慢性阻塞性肺疾病急性加重期患者外周组织氧摄取率动态监测

Dynamic monitoring on O2ER of peripheral tissues in AECOPD patients

目的探讨慢性阻塞性肺疾病急性加重期（AEC（）PD）患者外周组织氧摄取率（O。ER）及变化情况。方法所有符合条件患者分两组（单纯AECOPD组14例，AECOPD合并呼吸衰竭和肺源性心脏病组24例），分别于人院后第1天、第3天和第7天（或出院时）卧床休息，停止吸氧30min后分别同时抽桡动脉及肘静脉血行血气分析并计算出O2ER。应用统计学方法分别比较两组患者外周O2ER动态改变以及O2ER与呼吸困难评分、出院时第1秒用力呼气容积（FEV。）的相关性。结果①单纯AECOPD组患者病情稳定后外周O2ER显著下降（P〈O．01），而合并呼吸功能衰竭和肺源性心脏病组患者外周O2ER变化动态改变差异无统计学意义（P〉0．05）；②两组患者在人院时及入院第3天外周O2ER差异无统计学意义，出院时单纯AECOPD组外周O2ER较合并呼吸功能衰竭肺源性心脏病组显著降低（P〈O．01）；③两组患者在第1天和第3天外周O2ER与呼吸困难评分及FEV。均无相关性（P〉O．05），病情稳定及出院时外周O2ER与呼吸困难评分呈正相关，（r=0．365，P=0．024），与FEV。呈负相关（r=0．342，P〈O．05）。结论①单纯AECOPD组患者病情稳定后外周O2ER较急性期或AECOPD合并呼吸功能衰竭和肺源性心脏病组患者下降；②AECOPD患者病情稳定及出院时外周O2ER与呼吸困难评分呈正相关，与FEV1呈负相关。

Objective To explore the O2ER and its change of peripheral tissues in AECOPD patients. Methods All the enrolled patients were divided into two groups （14 cases in the single AECOPD group and 24 cases in the AECOPD＋RF＋PHD group） to complete bed rest separately at 1 d, 3 d and 7 d （or at discharge） after admission, and the radial arterial and ulnar venous blood was collected at 30 rain after discontinuation of oxygen inhalation for blood gas analysis and calculation of 02ER. The statistical methods were used for comparison in the dynamic change of peripheral 02ER between two groups, as well as in the correlation among 02ER, dyspnea score and FEV1 at discharge. Results ①The peripheral 02ER was significantly decreased in the single AECOPD group after the condition became stable （ P 〈0.01）, while there was no statistical significance for the dynamic change of peripheral O2ER in the AECOPD＋ RF＋PHD group （ P 〈 0.05）. ② No statistical significance was identified for the difference in the peripheral 02ER between two groups at admission and 3 d after admission, but it was obviously decreased in the single AECOPD group at discharge compared with the AECOPD＋RF＋PHD group （ P〈0.01）. ③In the two groups, the peripheral O2ER was not associated with dyspnea score and FEV1 at 1 d and 3 d （ P 〉0.05）, but positively correlated to dyspnea score （ r =0. 365, P =0. 024） and negatively correlated to FEVI （ r =0. 342, P 〈0.05） after the condition was stable and at discharge. Conclusions ①Compared with the acute stage or the AECOPD＋RF＋PHD group, the peripheral O2ER in the single AECOPD group was decreased after the condition became stable. ②After the condition was stable and at discharge, the peripheral O2ER in AECOPD patients was positively correlated to dyspnea score and negativelycorrelated to FEV1.