mwwXaiv lus
Tsev / Kev paub / Ntsiab lus

Kev paub

Cov txiaj ntsig ntawm Kev Txhaj Tshuaj Txhaum Txhaum Txhaum Cai ntawm Kev Nyuaj Siab hauv cov neeg mob hauv tsev kho mob uas muaj ntshav liab

Mar 17, 2022

Micah T. Prochaska1, Richard Newcomb2, David Jiang3,i ibDavid O. Meltzer1


1 Department of Medicine, Section of Hospital Medicine, University of Chicago, Chicago IL.

2Internal Medicine Residency Program, Massachusetts General Hospital, Boston MA.

3Pritzker Tsev Kawm Ntawv ntawm Tshuaj, University of Chicago, Chicago IL.


Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791



Cistanche


Abstract


Keeb Kwm & Lub Hom Phiaj:


Cov lus qhiaxav tiasntshav liab ntshavkev txiav txim siab rau feem ntauCov neeg mob hauv tsev kho mob yuav tsum ua raws li hemoglobin (Hb) concentration thiab muaj cov tsos mob ntawmanemia, suav nrogqaug zog. Txawm li cas los xij, kev tshawb fawb sib txawv ntawm seb qhov kev hloov pauv puas cuam tshuam nrogkev txhim kho hauvqaug zog. Ib qho kev piav qhia yog tias qhov txiaj ntsig ntawm kev hloov pauv hloov pauv raws li hauv pausqaug zogqib, uas cov kev tshawb fawb uas twb muaj lawm tsis tau tshuaj xyuas. Lub hom phiaj ntawm txoj kev tshawb no yog lostxiav txim siab seb puas muaj kev sib raug zoo ntawm kev tso ntshav thaum mus pw hauv tsev kho mob thiab kev txhim kho hauvqaug zog30 hnub tom qab tso tawm nws txawv raws li theem pib qaug zog.


Txoj kev:


Kev soj ntsuam yav tom ntej ntawm cov neeg mob hauv tsev kho mob dav dav nrog ib qhoHb<9g l.="" patients="" with="" sickle="" cell="" anemia="" and="" gastrointestinal="" bleeding="" were="" excluded="" since="">Cov kev kuaj mob no muaj lwm txoj kev hloov ntshav. Cov neeg mob uas muaj kev nyuaj siab raug cais tawmvim lawvqaug zogfeem ntau tsis yog los ntawm anemia. Kev qaug zog tau ntsuas thaum nyob hauv tus neegkev xam phaj thiab 30-hnub kev sib tham hauv xov tooj tom qab tso tawm. Hb qhov tseem ceeb thiab tau txais kev hloov pauvtau sau los ntawm tsev kho mob cov ntaub ntawv tswj hwm. Linear regression tau siv los ntsuas cov koom haumntawm "hloov hauvqaug zog", Hb concentration, thiab tau txais kev tso ntshav.


Cov txiaj ntsig:


Kev hloov pauv nrog nadir Hb cuam tshuam nrog txo qisqaug zogncejtso tawm rau cov neeg mob uas muaj qhov pib siab duaqaug zog(20 feem pua ​​​​tau qaug zog tshaj plaws: =12, p=0.02; 10 feem pua ​​feem ntaunkees: =17, p=0.02). Cov neeg mob<50 years="" old="" with="" high="" baseline="">qaug zogtau loj txo nyob rau hauvqaug zoglos ntawm kev tso ntshav (20 feem pua: =23, p=0.02; 10 feem pua: =29, p=0.03).


Cov lus xaus:


Kev hloov pauv thaum mus pw hauv tsev kho mob yog txuam nrog txoqaug zog30 hnubtom qab tso tawm hauv cov neeg mob uas muaj qib siab dua ntawm lub hauv pausqaug zog.


Ntsiab lus:Ntshav Qab Zib; qaug zog; Kev hloov ntshav liab; Cov tsos mob ntawm anemia



Acteoside molecular formula of Cistanche

Taw qhia


Kev txwv tsis pub ntshav ntshav liab (RBC) kev coj ua tau dhau los ua tus qauv kev saib xyuas rau feem ntautsev kho mob cov neeg mob ntshav qab zib [1, 2]. Kev txwv tsis pub hloov pauv tau txais kev txhawb nqa los ntawmCov lus qhia qhia pom zoo uas pom zoo raws li "muaj zog" kev pom zoo, hloov pauv feem ntauCov neeg mob tau mus pw hauv tsev kho mob tsuas yog thaum lawv cov hemoglobin (Hb) poob qis dua txwv tsis pub hloov pauvQhov ntsuas (7-8g / dL) [3, 4]. Txij li thaum tshaj tawm cov lus qhia no, feem ntau cov ntshavKev txiav txim siab hauv cov neeg mob hauv tsev kho mob tau los ua raws li kev txwv Hb concentrationib leeg [5]. Qhov cuam tshuam ntawm qhov kev cia siab ntawm Hb qhov pib yog qhov sib txawv hauvCov neeg mob cov yam ntxwv kho mob tsis niaj hnub txiav txim siab thaum hloov ntshavkev txiav txim siab.


Nws yog qhov tseem ceeb, txawm li cas los xij, cov lus qhia los ntawm AABB thiab lwm lub koom haum kev tshaj lij kujqhia tias kev txiav txim siab ntshav tsis yog cuam tshuam los ntawm Hb nkaus xwb tab sis los ntawm tus neeg mob cov tsos mob,xws li qaug zog [3, 6–8]. Kev qaug zog yog thawj cov tsos mob ntawm anemia [9], thiab yog lub cev muaj zogteb rau cov ntaub so ntswg txo oxygenation uas tuaj yeem tshwm sim los ntawm anemia. Ob leeg kho mob thiabphysiologic laj thawj qhia tias kev tso ntshav, uas ua rau kom Hb concentration thiaboxygen xa mus rau cov ntaub so ntswg, yuav txhim kho cov neeg mob qaug zog. Txawm li cas los xij, txawm tias cov lus qhiakev pom zoo rau cov neeg mob uas muaj cov tsos mob xws li qaug zog, cov ntaub ntawv raug txwv thiabCov kev tshawb fawb yav dhau los yog sib xyaw ntawm seb qhov kev hloov pauv thaum mus pw hauv tsev kho mob puas txhim kho cov neeg mob 'qaug zog [10–13]. Generalizability ntawm cov kev tshawb fawb yav dhau los rau cov pej xeem davCov neeg mob hauv tsev kho mob uas muaj ntshav qab zib tsawg yog txwv, thiab kev ntseeg siab rau qhov siv tau ntawm qhov kev tshawb pom hauvtxoj kev tshawb fawb loj tshaj plaws (FOCUS) [12] raug txwv vim ntau dua ib nrab ntawm cov neeg koom nrog kev kawm tau ploj musua raws. Ntxiv mus, cov kev tshawb fawb yav dhau los yuav txawv ntawm lawv qhov kev tshawb pom ntawm qhov tshwm sim ntawmKev hloov pauv ntawm qaug zog vim cov neeg mob tau hloov pauv raws li Hb concentration ib leeg,thiab cov kev tshawb fawb tsis tau tshuaj xyuas seb puas muaj kev sib koom ua ke nrog kev txo qis qisNws txawv raws li theem pib (hauv tsev kho mob) qaug zog.


