睡眠呼吸紊乱对慢性阻塞性肺疾病急性加重期患者动脉血气影响.docVIP

睡眠呼吸紊乱对慢性阻塞性肺疾病急性加重期患者动脉血气影响 　　[摘要] 目的 研究呼吸睡眠紊乱对慢性阻塞性肺疾病急性加重期(AECOPD)患者动脉血气的影响。方法 选取86例单纯AECOPD(AECOPD组)和27例重叠综合征(OS)患者(OS组),分别在入院及出院时抽动脉血,比较动脉血气的变化特点。结果 OS组治疗前后动脉血pH、动脉血氧分压(PaO2)和动脉血氧饱和度(SaO2)均低于AECOPD组(P2饱和度(PaCO2)均高于AECOPD组(P2、PaO2和SaO2均基本恢复正常,而OS组PaCO2及PaO2仍未能恢复正常,两组间比较差异有统计学意义(P 　　[关键词] 慢性阻塞性肺疾病;急性加重期;重叠综合征;血气分析? 　　[中图分类号] R563 　　[文献标识码] A 　　[文章编号] 1671-7562(2009)04-0258-03?? 　　 　　Effect of sleep apnea hypopnea on arterial blood gas of the patients?with acute exacerbation of chronic obstructive pulmonary disease 　　ZHANG Jing-hao, LIN Yong 　　(Department of Respiratory Medicine, Zhongda Hospital, Southeast University, Nanjing 210009, China) 　　 　　Abstract:Objective To explore the impact of sleep apnea hypopnea on arterial blood gas of the patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Eighty six AECOPD patients and 27 OS patients were selected as cases to be studied,the changes of whose arterial blood gas are compared both when they are admitted and discharged.Results The value of pH, PaO2, SaO2of all OS patients were lower than those of AECOPD patients, and PaCO2 was higher than those of AECOPD patients. Even though pH, PaCO2, PaO2, SaO2 of AECOPD patients were restored to their original conditions after treatment, hypercapnia and relatively low oxygen saturation continued to exist in OS patients.The difference between the two groups is statistically significant.Conclusion Sleep apnea hypopnea is one of the most important factors for exacerbating hypoxemia,carbon dioxide retention and acidosis.? 　　Key words:chronic obstructive pulmonary disease;acute exacerbation;overlap syndrome;blood gas analysis ? 　　(Modern Medical Journal,2009,37:258-260)?? 　　 　　慢性阻塞性肺疾病(COPD)是一种以气流受限并且不能完全可逆为特征的可以预防和治疗的疾病,是累及气道、肺实质以及肺血管的慢性炎症。据对我国7个地区20 245例成年人进行调查显示,COPD患病率占40岁以上人群的8.2%[1],其患病率之高十分惊人。COPD急性加重期(AECOPD)可导致低氧血症和高碳酸血症,患者常需住院治疗。阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是以睡眠中反复上气道阻塞为特征的呼吸障碍,是常见的睡眠呼吸障碍性疾病。成年人的发病率为2%～4%。COPD与OSAHS合并存在称为重叠综合征(OS)