肺心病病人动脉血红细胞内外血气变化的研究  

Changes of arterial intra -and extra erythrocytic blood gases in patients with cor pulmonale

作　　者：赵志强[1] 钱桂生[1] 王金平[1] 

机构地区：[1]第三军医大学附属新桥医院全军呼吸内科研究所,重庆400037

出　　处：《第三军医大学学报》2000年第5期414-416,共3页Journal of Third Military Medical University

摘　　要：目的　探讨肺心病病人动脉血红细胞内外血气变化。方法　分别同步测定 5 5例肺心病Ⅰ型呼吸衰竭 (A组 )、90例Ⅱ型呼吸衰竭 (B组 )、15例Ⅱ型呼吸衰竭吸氧时 (C组 )、72例肺心病缓解期 (D组 )和10 8例健康者 (E组 )的动脉血红细胞内外血气 ,并比较各组结果间的差别。结果　B组和C组的peH、△pH非常显著低于其他各组 (P <0 .0 1) ,PeCO2 、PiCO2 、HeCO-3 和HiCO-3 非常显著高于其他各组 (P <0 .0 1) ,piH和其他各组无差异 (P >0 .0 5 ) ,B组的peH、piH、△pH、PeCO2 、PiCO2 、HeCO-3 等参数和C组无差异 (P >0 .0 5 ) ;D组的peH、piH、△pH和E组无差异 (P >0 .0 5 )。结论　肺心病呼吸衰竭病人随病情加重动脉血红细胞内相对偏碱程度加大 ,HiCO-3 相对增高 ;持续低流量吸氧可提高peH、piH而不引起CO2 潴留和酸血症 ;治疗缓解后 。Objective To study the changes of arterial intra and extraerythrocytic blood gases in patients with cor pulmonale.Methods The changes of blood gases of in and out of the erythrocytes in the arteries were observed in 55 cases of type Ⅰ respiratory failure(RF)(Group A), 90 cases of type Ⅱ RF(Group B), 15 cases of type Ⅱ RF while inhaling oxygen(Group C), 72 cases of cor pulmonale in remission (Group D) and 108 healthy subjects (group E) respectively and the findings were compared among the groups.Results p eH and △pH (of group B and C) were significantly lower than in other groups (P<0.01) and p eCO 2, p iCO 2, H eCO 3 and H iCO 3 were significantly higher than in the other groups(P<0.01). p iH showed no significantly difference as compared with other groups. p eH, p iH, △pH,p eCO 2,p iCO 2 and H eCO 3 were similar in groups B and C (P>0.05). p eH, p iH and △pH of group were similar as group E (P>0.05).Conclusion Arterial intraerythrocytic alkilinization is likely to increase along with the aggravation of RF in patients with cor pulmonale and H iCO 3 is relatively elevated. Persistent oxygen inhalation in small volume can increase p eH and p iH without the risk of CO 2 retention and academia. When remission of cor pulmonale is achieved after therapeutic measures, normal acid base ratio of arterial blood gases in and out of erythrocytes can be restored.

关 键 词：肺心病 呼吸衰竭 红细胞 血气分析 

分 类 号：R541.506[医药卫生—心血管疾病] R563.802[医药卫生—内科学]