Qhov muaj peev xwm hloov pauv hauv cov txiaj ntsig ntawm kev hloov pauv ntawm kev qaug zog los ntawm cov neeg mob lub hauv paus qaug zogtheem yog qhov tseem ceeb vim tias qhov hnyav ntawm tus neeg mob qaug zog sawv cev rau lub cevlub nra ntawm lawv cov anemia, yog li cov neeg mob uas muaj kev qaug zog ntau dua tuaj yeem ua rautau txais txiaj ntsig thiab ua rau txo qis qaug zog los ntawm kev hloov ntshav. Raws li anemia muaj ntau yampathophysiologic mechanisms, cov neeg mob uas muaj tib Hb concentration tab sis txawv chaw kho mobcov yam ntxwv (xws li comorbidities, hnub nyoog) yuav muaj ntau theem ntawm qaug zog los ntawm lawvanemia [14]. Yog li ntawd, nyob rau hauv Hb concentrations nyob rau hauv txwv tsis pub hloov pauv ntau yam,Cov neeg mob uas muaj qib siab dua ntawm qhov pib qaug zog tuaj yeem ua rau txo qis qaug zog los ntawmnce cov ntaub so ntswg oxygenation tom qab hloov. Xwb, cov neeg mob me me lossis tsis muajqaug zog tsis tshua muaj txiaj ntsig los ntawm kev hloov ntshav. Yog li ntawd, to taub seb lubCov txiaj ntsig ntawm kev tso ntshav rau kev qaug zog txawv ntawm cov neeg mob lub hauv paus qaug zog, tuaj yeem pab qhia meej sebKev hloov pauv thaum mus pw hauv tsev kho mob txhim kho cov neeg mob qaug zog. Ntxiv mus, nws yuav pab tauCov kws kho mob nkag siab seb qhov ntsuas ntawm cov neeg mob qaug zog yuav tsum tau koom nrog, nrog raunrog Hb concentration, rau hauv kev txiav txim siab txog ntshav rau cov neeg mob ntshav qab zib hauv tsev kho mob.Lub hom phiaj ntawm txoj kev tshawb no yog los txiav txim seb puas muaj kev sib raug zoo ntawm kev hloov ntshavthaum mus pw hauv tsev kho mob thiab txhim kho kev qaug zog 30 hnub tom qab tso tawm txawv ntawmtheem pib qaug zog hauv tsev kho mob cov neeg mob ntshav qab zib. Peb hypothesize tias nyob rau hauvpw hauv tsev kho mob cov neeg mob uas muaj ntshav qab zib, kev tso ntshav hauv cov neeg mob uas muaj kev qaug zog ntau yuavua rau txo qis qaug zog 30 hnub tom qab tawm hauv tsev kho mob.



Txoj kev


Kawm Tsim


Peb tau ua qhov kev soj ntsuam yav tom ntej ntawm cov neeg mob hauv tsev kho mob dav davnrog ntshav liab. Lub Tsev Kawm Ntawv Qib Siab Chicago Medical Center (UCMC) lub koom haum saib xyuaspom zoo cov txheej txheem kev kawm thiab txhua yam kev kawm tau txais kev pom zoo.


Kawm Kev Tsim Nyog


Nyob nruab nrab ntawm lub Plaub Hlis 2014 thiab Lub Rau Hli 2015, tag nrho cov tshuaj kho mob hauv tsev tau raug xa mus rausau ntawv tso cai rau University of Chicago Hospitalist Project [15], kev tshawb fawbinfrastructure ntawm UCMC. Ntawm cov neeg mob pom zoo koom nrog hauv Hospitalist Project,cov neeg mob tsim nyog yog tias lawv muaj Hb<9g l="" at="" any="" point="" during="" their="" hospitalization,="">uas suav nrog ntau yam ntawm Hb qhov tseem ceeb uas them los ntawm cov cai txwv tsis pub hloov pauv feem ntau [12,16, 17, 3] ib. Yog tias cov neeg mob tsis tsim nyog suav nrog thaum lub sijhawm pom zoo rau Tus Kws Kho MobQhov project, lawv cov txiaj ntsig Hb tau raug tshuaj xyuas ob zaug ib hnub kom txog thaum lub tsev kho mob tso tawm los ntsuas seb lawvHb ua<9g l.="" proxies="" were="" sought="" to="" answer="" questions="" for="" patients="" who="" failed="" the="" short="">Portable Mental Status Questnaire [18].


Echinacoside molecular formula of Cistanche

Kev Sau Cov Ntaub Ntawv Tus Neeg Mob


Cov kws pab tshawb fawb tau pom cov neeg mob hnub nyoog thiab poj niam txiv neej los ntawm cov ntaub ntawv kho mob hluav taws xob (EHR), thiab hais kom cov neeg mob txheeb xyuas lawv tus kheej lawv haiv neeg. Cov ntaub ntawv tswj xyuas tsev kho mob tau siv los txiav txim siab nyob hauv tsev kho mob ntev thiab tus qhab nia Charlson Comorbidity Index [19] rau txhua tus neeg mob siv International Classification of Disease 9 codes. Peb kuj tau siv Health Care Utilization Project (www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp) diagnosis categories los txheeb xyuas seb cov neeg mob puas muaj mob mob (sickle cell anemia (SC), gastrointestinal bleeding (GIB), lossis muaj kev nyuaj siab. (DD), vim tias cov xwm txheej no cuam tshuam nrog ntshav ntshav (SC, GIB) thiab qaug zog (DD) [20], thiab tsis suav nrog Charlson Comorbidity Index.


Kev ntsuas ntshav qab zib


Thawj Hb<9g l="" during="" a="" patient's="" hospitalization,="" making="" them="" eligible="" for="" study="">kev koom tes, tau txais los ntawm kev txheeb xyuas phau ntawv ntawm EHR. Tag nrho cov nqi Hb ntxivthaum tus neeg mob lub tsev kho mob tau txais los ntawm lub tsev kho mob cov ntaub ntawv tswj hwmmart.


Txiav txim siab tau txais cov ntshav liab hloov ntshav thaum pw hauv tsev kho mob


Txawm hais tias cov neeg mob tau txais kev hloov pauv RBC thiab cov naj npawb ntawm RBCs hloov pauvthaum mus pw hauv tsev kho mob tau txais los ntawm tsev kho mob cov ntaub ntawv kho mob.


