呼吸指数判断高原慢性肺源性心脏病急性加重期呼吸衰竭程度及预后的意义

Changes of respiratory index in chronic pulmonary heart disease at altitudes

目的 :探讨高原性慢性肺心病呼吸指数 (RI)变化与病情严重程度的关系及判断预后的意义。方法 :188例高原慢性肺心病急性加重期患者测定了肺泡气氧分压 (PAO2 )和动脉血气 ,计算RI,RI=PAO2 -PaO2 /PaCO2 ,并与 36例当地健康人比较。结果 :肺心病无呼衰 (NRF)、轻度呼衰 (LRF)、中度呼衰 (MRF)、重度呼衰 (SRF)组PaO2 显著低于对照组 ,A -aDO2 和RI显著高于对照组 ,肺心病各组之间比较也有显著性差异 ,P均 <0 .0 1。肺心病各组治疗后较治疗前均显著改善 (P <0 .0 1)。RI与PaO2 、PAO2 呈显著负相关 (r=- 0 .96 8、- 0 .5 2 6 ,P <0 .0 1) ;与PaCO2 、A -aDO2 呈显著正相关 (r=0 .6 97、0 .92 7,P <0 .0 1)。结论 :高原肺心病RI变化与呼衰的严重程度一致 ,RI可作为判断高原肺心病呼衰程度、病情监测和预后的指标之一。

Objective:To study the changes and the clinical significance of respiratory index(RI)in chronic pulmonary heart disease(CCP) at high altitude.Methods:Alveolar PO 2(PAO 2) and arterial blood gas were measured in 188 cases of CCP in exacerbation stage and 36 health persons at 2 260-3 300 m altitude.The CCP group was divided upon normal respiratory function(NRF),light respiratory failure(LRF),moderate respiratory failure (MRF) and severe respiratory failure(SRF)subgroup.Results:PaO 2 level was significantly lower in CCP group than that in control group and the levels of A-aDO 2 and RI were higher in CCP group than those in control group.The difference of PaO 2,A-aDO 2 and RI levels between each subgroup and another were significant.The differences of these indexes between in before and after treatment wree significant( P <0.01).The level of RI was significantly negatively correlated with those of PaO 2,PAO 2 and positive correlated with those of PaCO 2 and A-aDO 2.Conclusion:[WT5BZ]The change of RI is significantly correlated with the degree of RF.RI is helpful for evaluating the RF and prognosis in CCP at high altitude.