±201.04、2 337.5±333.04、2 236.99±237.07,显著低于对照组60、90、120分钟的2 184.49±336.03、3 560.±255.17和4 337.4±377.35.5 ng/ml VEGF降低肝癌细胞E-cadherin的表达,荧光强度为757±103,显著低于对照组的352±56.结论 VEGF降低肝癌细胞同质性粘附作用可能与其降低肝癌细胞E-cadherin有关.     

血管内皮细胞生长因子对大肠癌HT-29细胞粘附作用的影响

目的观察血管内皮细胞生长因子(vascular endothelial growthfactor,VEGF)诱导大肠癌HT-29细胞转移及其对粘附作用的影响. 方法采用3H-TdR掺入及鼠尾胶粘附实验测定VEGF对大肠癌HT-29细胞同质性和异质性粘附作用以及Bodyen-Chamber观察VEGF诱导大肠癌细胞转移.结果1,5mg/LVEGF诱导HT-29细胞60,90min 3H-TdR掺入实验(cpm)分别为1759±289,1380±329和3124±226,2246±273,10mg/L VEGF诱导HT-29细胞60,90,120min 3H-TdR掺入实验分别为1232±201,2338±333,2237±237,显著低于对照组60,90,120min的2184±336,3560±255,4337±377,(P<0.05或0.01).5,10 mg/L VEGF诱导HT-29细胞60min鼠尾胶粘附实验A值为0.263±0.021,0.238±0.034;1,5,10mg/L VEGF诱导HT-29细胞90,120min鼠尾胶粘附实验A值分别为0.269±0.023,0.373±0.083,0.393±0.081和0.371±0.061,0.390±0.074,0.433±0.122,分别高于对照组的0.130±0.025,0.143±0.036,0.210±0.028,(P<0.05或0.01).用VEGF 1,5,10mg/L培养5 h,下室浸润的肝癌细胞数分别为(5.75±1.00,17.17±2.38,10.33±0.88)×107/L,分别高于对照组(1.58±0.38)×107/L(P<0.05或0.01).结论VEGF可以促进大肠癌HT-29细胞转移,与VEGF增加细胞异质性粘附作用以及降低大肠癌细胞的同质性粘附作用有关细胞.     

P38MAPK信号通路影响血管内皮细胞生长因子诱导肝癌细胞超微结构变化

目的研究p38信号传导通路在血管内皮细胞生长因子(vascular endothelial growth factor,VEGF)诱导肝癌细胞超微结构变化中的作用.方法采用扫描电子显微镜观察VEGF以及预先用SB203580特异性阻断p38MAPK信号传导通路后VEGF诱导肝癌细胞HepG2形态学改变. 结果扫描电镜显示肝癌细胞呈梭形,表面有细而稀疏的突起,VEGF诱导后肝癌细胞成椭圆形,细胞表面伪足增多、变粗.阻断p38MAPK信号通路后,可抑制VEGF诱导的肝癌细胞表面伪足增多、变粗,促进肝癌细胞融合.结论VEGF通过p38MAPK信号通路诱导肝癌细胞伪足增多、变粗,降低细胞间粘附作用.     

分裂原激活蛋白激酶p38信号传导通路在抑制血管内皮细胞生长因子诱导肝癌转移的实验研究

目的　研究血管内皮细胞生长因子 (vascularendothelialgrowthfactor ,VEGF)诱导肝癌转移时 p38分裂原激活蛋白激酶 (mitogen activatedproteinkinase,MAPK)信号传导通路的作用。 方法　运用Bodyenchamber膜侵袭培养系统 ,应用 p38MAPK信号传导通路特异性阻断剂SB 2 0 35 80 ,观察其对VEGF诱导肝癌细胞转移抑制作用。结果　 5ng/mlVEGF培养 5h ,向下室浸润肝癌细胞数为 16×10 4 /ml,高于对照组 1.2 5× 10 4 /ml,P <0 .0 1。预先用 5 μMSB 2 0 35 80 ,可阻断 95 %VEGF诱导肝癌转移能力。结论　VEGF通过 p38MAPK信号传导通路诱导肝癌细胞转移 ,阻断p38MAPK信号传导通路 ,可抑制VEGF诱导的肝癌细胞转移。     

