慢性阻塞性肺疾病患者血气分析指标,FeNO,EOS%水平变化与CAT评分的相关性研究

目的探讨慢性阻塞性肺疾病(chronic obstruotive pilmonary COPD)患者血气分析指标,呼出气一氧化氮(fractional exhaled nitric FeNO),外周血嗜酸性粒细胞占比(eosinophil EOS%)水平变化与COPD评估测试(CAT)评分的相关性。方法选取2017年2月~2019年10月遂宁市中心医院收治的急性加重期COPD(AECOPD)患者127例(A组),COPD稳定期患者124例(B组),健康志愿者120例(健康组)。对比A组与B组CAT评分;对比三组及A组,B组不同GOLD分级患者FeNO,EOS%与血气分析指标;分析血气分析指标以及FeNO,EOS%与CAT评分的相关性。结果A组CAT评分高于B组(25.63±4.50分vs 16.39±3.04分),差异有统计学意义(t=16.938,P<0.001)。A组FeNO,EOS%,PaO_(2),PaCO_(2),氧合指数和pH值分别为45.84±8.10ppb,(8.15±0.62)%,61.05±6.82mmHg,60.20±6.71mmHg,278.52±24.08和7.28±0.05;B组分别为32.58±6.02ppb,(4.80±0.48)%,74.55±7.15mmHg,48.50±6.10mmHg,374.69±35.89和7.35±0.05;C组分别为26.25±3.06ppb,(2.51±0.32)%,94.56±9.13mmHg,40.01±6.02mmHg,452.46±46.93和7.42±0.06,差异均有统计学意义(F=96.752,49.803,36.955,37.982,125.406和52.844,均P<0.001)。A组FeNO,EOS%,PaCO_(2)均高于B组和健康组,且B组均高于健康组;A组PaO_(2),氧合指数,pH值均低于B组和健康组,且B组均低于健康组;A组,B组患者CAT评分,FeNO,EOS%,PaCO_(2)均随GOLD分级增加而增加(A组:r=0.812,0.835,0.796和0.743,P=0.007,0.003,0.012和<0.001;B组:r=0.759,0.762,0.731和0.702,P=0.015,0.009,0.023和0.004),而PaO_(2),氧合指数,pH值均随GOLD分级增加而降低(A组:r=-0.832,-0.845和-0.877,P=0.004,0.009和<0.001;B组:r=-0.796,-0.811和-0.836,P=0.005,0.017和0.009);A组,B组中PaO_(2),氧合指数,pH值与CAT评分均呈负相关(A组:r=-0.841,-0.791和-0.763,均P<0.05;B组:r=-0.806,-0.744和-0.722,均P<0.05);PaCO_(2),FeNO,EOS%与CAT评分均呈正相关(A组:r=0.836,0.812和0.704,均P<0.05;B组:r=0.820,0.836和0.758,均P<0.05)。结论AECOPD和COPD患者FeNO,EOS%,PaCO_(2)均偏高,而PaO_(2),氧合指数和pH值均偏低,且与病情密切相关。