COPD患者血气分析和生化试验的结果分析

Results of analysis to blood gas and biochemical experiment of COPD patients

目的研究各级COPD患者治疗前血气和生化结果的数值、互相的相关性和诊断价值。方法 120例COPD患者进行分级、主要血气和相关生化指标的测定、指标间的相关性分析以及诊断价值研究。结果 PaO2、PaCO2、pH、NA、CL、CO2结合力、TP、ALB、A/G在COPD患者各个分级之间的差异显著（P〈0.05）。ALT、AST、GLB在各个级别之间的差异不显著（P〉0.05）。除了PO2与CO2结合力、PO2与A/G之外（P〉0.05）,其他指标两两之间均具有相关性（P〈0.05）。鉴别COPD患者处于0~Ⅱ级或Ⅲ~Ⅳ级,下列指标的诊断价值中等：PO2、PCO2、CL、CO2结合力。当PCO2/PO2大于0.75、CO2CP/PCO2大于0.60、PCO2/CL大于0.46时,诊断为COPD的Ⅲ级以上的灵敏度和特异度均较高。结论 COPD患者血气和生化指标随着患者的病情进展而变化。PO2与PCO2、PCO2与CO2结合力之间的具有很强的相关性。PO2、PCO2、CL、CO2结合力在其切点下,对患者的病情具有中等水平的鉴别诊断价值。当PCO2小于48.70mmHg时,其灵敏度为100%,即区别0~Ⅱ级与Ⅲ~Ⅳ级COPD的漏诊率为0。PCO2/PO2、CO2CP/PCO2、PCO2/CL的联合指标对COPD患者处于0~Ⅱ级或Ⅲ~Ⅳ级具有优秀的诊断价值。

Objective To study the results of levels,the diagnostic value and correlation with each other.of blood gas and biochemical values in pre-treatment patients with COPD.Methods 120 COPD patients were leveld,main blood gas and biochemical indexes were measured and the correlation among the indicators were analysed.Results PaO2,PaCO2,pH,NA,CL,CO2 CP,TP,ALB,A / G in COPD patients with difference levels had significant differences（P〈0.05）.ALT,AST,GLB had no significant difference at all levels（P〉0.05）.Between any two other indicators were correlated（P〈0.05） in addition to PO2 and CO2 CP,PO2 and A / G（P〉0.05）.PO2,PCO2,CL,CO2 binding,ALB had medium diagnostic values to identify the levels.When PCO2 / PO2 greater than 0.75,CO2CP / PCO2 greater than 0.60,PCO2/CL greater than 0.46,the diagnosis of COPD Ⅲ level above had high sensitivity and specificity.Conclusion With the progress of the disease,COPD patients′blood gas and biochemical indicators gradually changed.PO2 and PCO2,PCO2 and CO2CP had a strong correlation with eath other.PO2,PCO2,CL,CO2 CP,ALB in their cut-off point have a differential diagnosis to the patient＇s condition.When PCO2 is less than 48.70 mmHg,the sensitivity is 100%,that is,the missed diagnosis rate of COPD is zero.Joint indexes PCO2 / PO2,CO2CP / PCO2,PCO2/CL has excellent diagnostic value.