肺泡气动脉血氧分压差在肺栓塞诊断中的应用及其影响因素分析

Use of the Alveolar Arterial Oxygen Gradient in the Assessment of Pulmonary Embolism

明确肺栓塞患者肺泡气 动脉血氧分压差P(A a)O2 变化的影响因素 ,探讨P(A a)O2 等血气指标在肺栓塞诊断中的价值。对 4 7例肺栓塞患者血气分析指标及其影响因素 (年龄、性别、肺栓塞面积、原有心肺疾患、诊断间隔 )之间的相关关系进行了单因素及多因素回归分析。 74 %的患者 ( 35例 )动脉血氧分压 (PO2 )低于 80mmHg ,85% ( 4 0例 )患者P(A a)O2 高于正常 ,经多元回归方程筛选出P(A a)O2 的影响因素为肺栓塞面积、性别、年龄。在肺栓塞诊断中 ,P(A a)O2 具有较PO2 更高的敏感性 ,影响肺栓塞患者P(A a)O2 的因素为肺栓塞面积、性别。

Objective to evaluate the utility of the alveolar arterial(A a) oxygen gradient in the diagnosis of pulmonary embolism,explore it's protential factors.Methods In a retrospective follow up cohort study we included 47 patients with PE,diagnosed lung from a ventilation/perfusion scan. Arterial blood gas samples were performed at diagnosis.Protential factor studied were:age,sex,presence of underlying cardiac or pulmonary disease,delay in diagnosis,and the size of defects.All factors were studied with regards to alveolar arterial oxygen gradient through a univariate statistical analysis and a multiple stepwise regression analysis.Results PO 2 were lower than 80 mmHg in 35 patients(74%),40 patients(85%) have higher P(A a)O 2.Multivariate statistical analysis selected three factors:size of defects,sex,age.Conclusions P(A a)O 2 has higher sensitiveness than PO 2 in the assessment of pulmonary embolism,it's potential factors include size of defect,sex and age.