慢性阻塞性肺疾病患者夜间低氧发生情况的初步探讨

Study of nocturnal desaturation in patients with chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病(COPD)患者夜间低氧的发生情况并探讨其发病机制。方法将60例COPD稳定期患者分为两组:非呼吸衰竭组(40例)、呼吸衰竭组(20例),另选急性肺炎治愈患者作为对照组(20例)。采用东方万泰公司提供的便携式初筛诊断仪进行睡眠监测。结果夜间低氧血症在三组的发生率分别为45%、100%及10%,COPD组明显高于对照组(P<0.05)。夜间低氧与日间血氧饱和度(SaO2)相关。结论COPD患者夜间睡眠时出现低氧或低氧血症加重,夜间低氧血症可通过白天SaO2来预测,COPD与睡眠暂停低通气综合征(OSAHS)并存可加重夜间低氧血症。

Objective To determine the incidence and pathogenesis of nocturnal hypoxemia in patients with COPD. Methods According to the daytime artery blood gases analysis 60 stable COPD patients were divided into two groups： COPD patients without chronic respiratory failure （non-CRF,n =40） and patients with chronic respiratory failure （CRF n = 20）. Control group （n = 20） ：patients with cured acute pneumonia. All patients were monitored with overnight pules oximetry（OPO） for 7 ~ 8h at night under air breathing. Results The incidence of nocturnal hypoxemia in patients with COPD were found higher than those in control group. The level of nocturnal oxygen could be predicted by daytime oxyhemoglobin saturation （ SaO2 ）. Conclusion It was observed that the nocturnal oxygen level signifieandy decreased in COPD patients than that in normal. The presence of both COPD and OSAttS led to greater blood gas and pulmonary hemodynamic perturbations than found in individuals with each alone.