运动指脉氧监测在稳定期慢性阻塞性肺疾病中管理价值探讨

发布时间：2018-04-05 22:07

本文选题：慢性阻塞性肺疾病　切入点：亚极量运动　出处：《南京医科大学学报(自然科学版)》2017年10期

【摘要】：目的:评价运动指脉氧(pulse oxygen saturation,SpO_2)监测在稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)中的管理价值。方法 :选取23例稳定期COPD患者,同时选取20例既往无呼吸系统疾病的受试者作为对照组,在接受运动平板试验时监测指脉氧并比较两组间差异,分析COPD组运动指脉氧与肺功能、COPD评估测试(COPD assessment test,CAT)评分、改良医学委员会呼吸困难指数(modified medical research council dyspnea scores,m MRC)评分及过去1年急性加重次数的相关性。结果:(1)COPD组亚极量运动过程中最低指脉氧(SpO_2ML)低于对照组,差异具有统计学意义(P0.05);(2)COPD组SpO_2ML与第1秒用力呼气容积(FEV1)、用力肺活量(FVC)及FEV1占预计值百分比(FEV1%pred)相关,与FEV1/FVC、每分钟最大通气量(MVV)及每升肺泡容积的一氧化碳弥散量(DLCO/VA)无明显相关性,与过去1年急性加重次数无明显相关性;(3)COPD组运动过程中CAT评分与静息SpO_2、SpO_2ML及SpO_2波动值(ΔSpO_2)无相关性。m MRC评分与SpO_2ML及ΔSpO_2相关,与静息SpO_2无相关性。结论:(1)COPD患者更易发生运动相关的低氧血症,且肺功能受损越重,运动中手指脉氧下降更显著。(2)COPD患者排除心血管疾病后,SpO_2ML可作为COPD管理中一项有临床意义的监测指标,有望成为COPD筛查的一项检测指标。
[Abstract]:Objective: to evaluate the management value of exercise pulse oxygen saturation2 in stable chronic obstructive pulmonary disease (copd).Methods: 23 patients with stable COPD and 20 subjects without respiratory diseases were selected as control group. The oxygen of finger pulse was monitored and the difference between the two groups was compared during the exercise treadmill test.There was no significant correlation with FEV1 / FVC (MVV) and DLCO / VA per liter of alveolar volume.There was no significant correlation between CAT score and resting SpO2SpO2ML and SpO_2 fluctuation value (螖 SpO2) in COPD group during exercise. There was no correlation between m MRC score and SpO_2ML and 螖 SpO_2, but no correlation with resting SpO_2.Conclusion the patients with COPD are more likely to develop exercise-related hypoxemia, and the more serious the lung function is, the lower the oxygen of the finger pulse is during exercise. The SpO2ML can be used as a clinical monitoring index in COPD management after excluding cardiovascular diseases.It is expected to be an indicator of COPD screening.
【作者单位】：南京医科大学第一附属医院呼吸与危重症医学科;海门市人民医院呼吸内科;南京医科大学附属江苏盛泽医院呼吸内科;
【基金】：江苏省呼吸病临床医学研究中心项目(BL2012012) 网络信息化多层次呼吸系统慢性病实时管理模式研究(WS201217)
【分类号】：R563.9

【相似文献】