日间清醒状态血氧正常的慢性阻塞性肺疾病患者昼夜血氧变化相关因素分析

Analysis of predictive factors of blood oxygen fluctuation in patients with chronic obstructive pulmonary disease for normal blood oxygen in awake

目的观察日间清醒状态血氧正常的慢性阻塞性肺疾病患者昼夜血氧变化情况及其相关因素分析。方法比较28例COPD患者和28例正常对照者的昼夜血氧饱和度变化情况、日间血气分析、肺功能情况。结果 COPD组日间清醒MSpO_2与对照组比较,差异无统计学意义(P>0.05);COPD组夜间MSpO_2、日间PaO_2低于对照组(P<0.05),COPD组昼夜血氧变化率、日间PaCO_2高于对照组(P<0.05)。FEV_1绝对值、FEV_1/FVC、FVC%,COPD组均低于对照组(P<0.05)。昼夜血氧变异率与年龄、BMI、吸烟指数均呈正相关(r分别为0.334、0.512、0.628,P<0.05),与日间PaO_2、夜间MSpO_2、FEV_1绝对值均呈负相关(r分别为-0.456、-0.698、-0.412,P<0.05)。结论昼夜血氧变异率更能反映COPD患者的病情和预后,可以通过日间血气分析和肺功能进行预测。

Objective To study the predictive factors of blood oxygen fluctuation in patients with chronic obstructive pul- monary disease for normal blood oxygen in awake. Methods Daytime and nocturnal oxygen level were monitored, daytime arterial blood gases were analyzed, pulmonary function test was performed both in 28 COPD patients and 28 normal controls. Results . Compared with normal controls, the extents of nocturnal MSpO2. daytime PaO 2, absolute value of FEVI, FEV J FVC, FVC% were significantly decreased in COPD patients （P 〈 0. 05）. Age, BMI and smoke index were positive related to the blood oxygen fluctuation（ r = 0. 334,0. 512,0. 628 ,P 〈 0. 05）. Daytime PaO2, nocturnal MSpO2, absolute value of FEV 1 were negative related to the blood oxygen fluctuation （ r = - 0. 456, - 0. 698, -0. 412, P 〈 0. 05 ）. Conclusion The condition and prognosis of COPD cases were associated with blood oxygen fluctuation. Daytime arterial blood gases and pulmonary function test were also found cor- related with blood oxygen fluctuation.