慢性阻塞性肺病急性加重期并高血糖患者酸碱失衡类型分析

Analysis of the type of acid-base balance disorder in aute exacerbation of chronic obstructive pulmonary disease with hyperglycemia

目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并高血糖与否的两组病例酸碱失衡类型,并发症及病死率。方法对比分析66例AECOPD合并高血糖患者(实验组)及80例AECOPD患者(对照组)住院期间的首次动脉血气、电解质检测结果和相关临床资料,判断初次酸碱失衡类型对并发症和病死率的影响。结果实验组发生酸碱失衡63例(95.5%),其中单纯呼吸性酸中毒最多,共38例(57.6%),发生二重酸碱失衡12例(18.2%),三重酸碱失衡3例(4.5%),多有多脏器损害。对照组发生酸碱失衡71例(88.8%),其中单纯呼吸性酸中毒最多,共35例(43.8%),二重酸碱失衡23例(28.8%),三重酸碱失衡7例(8.8%)。两组发生二重酸碱失衡与三重酸碱失衡的比例均有统计学差别(P<0.05)。两组总病死率分别为10.0%(8/80)和7.8%(5/66),两组比较有统计学差异(P<0.05)。结论实验组发生酸碱失衡的比例高于对照组,酸碱失衡类型都以呼吸性酸中毒最多。但二重酸碱失衡与三重酸碱失衡及两组总病死率的比较发现对照组更高。

Objective To evaluate the status of the type of acid-base balance disorders and complications and mortality in aute exacerbation of chronic obstructive pulmonary disease with hyperglycemia.Methods Analysis the first arterial blood gas and electrolyte test results and related clinical data 66 patients of aute exacerbation of chronic obstructive pulmonary disease with hyperglycemia（experimental group） and 80 cases of aute exacerbation of chronic obstructive pulmonary disease（control group） to determine the type of acid-base imbalance and the complications and mortality.Results 63 cases （95.5%） occurred acid-base disorders in the experimental group,in which a simple respiratory acidosis up to a total of 38 cases （57.6%）,12 patients （18.2%） occurred double acid-base balance disorders,3 cases （4.5%） occurred triple acid-base disorders,most of them have more organ damage.71 cases （88.8%） occurred acid-base balance disorders in the control group,in which a simple respiratory acidosis up to a total of 35 cases （43.8%）,23 patients （28.8%） occurred double acid-base balance disorders,7 cases （8.8%） occurred triple acid-base disorders.The ratio of two groups took place double and triple acid-base disorders were statistically different （P0.05）.The mortality of two groups were 10.0% （8/80） and 7.8% （5/66）,there was statistically different （P0.05）.Conclusion The proportion in experimental group occurred acid-base balance disorders more than control group′s.A simple respiratory acidosis up to a total in two groups.However,the case of double and triple acid-base disorders and the total mortality was found higher in control group.