老年慢性阻塞性肺病患者动脉血气分析与心律失常的关系

Relationship between Arrhythmia and Arterial Blood Gas Analysis in Elderly Patients with COPD

目的:探讨老年慢性阻塞性肺病(COPD)患者发生心律失常与动脉血气分析的相互关系。方法:196例老年COPD患者和30例健康体检者(对照组)常规行动态心电图及动脉血气分析,COPD患者按有无心律失常分为两组,观察治疗前后两组患者动脉血气分析指标的变化。结果:①对照组心律失常比例明显低于COPD组(13.3%vs 72.1%,X2=23.356,P<0.05),COPD组共计62.2%(122/196)例合并心律失常,其中72.1%(88/122)的患者为室上性心律失常,27.9%(34/122)为室性心律失常。②心律失常组pH值、PaO2低于非心律失常组(t=5.745、4.811,P<0.05),PaCO2高于非心律失常组(t=3.258,P>0.05)。③多因素Logistic回归分析结果显示,pH(β=1.761,OR=4.765)、PaO2(β=1.602,OR=3.492)、PaCO2(β=1.635,OR=3.451)是影响老年COPD患者心律失常的主要因素(P<0.05)。结论:老年COPD患者中心律失常发生率高,低氧血症、酸中毒、高碳酸血症与老年COPD患者心律失常发生密切相关。

Objective： To explore the relationship between arrhythmia and arterial blood gas analysis in elderly patients with chronic obstructive pulmonary disease（COPD）.Method： 196 elderly COPD patients and 30 healthy subjects（control group） were selected,and dynamic electrocardiogram（DCG） and arterial blood gas analysis were detected for each subject.COPD patients were divided into arrhythmia group and non-arrhythmia group,and the index of arterial blood gas analysis before and after treatment between two groups were analyzed.Results： ①The incidence of arrhythmia in control group was lower than that in COPD group.There was 62.2%（122 /196） COPD patients complicated with arrhythmia,in which 72.1%（88 /122） patients were complicated with supraventricular arrhythmia and 27.9%（34 /122） patients were complicated with ventricular arrhythmia.② pH and PaO2 in arrhythmia group were lower than those in non-arrhythmia group（t=5.745,4.811）,and PaCO2 in arrhythmia group was higher than that in non-arrhythmia group（t = 3.258）,and the differences were significantly（P 0.05）.③ Multivariate Logistic regression analysis showed that pH（β=1.761,OR=4.765）,PaO2（β=1.602,OR=3.492）,PaCO2（β =1.635,OR =3.451） were major factors for arrhythmia in elderly COPD patients（P0.05）.Conclusion： The incidence of arrhythmia was very high in elderly COPD patients.Hypoxemia,acidosis and hypercapnemia were closely related with arrhythmia in elderly patients with COPD.