Kev ntsuas tus neeg mob nkees thaum pw hauv tsev kho mob thiab tom qab tsev kho mob tso tawm


Lub hauv paus qaug zog tau ntsuas ib zaug thaum tus neeg mob mus pw hauv tsev kho mob nrog tus neeg nyob hauvxam phaj yog thawj hnub ntawm kev nkag mus rau hauv tsev kho mob rau cov neeg mob tsim nyog tau txais kev tso npe, lossishnub tus neeg mob tau tsim nyog rau kev kawm rau cov neeg mob uas tsis yogtam sim ntawd tsim nyog nyob rau hauv tsev kho mob. Kev qaug zog tau ntsuas dua nrog kev hu xov tooj 30hnub tom qab tawm hauv tsev kho mob. Lub sijhawm rau kev hu xovtooj rov qab tau raug xaiv vimCov teebmeem ntawm kev mus pw hauv tsev kho mob los ntawm kev mob hnyav ntawm kev qaug zog tuaj yeem txo qis, tseemCov txiaj ntsig ntawm qhov nce hauv cov ntshav suav los ntawm kev hloov ntshav tseem yuav tsum yog qhov tseem ceeb[21]. Kev qaug zog tau ntsuas siv 13- lo lus nug fatigue subscale uas yog ib feem ntawm Kev Ua HaujlwmKev soj ntsuam ntawm Chronic Illness Therapy Anemia (FACIT-An) daim ntawv nug (appendix 1) [9,22–25] ib. Kev qaug zog subscale ntsuas cov neeg mob qaug zog dhau 7 hnub dhau los, nrog cov qhab niaxws li ntawm 0–52, qhov twg cov qhab nia qis dua qhia txog kev qaug zog ntau dua. Tus nqi rau ib qho twgcov ntaub ntawv uas ploj lawm hauv qhov qaug zog subscale rau ib tus neeg kawm tau sau rau hauv kev siv ib qho proratedtau qhab nia los ntawm lawv cov lus teb, raws li cov lus pom zoo rau kev haisCov ntaub ntawv uas ploj lawm hauv FACIT [26].


Hloov hauv Fatigue


Peb qhov txiaj ntsig tseem ceeb yog qhov hloov pauv ntawm cov neeg mob qaug zog los ntawm kev mus pw hauv tsev kho mob mus rau 30 hnubtom qab tso tawm. Ib qho kev hloov pauv ntawm qhov qaug zog tau suav los ntawm kev rho tawm FACIT qaug zogtau qhab nia thaum mus pw hauv tsev kho mob los ntawm FACIT cov qhab nia qaug zog 30 hnub tom qab tawm hauv tsev kho mob(Hloov hauv Fatigue=FACIT30 hnub– FACITua inpt). Kev hloov pauv zoo hauv cov qhab nia qaug zog qhia txogtxo qis ntawm qaug zog ntawm 30 hnub tom qab tso tawm piv rau cov neeg mob qaug zogthaum mus pw hauv tsev kho mob. Kev hloov pauv tsis zoo hauv cov qhab nia qaug zog qhia txog qib siab dua ntawm kev qaug zog ntawm 30hnub tom qab tso tawm piv rau cov neeg mob qhov qaug zog thaum mus pw hauv tsev kho mob.


Flavonoids molecular formula of Cistanche

Kev txheeb cais


Kev txheeb xyuas txheeb cais tau ua tiav siv Stata statistical software, StataCorp, CollegeStation, TX. Cov txheeb cais piav qhia tau siv los txheeb xyuas cov neeg mob. MannWhitney U cov kev ntsuam xyuas tau siv los sib piv cov ntaub ntawv uas tsis yog ib txwm faib rau cov neeg mob,theem pib qaug zog, thiab qib Hb rau cov neeg tau txais kev tso ntshav rau cov tsis tau txaiskev hloov pauv thaum lawv mus pw hauv tsev kho mob. Chi-Squared xeem tau siv los sib pivproportions. P-tus nqi<0.05 were="" considered="" statistically="">


Linear Regression Models los ntsuam xyuas qhov cuam tshuam ntawm kev hloov pauv ntawm kev hloov hauv kev qaug zog


Multivariable linear regression tau siv los kuaj xyuas cov txiaj ntsig ntawm kev hloov pauv ntawm "hloov hauvqaug zog", peb qhov tshwm sim thawj zaugqaug zog, thaum cov kev hloov pauv ywj pheej ntawm kev txaus siab tau txais kev tso ntshav thiab covkev sib cuam tshuam ntawm qhov tau txais kev tso ntshav thiab cov neeg mob nadir Hb thaum mus pw hauv tsev kho mob.Peb kuj siv FACIT30 hnubraws li qhov sib txawv ntawm qhov sib txawv thiab tswj tau rau qhov pib qaug zog(FACITinpt) ua ib qho kev hloov pauv ywj pheej los suav txog qhov muaj peev xwm sib txawv hauv qhov pibKev qaug zog ntawm cov neeg mob uas tsis tau hloov pauv thiab tsis hloov pauv. Cov txiaj ntsig tsis yogsib txawv heev thiab yog li peb tshaj tawm cov txiaj ntsig siv cov neeg mob hloov pauv hauv kev qaug zogtau qhab nia raws li qhov sib txawv.


Peb qhov kev txheeb xyuas thawj zaug tsis suav nrog cov neeg mob uas muaj kev kuaj mob ntawm SC, GIB, lossis DD, thiab kev tswj hwm rauhnub nyoog tus neeg mob (<50, 50–64,="" ≥65),="" sex,="" length="" of="" hospital="" stay,="" the="" number="" of="" rbc="" units="">transfused, nadir Hb thaum mus pw hauv tsev kho mob, thiab Charlson Comorbidity Index qhab nia. Lub hnub nyoogpawg tau txiav txim siab los ntawm kev faib cov qauv mus rau ze rau cov tertiles raws li hnub nyoog. Cov neeg mobnrog SC thiab / lossis GIB raug tshem tawm los ntawm kev tshuaj xyuas thawj zaug vim tias cov lus qhia txog kev hloov ntshavcais cov neeg mob nrog SC los ntawm lawv cov lus pom zoo (hloov ntshav-dependentanemia)[4], thiab cov qauv kev kho mob hloov pauv hauv cov neeg mob SC[27, 28] thiab/los yogGIB[29, 30] tsis ua raws li kev txwv kev hloov ntshav. Tsis tas li ntawd, txhaj tshuajkev coj ua ntawm peb lub tsev kawm ntawv sib txawv heev rau cov neeg mob nrog GIB piv rau cov neeg mobtsis muaj GIB, thiab los ntawm qhov chaw ntawm GIB. Thaum kawg, cov neeg mob uas muaj GIB thiab SC no muajsib txawv ntawm kev sib txuam ntawm anemia nrog qaug zog dua li lwm cov neeg mob hauv tsev kho mob uas muaj ntshav liab[31]. Cov neeg mob DD raug cais tawm hauv peb qhov kev tshuaj ntsuam thawj zaug vim tias lawv qaug zog yog ib qhoCov tsos mob ntawm residual thiab feem ntau yog vim DD, tsis yog anemia [32–34]. Nyob rau hauv rhiab heevkev tsom xam, peb suav nrog cov neeg mob SC, GIB, thiab / lossis DD thiab kev tswj hwm rau txhua tus tib yamkev hloov pauv raws li hauv peb tus qauv tseem ceeb, nrog rau peb tswj xyuas seb cov neeg mob puas muaj kev kuaj mobSC, GIB, and/or DD.


