测定呼气末二氧化碳分压在COPD患者急性加重期和稳定期的临床意义  

Application and Clinical Significance of End-tidal Carbon Dioxide Tension Monitoring in Stable and Acute COPD Patients

作　　者：刘珊珊[1] 刘雪白 李翠萍[1] 周秀梅[1] 刘健群[1] 张雪芹[1] 高俊霞[1] 马杰[1] 阎菊[1] 

机构地区：[1]北京市丰台医院呼吸科

出　　处：《首都医科大学学报》2008年第4期505-507,共3页Journal of Capital Medical University

摘　　要：目的探讨慢性阻塞性肺病(chronic obstructive pulm onary diseases,COPD)患者急性加重期与缓解期呼气末二氧化碳分压(PetCO2)与动脉血二氧化碳分压(PaCO2)的相关性及其临床意义。方法正常对照组20例(A组),COPD组30例,将COPD组按照治疗前后分为急性期组(B组)和缓解期组(C组)。同时测定患者PaCO2和PetCO2值,并计算PaCO2与PetCO2的差值(ADCO2)。结果1)B组和C组与A组比较,其PaCO2和ADCO2值均明显升高且差异有统计学意义(P均<0.01),B组与A组比较,其PetCO2明显降低且差异有统计学意义(P<0.01),C组与A组比较其PetCO2差异无统计学意义;C组PetCO2明显高于B组,PaCO2和ADCO2明显低于B组,且差异有统计学意义(P均<0.01)。2)A组和C组PaCO2与PetCO2显著相关(r值分别为0.95和0.56,P均<0.01)。结论PetCO2可以用来判断正常人和COPD缓解期患者体内PaCO2的变化,但在COPD急性加重期PetCO2的监测缺乏敏感性,不能作为直接判断机体PaCO2变化的指标。ADCO2是评价COPD急性加重期患者病情严重程度的有效指标。Objective To investigate the correlation and clinical value between PetCO2 and PaCO2 in stable and acute chronic obstructive pulmonary diseases （ COPD ） patients. Methods Fifty persons were tested in our study, 20 healthy persons as control （ A group） and 30 COPD patients. 30 COPD patients were divided into two groups, acute COPD patients （B group, fore-treatment） and stable COPD patients（ C group, post-treatment）. The value of PetCO2 and PaCO2 were measured at the same time, and then calculate the value of ADCO2. Results 1 ） The value of PaCO2 and ADCO2 in B and C groups were significantly higher than those in A group （ all P 〈 0.01 ）. Compared with A group, the value of PetCO2 in B group decreased significantly （ P 〈 0.01 ）, but no significant changes in PetCO2 value was found in C group（P 〉0.05）. Compared with B group, the value of PetCO2 in C group increased significantly, and the value of PaCO2 and ADCO2 in C group decreased significantly（ all P 〈0.01 ）. 2） PetCO2 was significantly correlated with PaCO2 in both A and C group（ r = 0.95 and 0.56, all P 〈 0.01 ）. Conclusion PetCO2 can be used to judge the change of PaCO2 in normal and stable patients of COPD, but it is not very sensitive and can not be used directly to judge the change of PaCO2 in acute patients of COPD. ADCO2 can be used to reflect the severity of acute COPD patients.

关 键 词：呼气末二氧化碳分压 动脉血二氧化碳分压 慢性阻塞性肺病 

分 类 号：R563[医药卫生—呼吸系统]