环氧合酶-2对人肝癌细胞增殖和凋亡的调节作用

目的:观察环氧合酶-2(cyclooxygenase-2, COX-2)在肝癌细胞中表达,探讨COX-2抑制剂celecoxib对肝癌细胞增殖和凋亡的作用．方法:免疫细胞化学、逆转录聚合酶链反应(RT-PCR)方法研究COX-2在肝癌细胞株中表达;MTT法观察COX-2抑制剂对肝癌细胞增殖的影响;透射电镜及流式细胞仪观察 celecoxib诱导肝癌细胞凋亡的作用、对细胞周期的影响及MDR1／P-gp表达的变化;用RTPCR 方法检测Survivin mRNA药物处理后表达的变化．结果:celecoxib对肝癌细胞抑制增殖、诱导凋亡呈时间和剂量依赖性．celecoxib作用HepG2 48 h抑制率为70．98％±0．67％(200 μmol／L)、 47．93％±1．08％(100 μmol／L);Bel-7402为 57．29％±0．67％(200 μmol／L)、43．84％± 0．86％(100 μmol／L);同样浓度但作用20 h, HepG2为45．51％±1．35％(200 μmol／L), 14.35％±1．55％(100 μmol／L);Bel-7402则为34．35％±0．63％(200 μmol／L),15．35％± 0．88％(100 μmol／L),不同浓度以及不同作用时间相比均有显著差异(P<0．01);100 μmol／L celecoxib作用24,48,72,96 h的肝癌细胞凋亡率分别为12．2％±2．44％,4．0％±1．67％,20．4％±4．38％,57．9％±5．74％(HepG2)和3．0％± 1．05％,18．5％±3．51％,29.3％±3．25％,48．4％±4．77％(Bel-7402),与对照组相比有显著差异(P<0．01);细胞周期分布改变,G0／G1期细胞比例增加,24,48,72 h分别为:44．17％±1．01％,59．60％±0．61％,62．7％±1．22％ (HepG2)和47．80％±0．41％,58．60％±0．46％, 78．40％±1．95％(Bel-7402),与对照组比较有显著差异(P<0．01);对照组PCNA蛋白表达呈强阳性( ),经药物处理后表达减弱,并随时间延长而显著;HepG2中COX-2蛋白表达明显弱于Bel-7402,药物处理后表达也不同．Survivin在肝癌细胞株中呈高表达状态, celecoxib作用48 h mRNA表达降至零,而72 h 后表达水平又有上升;两株肝癌细胞中经 celecoxib处理后,MDR1／P-gp表达有降低的趋势(Bel-7402),或是基本上不受影响(HepG2)．结论:COX-2抑制剂celecoxib体外对肝癌细胞有较强的细胞毒作用且以剂量、时间依赖方式抑制细胞增殖,并诱导凋亡,使细胞周期阻滞于G1／S期．COX-2与P-gp,Survivin表达密切相关．     

p38信号通路在内皮细胞微粒诱导人脐静脉内皮细胞表达细胞间黏附分子-1中的作用

目的观察p38信号通路（P38MAPK）在内皮细胞微粒（EMPs）诱导人脐静脉内皮细胞（HU—VECs）表达细胞间黏附分子-1（ICAM-1）中的作用。方法将体外培养的HUVECs随机分组：①EMPs不同时点观察组：用EMPs（终浓度105／m1）分别刺激细胞0、3、6、12、24h;②EMPs不同剂量作用组：分别用终浓度为0、10^2、10^3、10^4、10^5／ml的EMPs刺激细胞24h;③EMPs＋p38MAPK特异性抑制剂SB203580组：在EMPs（终浓度10^5／ml）刺激前,与终浓度为5μmol／L的SB203580共同孵育30min。用蛋白免疫印迹法（Western blot）测定p38MAPK磷酸化表达,实时荧光定量PCR测定ICAM—1mRNA的表达。结果EMPs可激活p38MAPK,使磷酸化p38MAPK蛋白表达量及ICAM—1mRNA表达量增加,且呈剂量和时间依赖性。p38MAPK特异性拈抗剂SB203580可显著抑制EMPs的此作用。结论p38信号通路可能部分参与了对EMPs诱导HUVECs表达ICAM-1的调控。     