Txhawm rau kuaj cov txiaj ntsig ntawm kev tso ntshav ntawm qhov sib txawv ntawm cov theem pib ntawm kev qaug zog, cov qauv regression yogkuaj nyob rau hauv stratified theem ntawm lub hauv paus qaug zog siv ob txoj kev sib txawv. Ua ntej,Cov neeg mob tau stratified rau hauv quintiles los ntawm lawv cov qhab nia FACIT, nrog ntau dua quintilessawv cev ntau dua ntawm kev qaug zog thaum mus pw hauv tsev kho mob. Thib ob, nkees nkeesdichotomized ntawm qhov qhab nia nruab nrab FACIT (<28) of="" the="" sample,="" and="" at="" facit="" scores="" that="">sawv cev rau 40 feem pua ​​(FACIT Tsawg dua lossis sib npaug li 23), 30 feem pua ​​(FACIT Tsawg dua lossis sib npaug rau 19), 20 feem pua ​​(FACIT Tsawg dua lossis sib npaug rau 14), thiab 10 feem pua(FACIT Tsawg dua lossis sib npaug li 8) feem ntau cov neeg mob qaug zog hauv cov qauv.



Cistanche can treat fatigue

TSEEM CEEB


Cov yam ntxwv ntawm tus neeg mob


9,676 tus neeg mob tau txais kev pabcuam tshuaj khomob thaum lub sijhawm kawm. 6, 189 ib(64 feem pua) cov neeg mob tau pom zoo rau kev koom tes hauv Tsev Kho Mob Project, thiab 4,442 (72 feem pua)cov neeg mob tau ua tiav qhov Hospitalist Project inpatient interview. 1,429 (32 feem pua) ntawm cov neeg mob nomuaj Hb<9g l,="" and="" 1,135="" (79%)="" of="" these="" patients="" completed="" the="" inpatient="" facit="">daim ntawv nug. 763 (67 feem pua) cov neeg mob tau mus txog rau 30-hnub kev sib tham tom qab, 513(67 feem pua) ntawm cov no tau ua tiav 30 hnub tom qab daim ntawv nug FACIT, thiab 357 (70 feem pua) tsis taumuaj kev kuaj mob ntawm SC, GIB, thiab / lossis DD (Daim duab 1). Cov neeg mob uas ua tiav 30 hnubkev sib tham tom qab tau laus dua me ntsis (56 vs 52, p<0.01) and="" had="" a="" slightly="" lower="" nadir="" hb="">(7.1 g/dL vs 7.2 g/dL, p=0.05), tiam sis tsis txawv ntawm lawv poj niam txiv neej, haiv neeg, haiv neeg, Charlsoncomorbidity index qhab nia, qhov ntev ntawm kev nyob, lossis theem pib qaug zog, piv rau cov neeg mob uasua tiav qhov kev xam phaj tus neeg mob nkaus xwb thiab tsis ua tiav 30 hnub tom qab kev xam phaj.Table 1 qhia txog cov yam ntxwv ntawm pej xeem, comorbidities, inpatient Hb ntsuas, thiabFACIT cov qhab nia rau cov neeg mob uas ua tiav ob qho tib si tus neeg mob thiab kev sib tham tom qab, los ntawmseb lawv puas tau txhaj tshuaj thaum lawv mus pw hauv tsev kho mob (Table 1).


Association of Transfusion and Hb with Changes in Fatigue los ntawm Baseline Fatigue Level


Thoob plaws tag nrho cov qauv, thaum tsis stratifying cov neeg mob los ntawm theem pib qaug zog, muajtsis muaj kev sib koom ua ke ntawm qhov tau txais kev tso ntshav lossis kev sib cuam tshuam ntawm qhov tau txais daim ntawvtso zis thiab nadir Hb thiab txo qaug zog. Txawm li cas los xij, thaum stratifying cov neeg mob los ntawmLub hauv paus qaug zog quintiles, kev sib cuam tshuam ntawm kev tso ntshav thiab nadir Hb tau txuam nrognrog txo qis qaug zog (Δ Fatigue= =12, p=0.02) rau cov neeg mob uas muaj qib siab tshaj ntawmlub hauv paus qaug zog (quintile 5). Cov txiaj ntsig no qhia tau hais tias hauv cov neeg mob uas muaj lub hauv paus qaug zog,Cov nyhuv ntawm kev tso ntshav yog nyob ntawm nadir Hb thiab qhov nce hauv nadir Hb ntawm1g / dL yuav nyob rau nruab nrab qhov tshwm sim hauv kev txhim kho ntawm 12 cov ntsiab lus ntawm FACIT nplai 30 hnubtom qab tsev kho mob tawm. Nyob rau hauv tag nrho lwm cov quintiles, tsis muaj kev tso ntshav los yog kev sib cuam tshuam ntawmKev tso ntshav thiab nadir Hb muaj kev koom tes nrog kev hloov hauv kev qaug zog (Table 2).


Thaum stratifying cov neeg mob ntawm 10 feem pua ​​​​ib ntus ntawm kev qaug zog ntau dua, kev hloov pauv tau cuam tshuamnrog nadir Hb tau rov cuam tshuam nrog txo qaug zog, thiab cov nyhuv loj dua raucov neeg mob siab dua lawv cov theem pib ntawm qaug zog. Kev sib cuam tshuam ntawm kev tso ntshav thiabCov neeg mob 'nadir Hb ua rau muaj kev hloov pauv hauv cov qhab nia qaug zog ntawm 2.3 (FACIT<28, p="0.44)," 3.8="">(FACIT Tsawg dua lossis sib npaug rau 23, p=0.26), 4.7 (FACIT Tsawg dua lossis sib npaug rau 19, p=0.2), 12 (FACIT Tsawg dua lossis sib npaug rau 14, p =0.02), thiab 17 (FACIT Tsawg dua lossis sib npaug rau 8,p=0.02) (Table 3). Kev taw qhia ntawm kev sib cuam tshuam ntawm kev tso ntshav thiab nadir Hbhauv cov qauv no tau zoo dua, qhia tias ntau dua nadir Hb rau cov neeg mob uas tau txais aKev hloov pauv tau ua rau muaj kev qaug zog zoo dua 30 hnub tom qab tawm hauv tsev kho mob. Hauv rhiab heevtsom xam, suav nrog cov neeg mob SC, GIB, thiab / lossis DD, kev sib cuam tshuam ntawm kev tso ntshavthiab cov neeg mob 'nadir Hb kuj ua rau muaj kev hloov pauv zoo hauv kev qaug zog rau cov neeg mob siabntawm lub hauv paus qaug zog. Txawm li cas los xij, qhov cuam tshuam loj thiab qhov txo qis qis qis dua ob qho tib sithaum qaug zog yog stratified los ntawm quintiles (cov lus ntxiv 2) thiab ntawm 10 feem pua ​​​​ntawm cov sijhawmLub hauv paus kev qaug zog (Table 3) piv rau peb qhov kev ntsuam xyuas thawj, thiab cov teebmeemtsis tau ncav cuag qhov tseem ceeb.


