慢性肾病患者可溶性转铁蛋白受体测定的临床意义及影响因素的研究

目的探讨慢性血液透析（HD），并用重组人促红细胞生成素（rHuEpo）治疗的患者，体内可溶性转铁蛋白受体水平（sTIR）测定的临床意义及其相关的影响因素。方法随机观察35例慢性HD患者和18例贫血但肾功能正常的患者，测定：血红蛋白（HB）、红细胞压积（HCT）、网织红细胞百分比（Ret％）、血清铁蛋白（SF）、血清铁（SI）、总铁结合力（TIBC）、转铁蛋白饱和度（TS）、血清促红细胞生成素（sEpo）、sTIR，并将结果两组对比。结果两组在HB、HCT、SF、SI、TIBC以及TS方面均无差异（P〉0．05），HD组sTIR、sEpo和Ret％则低于对照组（P〈0．05）。单变量相关分析表明HD组sTIR水平与sE-po呈正相关（r=0．770，P〈0．001）。多变量逐步回归分析表明sEpo、SF是两个能够独立影响sTIR水平的因素。结论在HD患者接受rHuEpo治疗时，循环中sTIR水平是反映骨髓红细胞生成活性的良好指标，sTIR的水平反映了HD患者铁的贮存和红细胞生成刺激的综合效应。

Observation on Effects of Pursed Lips-Diaphragm Type Breathing of Patients with COPD

Objective Investigate the impact of pursed lips-diaphragm type breathing to COPD pa-tients. Methods 98 cases of patients were randomly divided into 49 cases of the control group and 49 cases of intervention group. The pursed lips-diaphragm type breathing training of intervention group was guided by nurses and the control group was given conventional treatment and care. The clinical effects of 2 groups were compared after intervention and the indicators include vital capacity, forced expiratory volume in one second, forced vital capacity and Oxygen saturation. Results The intervention group had better effects than the control group( P < 0.05). Conclusion Pursed lips-diaphragm type breathing can promote the recovery of COPD patients.