肝癌-1号对大鼠巨噬细胞杀伤肝癌细胞能力的影响及机制

目的:研究中药复方肝癌-1号对Wistar大鼠巨噬细胞杀伤肝癌细胞HepG2能力的影响并探讨其可能机制．方法:用0,25,50,75,100 μmol／L肝癌-1号提纯液处理Wistar大鼠巨噬细胞24 h后,用四甲基偶氮唑盐法(MTT),检测不同浓度药物处理后的巨噬细胞对HepG2细胞的杀伤能力;RT- PCR法检测各组巨噬细胞TNF-α,NF-κB和 iNOS mRNA表达．结果:肝癌-1号处理后,巨噬细胞对肿瘤抑制率随药物剂量的升高而升高,与0 μmol／L 组相比,100,75 μmol／L浓度时,巨噬细胞对HepG2细胞具有明显的杀伤作用,肿瘤细胞抑制率分别为28．0％±4．5％、23．5％± 3．4％(P<0．05);同时TNF-α,NF-κB和iNOS mRNA表达增强．结论:肝癌-1号通过诱导巨噬细胞TNF-α, NF-κB和iNOS mRNA的表达,增强巨噬细胞对肝癌细胞HepG2的杀伤能力,其抗癌效应可能与其参与机体免疫调节作用有关．     

芍药甙诱导人肝癌细胞系HepG2凋亡的研究

目的：观察芍药甙诱导人肝癌细胞系HepG2凋亡及凋亡相关基因的变化。方法：用0．5～0．2g／L芍药甙处理人肝癌HepG2细胞，光镜下观察细胞形态；MTT法检测细胞增殖率；流式细胞仪检测凋亡峰；免疫组化法检测P53，bcl-2，bax等凋亡相关基因的表达。结果：0．5～2．0g／L浓度的芍药甙对HepG2有显著抑制作用；可诱导HepG2凋亡，并能上调凋亡相关基因P53和bax表达、下调抗凋亡基因bcl-2表达。结论：0．5～2．0g／L芍药甙可诱导人肝癌细胞HepG2凋亡，其机制可能与凋亡相关基因表达增强和抗凋亡相关基因表达减弱有关。     

肝癌耐药细胞中MDR1 mRNA、P-糖蛋白的表达变化及意义

目的观察肝癌耐药细胞中MDR1 mRNA及P-糖蛋白的表达变化,并探讨其临床意义。方法采用药物浓度递增法,诱导产生对盐酸阿霉素（Adr）具有稳定耐药性的肝癌HepG2细胞（HepG2Adr）;采用RT—PCR及免疫组化SP法,分别检测HepG2、HepG2Adr细胞中的MDR1 mRNA、P-糖蛋。结果经0．01、0．10、1．00、10．00μmol／LAdr诱导产生的HepG2Adr细胞中MDR1 mRNA的表达量分别为0．26±0．11、0．56±0．17、10．78±0．2、1．21±0．17,P-糖蛋白阳性表达率分别为15．44％±4．55％、26．76％±5．23％、64．21％±14．22％、90．23％±7．68％;HepG2细胞中MDR1 mRNA、P-糖蛋白分别为0．18±0．08、5．73％±0．52％。肝癌HepG2Adr细胞与HepG2细胞中MDR1 mRNA、P-糖蛋白表达量比较,P均〈0．05;且随着肝癌HepG2Adr细胞耐药性增高,MDR1 mRNA、P-糖蛋白表达量逐渐增高（P均〈0．05）。结论肝癌耐药细胞中MDR1 mRNA及P-糖蛋白高表达,二者可能与肝癌多药耐药的产生有关。     