Qhov cuam tshuam ntawm Kev Txhaum Cai thiab Hb ntawm Kev Hloov Kho hauv Kev Nyuaj Siab los ntawm Baseline Fatigue Level thiabHnub nyoog


Thaum tus neeg mob hnub nyoog thiab nws cov txiaj ntsig ntawm kev sib raug zoo ntawm kev tso ntshav thiab qaug zog tsis yog ib qhoLub koom haum tshwj xeeb uas peb tau npaj tseg, hauv peb lub hnub nyoog kev tshuaj ntsuam thawj zaug (<50) as="" an="">ywj pheej variable yog tsis tu ncua statistically ho txuam nrog txoqaug zog los ntawm kev tso ntshav. Muab qhov no, peb tau ua qhov kev tshawb nrhiav kev tshawb fawb stratifying pebqauv los ntawm hnub nyoog (<50, 50–64,="" ≥65).="">


Stratification los ntawm Baseline Fatigue thiab Hnub Nyoog


Thaum stratifying cov neeg mob los ntawm lub hauv paus qaug zog quintiles thiab hnub nyoog, kev sib cuam tshuam ntawmKev tso ntshav thiab nadir Hb tau zoo dua thiab cuam tshuam nrog kev txo qis hauv kev qaug zograu cov neeg mob uas qaug zog nyob rau saum quintile thiab hnub nyoog<50. patients="" in="" quintile="" 5="" and="" age=""><50 had="" estimated="" change="" in="" fatigue="" scores="" of="" 23="" (p="0.02)." this="" effect="" size="" is="" nearly="" double="">tus nqi ntawm txo qaug zog pom nyob rau hauv cov qauv tsis stratified los ntawm lub hnub nyoog. Rau cov neeg mob hauv lublwm yam qaug zog quintiles thiab tag nrho lwm pawg hnub nyoog, tsis muaj kev koom tes ntawm kev hloov ntshavlos yog kev hloov pauv tau cuam tshuam nrog nadir Hb ntawm kev hloov hauv kev qaug zog (Table 4).Thaum stratifying cov neeg mob ntawm 10 feem pua ​​​​ib ntus ntawm qhov pib qaug zog thiab hnub nyoog, kev hloov pauvcuam ​​tshuam nrog nadir Hb dua ua rau muaj txiaj ntsig zoo nrog kev txo qis hauv kev qaug zograu cov neeg mob<50 with="" high="" levels="" of="" fatigue="" at="" baseline.="" at="" each="" baseline="" level="" of="" fatigue,="" the="">koom nrog kev tso ntshav thiab txo qhov qaug zog yog qhov loj dua hauv cov qauv tsis stratifiedlos ntawm hnub nyoog. Rau cov neeg mob 50–64 lossis Ntau dua lossis sib npaug li 65, kev tso ntshav lossis kev hloov pauv tau cuam tshuam nrog nadir Hb yogtsis cuam tshuam nrog kev txo qis hauv kev qaug zog (cov lus ntxiv 1).



Cistanche can treat tiredness symptoms

Kev sib tham


Peb cov txiaj ntsig tau txhawb nqa rau cov neeg mob hauv tsev kho mob yam tsis muaj SC, GIB, lossis DD, tau txais daim ntawv txais nyiajKev hloov pauv yog txuam nrog kev qaug zog 30 hnub tom qab tso tawm hauv tsev kho mob hauv cov neeg mobnrog qib siab ntawm qhov pib qaug zog. Tsis tas li ntawd, ntawm cov neeg mob uas qaug zog siab, muajqhov txiaj ntsig loj dua (txo ntau dua hauv kev qaug zog) los ntawm kev tso ntshav siab dua tus neeg mob lub hauv pausqaug zog thaum pw hauv tsev kho mob. Hauv peb qhov kev tshuaj ntsuam, 20 feem pua ​​​​ntawm cov neeg mob qaug zog feem ntau hauv cov qauvtau soj ntsuam thiab txheeb xyuas qhov txo qis hauv kev qaug zog los ntawm kev tso ntshav 30 hnub tom qabtawm tsev kho mob. Tsis tas li ntawd, ntawm cov neeg mob uas qaug zog siab, ntawm txhua 10 feem pua ​​​​ib ntus ntawmsiab dua lub hauv paus qaug zog, kev hloov pauv tau cuam tshuam nrog kev kho mob loj zuj zus hauvqaug zog 30 hnub tom qab tso tawm rau cov neeg mob. Cov txiaj ntsig no yog physiologically zoo ib yam nroglub tswv yim hais tias cov neeg mob uas muaj cov tsos mob hnyav dua los ntawm lawv cov ntshav qab zib ntau duatau txais txiaj ntsig los ntawm kev hloov ntshav. Kev hloov pauv hauv cov txiaj ntsig ntawm kev tso ntshav rau txo qis qaug zog pebpom tau nyob rau hauv ib qho me me ntawm cov neeg mob nkees heev, thiab cov kev tshawb fawb yav dhau los uas tau uatsis xav txog cov neeg mob lub hauv paus qaug zog theem tej zaum yuav plam qhov tseem ceeb ntawmkev hloov pauv hauv cov neeg mob uas qaug zog tshaj plaws.


Nws yog qhov tseem ceeb tias hauv peb txoj kev tshawb fawb nws yog kev sib cuam tshuam ntawm kev tso ntshav thiab Hb uas yogcuam ​​tshuam nrog kev txo qis hauv kev qaug zog, tsis yog kev tso ntshav ib leeg vim nws qhia tiasOb qhov ntsuas ntawm Hb thiab ntsuas qhov qaug zog yog tsim nyog los txheeb xyuas cov neeg mob twg yuavtau txais txiaj ntsig los ntawm kev hloov ntshav. Nws kuj tseem ua rau muaj peev xwm ntsuas qhov qaug zogua ke nrog cov neeg mob 'Hb txhawm rau pab cov kws kho mob thiab cov neeg mob zoo sib npaug ntawm qhov kev pheej hmoo ntawmkev hloov ntshav, tiv thaiv qhov tshwm sim ntawm tus neeg mob yuav txo qis qaug zog, piv rautxwv tsis pub hloov cov kev coj ua raws li Hb concentration ib leeg. Yog li ntawd, peb cov txiaj ntsigmuab cov ntaub ntawv empirical los txhawb cov txheej txheem kev pom zoo uas kev txiav txim siab hloov ntshavcuam ​​tshuam ob qho tib si los ntawm tus neeg mob Hb thiab seb lawv puas muaj cov tsos mob los ntawm lawv cov ntshav liab. Pebkuj ntseeg tias peb qhov kev tshawb pom txhawb kev tshawb fawb loj dua thiab muaj zog dua yav tom ntej los txheeb xyuasvariation nyob rau hauv cov nyhuv ntawm transfusion ntawm qaug zog nyob rau hauv cov neeg mob uas sib txawv comorbidities, hnub nyoog,Kev nkag mus rau etiologies, thiab hom kev pabcuam hauv tsev kho mob (xws li cov neeg mob phais).


