急诊哮喘患者静脉血气转化后与动脉血气的对比研究

A comparison study between transferred venous blood gas and arterial blood gas in emergency asthma patients

目的:本次研究使用一种数学方法将静脉血气转化以得到与动脉血气类似的结果,在30例急诊哮喘患者中研究这一方法的准确性。方法:30例急诊哮喘患者入院后5min内于同一侧肢体采集动、静脉血标本,记录指脉氧饱和度,分别观察静脉血气、动脉血气和经过转化后的静脉血气pH值、PO2、PCO2的关系。结果:静脉血和动脉血比较,pH、PCO2、PO2相关性较好,r2分别为0.94、0.82、0.73,Bland-Altman法分析后偏倚和标准差分别为0.038±0.055,-1.41±1.48,3.13±2.02,均超过实验室可接受的误差范围。经过数学方法转化后的静脉血与动脉血指标比较,pH、PCO2、PO2相关性较好,r2分别为0.97、0.98、0.85,Bland-Altman法得出偏倚和标准差分别为-0.01±0.04,0.05±0.39,1.36±1.57,其中pH、PCO2在实验室可以接受的误差范围内,PO2超出了实验室可接受的误差范围。结论:静脉血气与动脉血气结果差异较大,通过数学方法转化的静脉血气可以提供与动脉血气类似的pH和PCO2结果,但PO2结果与动脉血气结果相差较大,需要进一步改进方法研究。

Objective：This study evaluates if the transferred venous blood gas using a mathematical method can replace the arterial bood gas in emergency asthma patients.Method：The peripheral venous blood samples,arterial blood samples and SpO2 of thirty emergency asthma patients were obtained from the same extremity within 5minutes after their admission to the emergency department.The values of pH,PCO2 and PO2of venous blood were transferred using a mathematical method.The transferred results and peripheral venous blood results were compared to the arterial blood results respectively.Result：Comparing the peripheral venous blood and the arterial blood,pH,PCO2 and PO2correlated well with the correlation coefficients（r2）pH 0.94,PCO20.82,PO20.73.But Bland-Altman limits of agreement pH（0.038±0.055）,PCO2（-1.41±1.48）,PO2（3.13±2.02）,beyond the limits of acceptable laboratory.Comparing the transferred venous blood and arterial pH,PCO2,PO2 correlated well with the correlation coefficients（r2）pH 0.97,PCO20.98,PO20.85;and Bland-Altman limits of agreement pH（-0.01±0.04）,PCO2（0.05±0.39）,well within the limits of acceptable laboratory,but Bland-Altman limits of agreement PO2（1.36±1.57）beyond the limits of acceptable laboratory.Conclusion：The difference between venous blood gas and arterial blood gas is huge.The results of pH and PCO2 transferred from values of peripheral venous blood by using a mathematical method are close to the measured arterial blood results.But the transferred result of PO2 is different to the result of arterial blood gas.The mathematical method of transferring venous blood to arterial blood will need more modification.