p38MAPK抑制剂对大鼠急性坏死性胰腺炎合并肺损伤的保护作用

目的 探讨p38MAPK特异性抑制剂SB203580对急性坏死性胰腺炎(ANP)大鼠合并肺损伤的保护作用.方法 54只雄性SD大鼠按数字表法随机分为对照组、ANP组和SB203580(干预)组,每组18只.以左旋盐酸精氨酸腹腔注射建立大鼠ANP模型,对照组大鼠腹腔注射等容积生理盐水,干预组在制模前腹腔注射SB203580(用二甲基亚枫溶解配制成10 μmol/L)5 mg/kg体重.术后3、6、12 h分批处死大鼠,取血测淀粉酶、TNF-α和IL-6含量,行胰腺及肺组织病理学检查,计算肺组织湿/干重比,测髓过氧化酶(MPO)含量,RT-PCR法检测中性粒细胞趋化因子(C1NC) mRNA表达,蛋白质印迹法检测磷酸化p38MAPK(p-p38MAPK)蛋白表达.结果 术后6h,对照组的血淀粉酶、TNF-α和IL-6含量、肺组织湿/干重比、MPO活性、CINC mRNA及p-p38MAPK蛋白表达量分别为(1035±73) U/L、(0.94±0.16) μg/L、(4.77±0.86) μg/L、3.92±0.29、(0.39±0.02) U/g、0.28 ±0.04、0.09±0.04;ANP组分别为(5848±656)U/L、(3.84±0.32) μg/L、( 103.54±15.32) μg/L、4.97±0.47、(1.03±0.08) u/g、0.62±0.06、0.52±0.14;干预组分别为(4259±286) U/L、(1.64±0.21) μg/L、(76.56±11.46) μg/L、4.32±0.34、(0.78±0.05)U/g、0.37±0.04、0.27 ±0.08.ANP组的各项指标均显著高于对照组,干预组的各项指标均显著低于ANP组,但仍显著高于对照组(P值均＜0.01).结论SB203580可通过阻断p38MAPK信号通路,在一定程度上减少炎症因子的产生,减轻ANP大鼠胰腺及肺组织损伤.     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

CagA-Hp抗体IgG与胃炎的组织学分析

研究幽门螺杆菌(Hp)感染与胃炎的关系。方法对204例慢性胃炎患者胃粘膜进行观察分析,并测定其中137例Hp阳性患者血清CagA-Hp抗体IgG水平,与组织学对照。结果慢性萎缩性胃炎伴肠上皮化生患者血清CagA抗体IgG明显高于对照组(P＜0.01);其他类型胃炎患者血清CagA抗体IgG水平无明显增高(P＞0.05)。结论CagA-Hp可能是导致慢性萎缩性胃炎伴肠上皮化生的因素之一,对这类患者应密切随访观察。     

慢阻肺急性加重期患者预后的影响因素分析

目的探讨慢性阻塞性肺病急性加重期(AECOPD)患者预后的相关危险因素。方法回顾性调查、收集58例AECOPD患者可能影响其预后的相关因素,并对其分别进行单因素分析。并进行Logistic多元逐步回归进行多因素分析,筛选影响AECOPD患者预后的独立危险因素。结果单因素分析后将结果 P0.1的因素纳入多因素Logistic回归,分析发现是否合并呼吸衰竭、气促程度、白细胞计数、APACHEⅡ、应用抗氧化剂、慢阻肺治疗依从性为影响AECOPD患者预后不佳的独立因素(P0.05)。结论根据AECOPD患者预后的独立危险因素,及早判断,选择合适的后续治疗方案,对提高其生存率及生存质量具有重要意义。