Tias cov nyhuv ntawm kev tso ntshav thiab nadir Hb ntawm cov neeg mob qaug zog yog ntau dua rau cov neeg mob hauvpeb txoj kev kawm hnub nyoog qis dua 50 xyoo, tsa cov lus nug nthuav txog kev qaug zog raws li qhov tshwm simntsuas hauv cov neeg mob ntshav qab zib. Cov neeg mob laus hauv peb txoj kev tshawb fawb tsis tau txais txiaj ntsig (kev paubtxo qis qaug zog) los ntawm kev hloov ntshav yog ua raws li kev tshawb fawb txog kev hloov pauv tsis ntev los no hauv cov neeg mobkev phais mob plawv, qhov twg txoj kev txwv tsis pub hloov pauv tau txais txiaj ntsig zoo duacov neeg mob [35]. Txawm li cas los xij, nws yog qhov xav tsis thoob vim tias nws yuav xav tias laus duacov neeg mob, uas qhov tshwm sim tsis zoo ntawm anemia tau piav qhia zoo, yuav yogxav tias yuav tau txais txiaj ntsig los ntawm kev hloov ntshav ntau dua li cov neeg mob hluas uas xav tias yuav yogmuaj peev xwm tiv taus qaug zog los ntawm anemia. Ib qho ua tau piav qhia rau peb qhov kev tshawb nrhiav yog qhov ntawdcov neeg mob hluas muaj zog dua, thiab yog li ntawd cov teebmeem ntawm qaug zog thiab cov txiaj ntsig ntawm aKev hloov pauv tau muaj kev paub ntau dua li tus neeg mob uas muaj ntau dua sedentary. Lub tswv yim no yogpiav qhia los ntawm lub tswv yim ntawm fatigability, uas ntsuas thiab normalizes qaug zog nyob rau hauv kev sib raug zoocov haujlwm tshwj xeeb thiab txhais tau tias [36]. Txawm tias kev tso ntshav tuaj yeem txo qhov qaug zog rau cov neeg mob ntawm ib qho twgtheem ntawm kev ua si, cov neeg mob nquag nquag tuaj yeem muaj txiaj ntsig zoo dua vim tias tom qabkev hloov ntshav lawv muaj peev xwm rov pib ua lub neej nquag. Tshawb xyuas seb qhov txo qishauv kev qaug zog los ntawm kev hloov pauv kuj cuam tshuam rau cov neeg mob cov kev ua ub no yog ib qho tseem ceeb rau yav tom ntejkev taw qhia txij li nws tuaj yeem hais txog seb qhov kev tso ntshav los kuj ua rau kev ua haujlwm zoo dua qubCov txiaj ntsig ntxiv los yog los ntawm kev txo qis qaug zog hauv cov neeg mob.


Txoj kev tshawb no muaj ntau yam kev txwv. Txawm hais tias peb cov qauv loj loj thiab suav nrog cov neeg mobnrog rau ntau yam ntawm comorbidities uas peb ntseeg tias yog tus sawv cev ntawm tsev kho mob dav davCov neeg mob cov tshuaj, raws li ib qho kev tshawb fawb ib leeg peb cov txiaj ntsig yuav tsis tuaj yeem ua rau lwm tuschaw. Tsis tas li ntawd, vim qhov ntev ntawm peb txoj kev tshawb fawb, tsis yog txhua tus neeg mob muaj nyob ntawmkev rov qab los (txawm tias ploj mus tom qab lossis tsis kam ua raws li xov tooj). Thaum cov neeg mob tau uatsis txawv qhov txawv ntawm lawv cov yam ntxwv ntawm cov pej xeem hauv paus (nrog rau qib qaug zog)piv rau cov neeg mob uas ua tiav qhov kev soj ntsuam tom qab, nws muaj peev xwm ua tau 30 hnubua raws li kev qaug zog ntawm cov neeg mob uas peb tsis tuaj yeem tiv tauj txawv ntawm cov uas peb muaj peev xwmtiv tauj, tsis ncaj ncees rau peb cov txiaj ntsig. Tsis tas li ntawd, txawm tias cov ntaub ntawv no txhawb kev ntseeg tauKev sib koom ua ke ntawm kev tau txais kev tso ntshav thiab kev txhim kho hauv kev qaug zog 30 hnub tom qabtawm hauv tsev kho mob, kev soj ntsuam kev tsim ntawm txoj kev tshawb no tsis tuaj yeem ua pov thawj tias qhov kev sib raug zoo noyog vim li cas. Txij li cov neeg mob tsis tuaj yeem ua rau qhov muag tsis pom kev, kev paub txog kev lees paub ntawm aKev hloov pauv kuj tuaj yeem cuam tshuam cov neeg mob qhov kev ntsuas ntawm lawv qhov qaug zog.


Hauv kev xaus, qhov kev tshawb fawb no qhia tau hais tias hauv tsev kho mob cov neeg mob ntshav qab zib, ntshav liabKev hloov pauv ntawm tes thaum mus pw hauv tsev kho mob yog cuam tshuam nrog txo qis qaug zog 30 hnub tom qab tso tawmrau cov neeg mob uas muaj theem pib qaug zog. Cov txiaj ntsig ntawm qhov kev tshawb fawb no yograws li physiologic laj thawj nyob rau hauv cov neeg mob nrog anemia thiab presumed nyhuv ntawmkev hloov pauv ntawm cov tsos mob thaum kho cov ntshav qab zib. Txoj kev tshawb no tseem ntxiv kev txhawb nqa raucov lus qhia qhia tias kev txiav txim siab ntshav rau cov neeg mob hauv tsev kho mob tau cuam tshuamlos ntawm tus neeg mob cov tsos mob, xws li qaug zog. Kev ua haujlwm yav tom ntej ntawm kev tshawb fawb no yuav tsum tsom mus rau qhovkev sib txawv ntawm kev hloov pauv ntawm cov tsos mob los ntawm tus neeg mob lub hnub nyoog, qhov cuam tshuam ntawm kev tso ntshav rauqaug zog thiab kev ua haujlwm ntawm tus neeg mob (fatigability), nrog rau cov nyhuv ntawm kev tso ntshav thiab rov ua duakev hloov pauv ntawm lwm yam kev ntsuas lub neej zoo, txhawm rau nkag siab zoo dua qhov tshwm simrau cov neeg mob tau txais cov ntshav liab ntshav thaum mus pw hauv tsev kho mob. Ntxiv thiab, thaumKev hloov pauv tseem yog thawj qhov kev kho mob ntshav qab zib rau cov neeg mob hauv tsev kho mob, ua haujlwm yav tom ntejyuav tsum tau tshuaj xyuas seb puas muaj lwm yam kev kho mob rau ntshav qab zib, xws li hlau lossis erythropoiesis-stimulatingcov neeg ua haujlwm, muaj kev cuam tshuam rau tus neeg mob qhov qaug zog thiab / lossis lawv lub neej zoo tom qabtawm tsev kho mob.


