睡眠呼吸监测结合肺功能、动脉血气分析对慢性缺氧性疾病家庭氧疗的评估意义

Significance of polysomnography monitoring combined with pulmonary function and arterial blood gas analysis for long-term oxygen therapy in chronic hypoxic disease

目的探讨睡眠呼吸监测结合肺功能、动脉血气分析对慢性缺氧性疾病长期家庭氧疗(LTOT)的评估意义。方法选取2016年6月2017年6月蚌埠市第二人民医院诊断为慢性阻塞性肺疾病(COPD)稳定期患者共120例,随机将其分为对照组和观察组,每组60例。对照组采用常规药物治疗,观察组结合LTOT,每日吸氧至少15 h,2 L/min。分别于治疗前、治疗后1、3和6个月,采用多导睡眠监测(PSG)仪监测夜间氧饱和度低于90%的时间占总睡眠时间的百分比(SIT90)和睡眠呼吸暂停低通气指数(AHI),肺功能检测第1秒用力呼气容积/用力肺活量(FEV1%)和FEV1%预计值,动脉血气分析动脉血二氧化碳分压(PaCO2)和动脉血氧分压(PaO2)。结果对照组与观察组治疗前、治疗后1、3和6个月的SIT90、AHI、FEV1%、FEV1%预计值、PaCO2及PaO2比较:①不同时间点的SIT90、AHI、FEV1%、FEV1%预计值、PaCO2及PaO2有差异(P<0.05);②两组的SIT90、AHI、FEV1/FVC、FEV1%预计值、PaCO2和PaO2有差异(P<0.05),治疗后观察组SIT90、AHI及PaCO2较低,FEV1%、FEV1%预计值及PaO2较高;③两组的SIT90、AHI、FEV1%、FEV1%预计值、PaCO2及PaO2变化趋势有差异(P<0.05)。结论LTOT对改善COPD稳定期患者的夜间缺氧、肺功能及动脉血气均有较好的应用价值。

Objective To study values of polysomnography monitoring(PSG)combined with pulmonary function and arterial blood gas analysis for long-term oxygen therapy(LTOT)in chronic hypoxic disease.Methods A total of 120 subjects as chronic obstructive pulmonary disease(COPD)of stable period from June 2016 to June 2017 were enrolled and divided randomly into control and observation groups,each of 60 cases;patients in control group received common drug treatment and patients in observation group adopted common treatment combined with LTOT,at least 15 h oxygen inhalation per day,2 L/min;then to compare differences of hour ratio of nocturnal oxygen saturation<90%time to total sleep time(SIT90)and apnea hypopnea index(AHI),FEV1%and FEV1%predicted value,PaCO2 and PaO2 were measured by PSG before treatment,one,three and six months after treatment.Results The SIT90,AHI,FEV1/FVC,FEV1 real/pre,PaCO2 and PaO2 of the control group were compared with those of the observation group before treatment,1 month,3 months and 6 months after treatment.The results of variance analysis of repeated measurement data were as follows:①SIT90,AHI,FEV1%,FEV1%pre,PaCO2 and PaCO2 at different time points were all different(P<0.05);②SIT90,AHI,FEV1%,FEV1%pre and PaCO2 between the control group and the observation group were different(P<0.05);compared with the control group,SIT90,AHI and PaCO2 in the observation group were lower,and FEV1%,FEV1%pre,and PaO2 were higher.③There were differences in the trend of SIT90,AHI,FEV1%,FEV1%pre,PaCO2 and PaO2 between the control group and the observation group(P<0.05).Conclusions LTOT can improve nocturnal anoxia,pulmonary function and arterial blood gas for patients with COPD stable period.