动脉血气参数与慢性阻塞性肺疾病伴意识障碍患者病情严重程度的相关性分析

Correlation between parameters of arterial blood gas and severity of patients having COPD accompanied with disturbance of consciousness

目的研究动脉血气参数与慢性阻塞性肺疾病(COPD)伴意识障碍患者病情严重程度的关系。方法选择COPD合并意识障碍患者120例,根据精神及意识状态分为清醒组40例,嗜睡组40例,昏迷组40例,同时选取40例健康体检者作为对照组。分析测定各组患者动脉血气参数并进行比较。结果研究组患者pH值(P<0.001)、动脉氧分压(PaO_2)(P=0.005)、血氧饱和度(SaO_2)(P=0.003)、氧合指数(P<0.001)、Na^+(P<0.001)、K^+(P=0.003)、Cl^-(P<0.001)均低于对照组,二氧化碳分压(PaCO_2)(P<0.001)、HCO_3^-(P<0.001)均高于对照组;不同意识障碍程度患者比较,三组患者随意识障碍程度加重,pH值、PaO_2、SaO_2、氧合指数、Na^+、K^+、Cl^-呈递减变化(P<0.05),PaCO_2、HCO_3^-呈递增趋势变化(P<0.05)。结论动脉血气参数与COPD患者意识障碍程度有相关性,动脉血气酸碱失衡的加重可反映患者意识障碍程度的加深,对临床评估与监测COPD患者意识障碍程度具有重要意义。

Objective To study the correlation between parameters of arterial blood gas and severity of patients having COPD accompa-nied with disturbance of consciousness.Methods A hundred and twenty cases of COPD patients were selected and assigned into awakeness group（40 cases）,drowsiness group（40 cases）and coma group（40 cases）according to the state of mind and consciousness. Another 40 cases of healthy persons were selected as control group.The arterial blood gas parameters were analyzed and compared a-mong the groups.Results In the study group,pH value（P 〈0.001）,PaO2 （P =0.005）,SaO2 （P =0.003）,oxygenation index（P 〈0. 001）,Na ＋（P 〈0.001）,K ＋（P =0.003）,Cl -（P 〈0.001）were lower than the control group,while PaCO2 （P 〈0.001）and HCO -3 （P〈0.001 ）were significantly higher than the control group.As for patients with different levels of consciousness,with the increased awareness disorder,pH,PaO2 ,SaO2 ,oxygenation index,Na ＋,K ＋,Cl - showed a decreasing change （P 〈0.05 ）,while PaCO2 and HCO -3 showed an increasing change（P 〈0.05）.Conclusions There was a correlation between the degree of arterial blood gas parame-ters and the disturbance of consciousness in patients with COPD.Aggravation of arterial blood gas acid-base imbalance can reflect the severity of patients with disorders of consciousness,which has important significance for clinical assessment and monitoring of COPD pa-tients with disorders of consciousness.