伴有夜间低氧的慢阻肺患者家庭氧疗的疗效研究

Study of oxygen therapy in COPD patients with nocturnal hypoxia

目的：对于伴有睡眠呼吸紊乱而无日间低氧血症的COPD患者进行系统的研究,并探讨早期介入家庭氧疗对保护肺功能,改善COPD患者生活质量的作用。方法：选择无日间低氧的COPD患者进行肺功能及整夜多导睡眠检测（PSG）,选取睡眠呼吸暂停低通气指数（AHI）为5~30的患者为研究对象,随机分为实验组及对照组,两组患者均接受常规治疗。实验组接受家庭氧疗,每日吸氧时间〉15h。对两组患者根据病情每1~3个月门诊随诊1次,两年后所有患者复查肺功能、血气分析、睡眠监测及血液生化检查。结果：两年后实验组患者FEV1与对照组比较有明显提高,差异有显著意义（P〈0.05）;而实验组FVC与对照组相比无明显变化（P〉0.05）。两年后实验组的PaO2、SaO2均有改善,与对照组比较差异均有显著性（P〈0.05）。同时复查PSG发现,实验组患者的AHI较对照组相比虽无明显差异,但对照组患者AHI已呈上升趋势,实验组患者的浅睡眠时间较对照组相比缩短,差异有显著性（P〈0.05）。结论：提早进行家庭氧疗对于无日间低氧的COPD患者可以改善其睡眠紊乱情况,延缓肺功能的下降。

Objective：To carry on the research on COPD patients with sleep disordered breathing and no daytime hypoxia,and to discuss early home oxygen treatment in the protecting lung function and improving the quality of life of COPD patients.Method：COPD patients without daytime low oxygen were chose in our study,their lung function and all night PSG were detected.The selected patients（AHI 5-30）were randomly divided into two groups：the experimental group and the control group.All patients received routine treatment.The experimental group received family oxygen,oxygen time〉15hours daily.According to the illness,all patients underwent outpatient referral every 1-3months.Two years later,all patients reviewed lung function,blood gas analysis,sleep monitoring and blood biochemical examination.Result：Compared with controls,FEV1increased significantly in the experimental group two years later（P〈0.05）.But no significant differences were found for the FVC in experimental group compared to controls（P〉0.05）.The experimental group had a significant improvement for PaO2,and SaO2 compared with controls（P〈0.05）.PSG review found that the AHI had no obvious differences in experiment group,but a rising trend was found in the control group.The experimental group had a shorter shallow sleeping time compared with control group,（P〈0.05）.Conclusion：Early family oxygen for COPD patients with no daytime hypoxia can improve the sleep disorders and slow decline of lung function.