氧疗对慢性阻塞性肺疾病患者血尿酸水平的影响

Influences of oxygen therapy to uric acid in patients with chronic ob-structive pulmonary disease

目的探讨慢性阻塞性肺疾病（COPD）患者血尿酸水平的变化及氧疗对COPD患者血尿酸水平的影响。方法收集2012年1月-2015年3月在佛山市高明区人民医院住院的COPD缓解期患者184例,根据肺功能分为Ⅰ级39例（1组）、Ⅱ级52例（2组）、Ⅲ级49例（3组）及Ⅳ级44例（4组）,检测空腹血尿酸水平、动脉氧分压、二氧化碳分压,给予低流量（1-2 L/min）吸氧,每天至少吸氧12 h,1周后再次检测空腹血尿酸水平,比较各组患者氧疗前后血尿酸水平的变化。结果四组患者氧疗前随COPD级别加重,血尿酸水平逐渐升高,分别为（315.64±26.50）、（406.22±99.61）、（523.76±155.47）、（597.05±192.53）μmol/L,组间比较差异有高度统计学意义（P〈0.01）。氧疗后,2、3、4组血尿酸水平较吸氧前下降,差异有统计学意义（P〈0.05或0.01）。2组氧疗前后血尿酸水平[（406.22±99.61）比（364.55±102.36）μmol/L）]比较,差异有统计学意义（P〈0.05）,3组氧疗前后血尿酸水平[（523.76±155.47）比（473.16±123.47）μmol/L）]比较,差异有高度统计学意义（P〈0.01）,4组氧疗前后血尿酸水平[（597.05±192.53）比（507.65±202.43）μmol/L]比较,差异有高度统计学意义（P〈0.01）,1组患者氧疗前后血尿酸水平[（315.64±26.50）比（302.58±32.14）μmol/L]比较,差异无统计学意义（P〉0.05）。结论随着COPD病情加重,血尿酸水平升高,氧疗可降低COPD患者血尿酸水平。

Objective To explore the changes of uric acid in patients with chronic obstructive pulmonary disease（COPD）, and study the influences of oxygen therapy to uric acid of patients with COPD. Methods From January 2012 to March 2015, in Gaoming People＇s Hospital, 184 patients with COPD during remission were enrolled and divided into four groups according to the pulmonary function. 39 patients were at the Ⅰ stage of COPD（group 1）, 52 patients were at the Ⅱ stage（group 2）, 49 patients were at the Ⅲ stage（group 3） and 44 patients were at the Ⅳ stage（group 4）. The levels of fasting blood uric acid, PO2 and PCO2were tested of all patients. A low flow of oxygen（1-2 L/min） was taken by all the patients at least 12 hours a day for 7 d. Fasting blood uric acid was tested again after the oxygen therapy.The serum uric acid before and after oxygen therapy of each group was compared. Results The serum uric acid level of COPD before oxygen therapy was increased with the classification of lung function. The level of serum uric acid of the four groups was（315.64±26.50）,（406.22±99.61）,（523.76±155.47）,（597.05±192.53） μmol/L, which had significant difference among the four groups（P〈0.01）. After oxygen treatment, the uric acid level of the group 2, group 3, group 4decreased（P〈0.05 or 0.01）. The serum uric acid level of the group 2 before and after oxygen treatment was compared [（406.22±99.61） vs（364.55±102.36） μmol/L], the difference was statistically significant（P〈0.05）, the serum uric acid level of the group 3 before and after oxygen treatment was compared [（523.76±155.47） vs（473.16±123.47）μmol/L], the difference was statistically significant（P〈0.01）, and the serum uric acid level of the group 4 before and after oxygen treatment was compared [（597.05±192.53） vs（507.65±202.43） μmol/L], the difference was statistically significant（P〈0.01）. The differences of the uric acid level of the group 1 before and after oxygen therapy [（315.64 ±26.50） vs（302.58±32.14） μmol/L] was no statistically significant（P〈0.05）. Conclusion The level of uric acid is positively correlated with classification of lung function. Oxygen therapy may reduce the level of uric acid of COPD.