高白细胞急性白血病患者血氧饱和度检测方法比较  

Comparison of Blood Oxygen Saturation Detection Methods in Patients with Hyperleukocytic Acute Leukemia

作　　者：郭慧霞[1] 曹淑雅 陈以娟[1] 李茜[1] 武悦[1] 尚禹汐 王立茹[1] GUO Hui-Xia;CAO Shu-Ya;CHEN Yi-Juan;LI Qian;WU Yue;SHANG Yu-Xi;WANG Li-Ru(Department of Hematology,Fu Xing Hospital,Capital Medical University,BeijingI 100038,China;Department of Hematology,Shenzhen Long Hua District Central Hospital,Shenzhen 518110,Guangdong Province,China)

机构地区：[1]首都医科大学附属复兴医院血液内科,北京100038 [2]深圳市龙华区中心医院血液内科,广东深圳518110

出　　处：《中国实验血液学杂志》2024年第4期1026-1031,共6页Journal of Experimental Hematology

基　　金：北京市西城区卫生健康委员会青年科技人才(科技新星)培养项目(XWKX2020-24)。

摘　　要：目的:探讨高白细胞急性白血病(HAL)患者进行血氧检测时应用动脉血氧饱和度(SaO_(2))和指尖脉氧仪检测的脉搏血氧饱和度(SpO_(2))哪种指标更有优势。方法:前瞻性分析18例HAL患者(观察组)和14例患者(对照组)SaO_(2)、SpO_(2)值之间的差异以及其差异与白细胞数之间的关系。结果:观察组的SaO_(2)值低于SpO_(2)值(P<0.05),SpO_(2)-SaO_(2)的差值与白细胞计数呈正相关(r=0.47);对照组的SaO_(2)值和SpO_(2)值之间无统计学差异(P>0.05)。观察组SaO_(2)、氧分压(PO_(2))值随着动脉血离体时间延长有下降趋势,但未显示统计学差异(P>0.05),对照组SaO_(2)、PO_(2)值随着动脉血离体时间延长无下降趋势(P>0.05)。结论:HAL患者存在SaO_(2)值低于SpO_(2)值的现象,即假性低氧血症,该现象可能是过高的白血病细胞在体外进一步耗氧所致。SpO_(2)可以床旁实时监测,且为无创操作,是检测HAL患者血氧状态的更好方法。Objective:To investigate which indicator is more advantageous when using arterial oxygen saturation(SaO_(2))and fingertip pulse oxygen saturation(SpO_(2))for blood oxygen detection in patients with hyperleukocytic acute leukemia(HAL).Methods:In this prospective research,the difference between SaO_(2)and SpO_(2)of 18 HAL patients(observation group)and 14 patients(control group),as well as the relationship between the difference and white blood cell(WBC)counts were analyzed.Results:SaO_(2)was lower than SpO_(2)in the observation group(P<0.05),and SpO_(2)-SaO_(2)difference was positively correlated with WBC counts(r=0.47).However,there was no statistical difference between SaO_(2)and SpO_(2)in the control group.SaO_(2)and PO_(2)showed a downward trend with the prolongation of detection time after arterial blood was collected in the observation group,but there was no statistical difference.There was no downward trend of SaO_(2)and PO_(2)in the control group.Conclusion:HAL patients have a phenomenon where SaO_(2)is lower than SpO_(2),that is pseudohypoxemia,and this phenomenon may be caused by excessive consumption of oxygen by the leukemia cells in vitro.SpO_(2)can be monitored bedside in real time and is non-invasive,it is a better way to detect the blood oxygen status of HAL patients.

关 键 词：高白细胞急性白血病 假性低氧血症 动脉血氧饱和度 脉搏血氧饱和度 

分 类 号：R733.7[医药卫生—肿瘤]