脉搏血氧波形参数正常人群参考值范围的制定

Reference value range of pulse oximetry plethysmographic waveform parameters in the normal adults

目的脉搏血氧饱和度监测目前广泛应用于临床。近年来研究显示脉搏血氧波形（pulse oximetry plethysmographic wavefoiTn，POP）能实时反应患者循环状态改变。本研究将POP参数化，通过观察正常人群POP参数的分布，制定其正常参考值范围。方法多中心前瞻性描述性研究。以全国7个城市的健康成人1019人为研究对象，记录性别、年龄、身高、体质量，采集其室温平静状态下脉搏血氧数据，应用基于MATLAB2012a专用软件进行脉搏血氧波形参数及血流灌注指数提取，并制定脉搏血氧波形参数[脉搏血氧波形幅度参数（the amplitude of POP，Amp）、脉搏血氧波形曲线下面积参数（the area under the curve of POP，AUC）]正常参考值范围。结果正常成人脉搏血氧波形参数在男性和女性之间有明显差异。95％置信区间下正常人群Amp正常参考值为（104．8—2298．7）PVA；AUC正常参考值为（3265．8—6028．5）PVPG。男性Amp正常参考值为（129．4—2433．6）PVA；AUC正常参考值为（3319．0—5862．2）PVPG。女性Amp正常参考值为（89．5—2138．2）PVA；AUC正常参考值为（3163．9～5929．9）PVPG。结论脉搏血氧波形参数包括脉搏血氧波形幅度参数和脉搏血氧波形面积参数，在正常成人中有一定的参考范围。

Objective To Pulse oximetry saturation has been wildly used clinically. It has been reported that pulse oximetry plethysmographic waveform （POP） reflected the peripheral tissue perfusion. In this study, we parameterized POP, observed the value of POP parameters in normal adults, and established the normal reference value range. Methods A multi-center prospective descriptive study. Total of 1 019 adult volunteers with normovolemia from 7 cities were enrolled in this study. Sex, age, height, weight and pulse oximetry data in awake and spontaneous breathing under in quiet conditions in the room temperature were collected. POP parameters and perfusion index were analyzed using MATLAB 2012a software. The normal reference value ranges of POP parameters, including the amplitude of POP （Amp） and the area under the curve of POP （AUC） , were formulated. Results Statistical differences of POP parameters were detected between men and women in the normal adult. The 95% confidence reference value of POP parameters in normal population was as follows： Amp （ 104. 8-2298. 7） PVA and AUC （3265. 8-6028. 5） PVPG in total, Amp （ 129. 4-2433. 6 ） PVA and AUC （ 3319.0-5862. 2 ） PVPG in male ; Amp （ 89. 5- 2138. 2） PVA and AUC （3163.9-5929. 9） PVPG in female. Conclusions POP, including the amplitude of POP （Amp） and the area under the curve of POP （AUC）, had normal reference value ranges in normal adults.