重症喘息性疾病合并肺动脉高压患儿动脉血气指标变化及其临床意义

The Changes and Clinical Significance of Arterial Blood Gas Index in Children Severe Asthmatic Diseases Combined Pulmonary Hypertension

目的：探讨重症喘息性疾病合并肺动脉高压患儿动脉血气指标变化及其临床意义。方法选取我院2011－01～2014－09间住院部收治的82例重症喘息性疾病患者，根据是否合并肺动脉高压将患者分为肺动脉高压组（35例）和非肺动脉高压组（47例），采用血气分析仪测定两组动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）和血氧饱和度（SaO2），并统计分析重症喘息性疾病合并肺动脉高压患儿不同时期的血气指标。结果血气分析显示，肺动脉高压组PaO2、SaO2明显低于非肺动脉高压组， PaCO2则明显高于非肺动脉高压组，两组比较差异具有统计学意义（ P＜0．05）。肺动脉高压组缓解期的PaO2、SaO2较急性发作期呈升高趋势，PaCO2则明显下降，两者比较差异具有显著性（P＜0．05）。 ROC曲线分析显示，PaO2、PaCO2、SaO2三项联合检测对重症喘息性疾病合并肺动脉高压病情程度预测ROC曲线下面积（AUC值）别为0．914，明显高于单项PaO2（0．812），PaCO2（0．804）和SaO2（0．754）（P＜0．05）。结论重症喘息性疾病急性发作合并肺动脉高压患儿动脉血PaO2、SaO2值下降，PaCO2值升高，三者随着患者病情变化而变化，可作为重症喘息性疾病急性发作合并肺动脉高压患儿预后评估的参考指标。

Objective To study the changes and its clinical significance of arterial blood gas index in children severe asthmatic disea-sescombinedpulmonaryhypertension.Methods 82casesofsevereasthmaticdiseasepatientswereselectedfromadmittedinpatientduring January 2011 to September 2014, according to whether combined pulmonary hypertension patients can be divided into pulmonary hyperten-sion group （35 cases） and none-pulmonary hypertension group （47 cases）, arterial blood gas index PaO2, PaCO2 and SaO2 between groups were evaluated, and blood gas index in different periods of children severe asthmatic diseases combined pulmonary hypertension were statistically analyzed.Results The blood gas analysis showed, PaO2 , SaO2 of pulmonary hypertension group were obviously lower than none-pulmonary hypertension group, but PaCO2 was significantly higher than none-pulmonary hypertension group （P〈0.05）.Compared with remission, PaO2 , SaO2 of pulmonary hypertension group acute exacerbation showed a trend of rise, and PaCO2 was markedly reduced （P〈0.05）.ROC curve analysis showed, the area under the ROC curve （AUC）in PaO2, PaCO2, SaO2 combined detection for forecast se-vere asthmatic diseases combined pulmonary hypertension illness was 0.914, significantly higher than PaO2（0.812）, PaCO2（0.804） and SaO2（0.754） （P〈0.05）.Conclusion The arterial blood gas index PaO2, SaO2 value of children severe acute asthmatic disease with pulmonary hypertension in are decreased, PaCO2 value increases, all changes by illness, and used as prognosis evaluation referent index for severe acute asthmatic disease combined pulmonary hypertension .