Khoom siv ntxiv


Xa mus rau Web version ntawm PubMed Central rau cov khoom siv ntxiv.


Cov peev txheej:


Dr. Prochaska tau txais kev txhawb nqa los ntawm National Heart, Lung, thiab Blood Institute (USA) K23 Career Development Award.(NIH/NHLBI 1K23HL140132-01, Prochaska PI)Dr. Meltzer tau txais kev txhawb nqa los ntawm National Institutes of Health (USA) Clinical and Translational Science Award (NIH/NCATS UL1TR0002389-01, Solway PI).



Cov ntawv ntxiv 1.



4

Kev soj ntsuam ua haujlwm ntawm Kev Kho Mob Kho Mob (FACIT) Anemia-Fatigue Subscale



image

Daim duab 1. Patient Eligibility and Enrollment Diagram



5

6

Table 1



image

Rooj 2.

Qhov cuam tshuam ntawm Kev Txhawj Xeeb thiab Hb ntawm Kev Hloov Pauv ntawm Kev Nyuaj Siab los ntawm Baseline Fatigue Quintiles.Kab rov tav regression tswj hnub nyoog, poj niam txiv neej, ntev ntawm kev nyob, tus naj npawb ntawm RBC transfused, Charlson Comorbidity Index qhab niaΔKev qaug zog = coefficient rau kev sib cuam tshuam ntawm kev hloov ntshav × nadir Hb ntawm qhov hloov pauv hloov pauv hauv kev qaug zog (FACITFU– FACITua inp)



8

Table 3.

Qhov cuam tshuam ntawm Kev Txhawj Xeeb thiab Hb ntawm Kev Hloov Pauv ntawm Kev Nyuaj Siab los ntawm Baseline Fatigue Level



9_

Rooj 4.
Qhov cuam tshuam ntawm Kev Txhawj Xeeb thiab Hb ntawm Kev Hloov Kho hauv Kev Nyuaj Siab los ntawm Baseline Fatigue Quintiles thiab Hnub nyoog.Linear regression tswj rau: hnub nyoog, poj niam txiv neej, ntev ntawm kev nyob, tus naj npawb ntawm RBC transfused, Charlson Comorbidity Index qhab nia

Δ Fatigue=coefficient rau kev sib cuam tshuam ntawm kev hloov ntshav × nadir Hb ntawm qhov hloov pauv hloov pauv hauv kev qaug zog (FACIT - FACIT )


Cistanche product

Qhov no yog peb cov khoom rau kev qaug zog! Nyem rau daim duab kom paub ntau ntxiv!




CEEB TOOM:


[1]. Yazer MH, Triulzi DJ. AABB Cov Lus Qhia Txog Kev Txhaum Ntshav Qab Zib: Ib Yam Rau Yuav luag Txhua Tus. JAMA 2016; 316: 1984–1985. [Pub Med: 27732707]
[2]. Hebert PC, Carson JL. Transfusion Threshold ntawm 7 g ib deciliter - Tus Tshiab Ib txwm. N Engl J med 2014; 371: 1459–1461. [Pub Med: 25270276]
[3]. Carson JL, Grossman BJ, Kleinman S, et al. Kev Txhaum Ntshav Qab Zib: Cov Lus Qhia Txog Kev Kho Mob Los ntawm AABB*. Ann Intern Med 2012; 157:49–58. [Pub Med: 22751760]

[4]. Carson JL, Guyatt G, Heddle NM, et al. Cov Lus Qhia Txog Kev Kho Mob Los ntawm AABB: Cov Ntshav Ntshav Ntshav Ntshav Ntshav thiab Kev Cia. JAMA 2016; 316: 2025–2035. [Pub Med: 27732721]

[5]. Vuille-Lessard E, Boudreault D, Girard F, et al. Kev kuaj ntshav ntshav ntshav liab hauv kev xaiv kev phais orthopedic: kev tshawb fawb ntau pawg. Hloov pauv (Paris) 2010; 50: 2117–2124.

[6]. Napolitano LM, Kurek S, Luchette FA, et al. Cov lus qhia txog kev coj noj coj ua: Kev hloov ntshav liab hauv cov neeg laus raug mob thiab kev saib xyuas tseem ceeb. Crit Care Med 2009; 37: 3124–3157. [Pub Med: 19773646]

[7]. Xyaum Cov Lus Qhia rau Kev Kho Cov Ntshav: Ib daim ntawv qhia los ntawm American Society of Anesthesiologists Task Force on Blood Component Therapy. Tshuaj loog 1996; 84: 732–747 : kuv. [PubMed: 8659805]

[8]. Hloov cov ntshav thiab ntshav cov khoom: Cov lus qhia thiab teeb meem - American Family Physician.

[9]. Yellen SB, Cella DF, Webster K, et al. Kev ntsuas kev qaug zog thiab lwm cov tsos mob ntsig txog ntshav qab zib nrog Kev Ntsuas Kev Ntsuas Kev Kho Mob Cancer (FACT) kev ntsuas. J Pain Symptom Management 1997; 13:63–74. [PubMed: 9095563]

[10]. Mercadante S, Ferrera P, Villari P, thiab al. Kev cuam tshuam ntawm kev hloov ntshav liab ntawm cov tsos mob ntsig txog ntshav qab zib hauv cov neeg mob qog noj ntshav. J Palliat Med 2009; 12:60–63. [Pub Med: 19284264]

[11]. Brown E, Hurlow A, Rahman A, thiab al. Kev soj ntsuam kev qaug zog tom qab kev ntshav hauv cov neeg mob Palliative Care: Kev Kawm Ua Tau. J Palliat Med 2010; 13: 1327–1330. [Pub Med: 20973677]

[12]. Carson JL, Terrin ML, Noveck H, et al. Liberal lossis txwv tsis pub hloov pauv hauv cov neeg mob uas muaj kev pheej hmoo siab tom qab phais mob. N Engl J Med 2011; 365: 2453–2462. [Pub Med: 22168590]

[13]. Chen LJ, Moeller KD, Wagman LD. Cov txiaj ntsig ntawm kev hloov ntshav liab ntawm cov neeg mob tau tshaj tawm cov txiaj ntsig hauv cov neeg mob oncology ambulatory. J Clin Oncol 2016; 34:78–78.

