呼气末C02分压监测在COPD患者中的应用价值

Application value of end-tidal C02 partial pressure monitoring in COPD patients

目的研究在慢性阻塞性肺疾病（COPD）患者中呼气末CO2分压（PETCO2）与动脉血气分析CO2分压（PaCO2）的关系，探讨其临床价值。方法168例COPD患者中COPDI级20例，COPDⅡ级25例，COPDm级30例，COPD1V级93例，无Ⅱ型呼吸衰竭82例，Ⅱ型呼吸衰竭86例．分别使用平静呼气法与延长呼气法测定P。C0，，同时抽取动脉血测定PaC02，记录数据。．结果PaC02为（55．65±16．69）rnrnHg，平静呼气法PETCO：（Q）为（51．094±12．29）mmHg，延长呼气法PFcC02（P）为（55．23±15．62）mmHg，COPDI级、COPDⅡ级、无Ⅱ型呼吸衰竭组PETC02（Q）与PaCO，比较差异无统计学意义（P〉0．05），而COPDⅢ级、COPD1V级、Ⅱ型呼吸衰竭组比较差异有统计学意义（P〈0．05）；各组PETC02（P）与PaCO2结果均大致相似（P〉0．05），故PExCO：（P）可反映PaCO2，且二者呈正相关（r=0．92，P〈0．05）。结论PETCO2（P）可反映不同程度COPD患者PaCO：的变化，为临床提供一种无创监测方法，有重要的临床价值．

Objective To investigate the correlation between end-tidal carbon dioxide tension （PETCO2） and the arterial PCO2 （PaCO2 ） in patients with chronic obstructive pulmonary disease COPD. Methods One hundred and sixty-eight patients with COPD, with 20 cases of COPD Ⅰ , 25 cases of COPD Ⅱ , 30 cases of COPDⅢ, 93 cases of COPDIV ,82 cases without respiratory failure, 86 cases with respiratory failure, concurrently. They were both tested by eupnea method and prolonged expiratory meth od, and the PaCO2 was recorded. Results PaCO2 was （55.65 ± 16.69） mm Hg, PET CO2 （Q） was （51.09 ± 12.29）mm Hg, PET CO2 （P） was （55.23 ± 15.62）mm Hg, there was no significant difference between the PET CO2 （Q） and PaCO2 of COPD Ⅰ , COPD Ⅱ, without respiratm-y failure groups （ P 〉 0.05 ）, the PET CO2 （Q）of COPD m, C OPD IV, with respiratory failure groups was lower than PaCO2 （P 〈 0. 05 ）, there was no significant difference between the PI.：TCO2 （P）and PaCO2 of each group（ P 〉 O. 05 ）, PETCO2 （P） was remarkably positive correlated with PaCO2 （ r = 0.92, P 〈 O. 05 ）. Conclusions In COPD patients, the value of PETCO2 can reflect the changes of PaCO2 in different degrees of COPD,which will provide an valuable non-invasive method for monitoring PaCO2 in COPD patients.