[14]. Prochaska MT, Newcomb R, Thaiv G, thiab al. Kev Koom Tes Ntawm Cov Mob Ntshav Qab Zib thiab Kev Nyuaj Siab hauv Cov Neeg Mob Hauv Tsev Kho Mob: Puas Yog Kev Ntsuas Ntawm Ntshav Qab Zib? J Hosp Med 2017; 12: 898–904 : kuv. [Pub Med: 29091977]

[15]. Meltzer D, Manning WG, Morrison J, et al. Cov txiaj ntsig ntawm tus kws kho mob kev paub txog cov nqi thiab cov txiaj ntsig ntawm kev pabcuam tshuaj kho mob dav dav: cov txiaj ntsig ntawm kev sim ntawm cov kws kho mob. Ann Intern Med 2002; 137: 866}-874. [Pub Med: 12458986]

[16]. Holst LB, Haase N, Wetterslev J, et al. Cov kev cai hloov pauv hauv septic shock (TRISS) sim - sib piv cov txiaj ntsig thiab kev nyab xeeb ntawm kev ywj pheej tiv thaiv kev txwv cov ntshav liab hauv cov neeg mob septic shock hauv ICU: raws tu qauv rau kev sim ntsuas randomized. Kev sim 2013; 14:150. [PubMed: 23702006]

[17]. Hébert PC, Wells G, Blajchman MA, et al. Lub Multicenter, Randomized, Tswj kev sim tshuaj ntsuam xyuas kev hloov pauv hauv kev kho mob tseem ceeb. N Engl J Med 1999; 340: 409–417. [Pub Med: 9971864]

[18]. Pfeiffer EA daim ntawv nug luv luv portable hlwb rau kev soj ntsuam ntawm cov organic hlwb tsis txaus rau cov neeg laus. J Am Geriatr Soc 1975; 23: 433–441. [Pub Med: 1159263]

[19]. Deyo RA, Cherkin DC, Ciol MA. Kev hloov kho qhov ntsuas ntsuas qhov sib txawv rau kev siv nrog ICD-9-CM cov ntaub ntawv tswj hwm. J Clin Epidemiol 1992; 45: 613–619. [Pub Med: 1607900]

[20]. HCUP Clinical Classifications Software (CCS) rau ICD-9-CM. Cov Nqi Kho Mob thiab Kev Siv Siv (HCUP). 2006–2009 Lub Chaw Haujlwm Saib Xyuas Kev Noj Qab Haus Huv thiab Kev Ua Zoo, Rockville, MD.

[21]. Simon TL, Snyder EL, Stowell CP, et al. (eds). Rossi's Principles of Transfusion Medicine. 4 tsab Chichester, UK; Hoboken, NJ: Wiley-Blackwell, 2009.

[22]. Cella DF, Tulsky DS, Grey G, et al. Kev Ntsuas Kev Ua Haujlwm ntawm Kev Kho Mob Cancer: Kev txhim kho thiab kev siv tau ntawm kev ntsuas dav dav. J Clin Oncol Off J Am Soc Clin Oncol 1993; 11: 570–579 : kuv.

[23]. Cella D, Lai JS, Chang CH, et al. Kev qaug zog hauv cov neeg mob qog noj ntshav piv nrog kev qaug zog hauv cov pej xeem hauv Tebchaws Meskas. Cancer 2002; 94: 528–538. [Pub Med: 11900238]

[24]. PROMIS FATIGUE THIAB FACIT-FATIGUE.

[25]. Cella D, Yount S, Rothrock N, et al. Cov Ntaub Ntawv Qhia Txog Tus Neeg Mob Tshaj Tawm Txog Kev Ntsuas (PROMIS). Med Care 2007; 45: S3–S11.
[26]. Webster K, Cella D, Yost K. Qhov Kev Ntsuam Xyuas Kev Ua Haujlwm ntawm Kev Kho Mob Hlwb (FACIT) Kev Ntsuas: cov khoom, kev siv, thiab kev txhais lus. Kev noj qab haus huv Qual Life Outcomes 2003; 1:79. [PubMed: 14678568]
[27]. Wun T, Hassell K Cov kev coj ua zoo tshaj plaws rau kev hloov ntshav rau cov neeg mob uas muaj kab mob cell. Hematol Rev; 1. Epub ua ntej luam tawm 7 Lub Ib Hlis 2010 DOI: 10.4081/hr.2009.e22.
[28]. Telen MJ. Lub hauv paus ntsiab lus thiab teeb meem ntawm kev tso ntshav hauv cov kab mob mob qog nqaij hlav. Semin Hematol 2001; 38: 315–323. [Pub Med: 11605166]
[29]. Wachter RM, Goldman L, Hollander H Tsev Kho Mob. Lippincott Williams & Wilkins, 2005.
[30]. Oakland K, Jairath V, Murphy MF. Kev nce qib hauv cov tshuaj txhaj tshuaj: gastrointestinal los ntshav. Transfus Med; n/a–n/a.
[31]. Prochaska M, Newcomb, Block G, thiab al. Kev Koom Tes Ntawm Cov Mob Ntshav Qab Zib thiab Kev Nyuaj Siab hauv Cov Neeg Mob Hauv Tsev Kho Mob: Puas Yog Kev Ntsuas Ntawm Ntshav Qab Zib?
[32]. Fava M, Ball S, Nelson JC, et al. Kev soj ntsuam qhov cuam tshuam ntawm qaug zog raws li cov tsos mob seem hauv kev nyuaj siab loj. Kev nyuaj siab ntxhov plawv 2014; 31: 250–257 : kuv. [Pub Med: 24115209]
[33]. Targum SD, Fava M. Fatigue as a Residual Symptom of Depression. Innov Clin Neurosci 2011; 8:40–43.
[34]. Ho SY, Rohan KJ, Parent J, et al. Kev tshawb fawb ntev ntawm kev nyuaj siab, qaug zog, thiab pw tsaug zog cuam tshuam raws li cov tsos mob hauv cov poj niam uas mob qog noj ntshav. J Pain Symptom Management 2015; 49: 707–715. [Pub Med: 25461671]
[35]. Mazer CD, Whitlock RP, Fergusson DA, thiab al. Kev txwv lossis Liberal Red-Cell Transfusion rau Cardiac Surgery. N Engl J Med 2017; 377: 2133–2144. [Pub Med: 29130845]
[36]. Eldadah IB. Fatigue thiab Fatigability nyob rau hauv cov neeg laus. PM&R 2010; 2:406–413. [Pub Med: 20656622]








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