文章摘要
陈良玉,张雅文,李媛媛,孙培莉,黄 茂.日常活动指脉氧监测在慢性阻塞性肺病评估管理中的价值探讨[J].南京医科大学学报,2019,(4):544~549
日常活动指脉氧监测在慢性阻塞性肺病评估管理中的价值探讨
The evaluation and management value research of monitoring oxygen saturation of patients with chronic obstructive pulmonary disease during daily activity
投稿时间:2018-10-31  
DOI:10.7655/NYDXBNS20190414
中文关键词: 慢性阻塞性肺疾病  日常活动  急性加重  指脉氧  脉率
英文关键词: chronic obstructive pulmonary disease  daily activity  acute exacerbation  pulse oxygen saturation  pulse rate
基金项目:江苏省研究生实践创新计划(SJCX17_0384);慢性阻塞性肺疾病大数据建设战略合作项目(KD18)
作者单位
陈良玉 南京医科大学第一附属医院呼吸与危重症医学科江苏 南京 210029 
张雅文 南京医科大学第一附属医院呼吸与危重症医学科江苏 南京 210029 
李媛媛 南京医科大学第一附属医院呼吸与危重症医学科江苏 南京 210029 
孙培莉 南京医科大学第一附属医院呼吸与危重症医学科江苏 南京 210029 
黄 茂 南京医科大学第一附属医院呼吸与危重症医学科江苏 南京 210029 
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中文摘要:
      目的:研究慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)稳定期患者日常活动中指脉氧(SpO2)及脉率变化与肺功能的关系,评价日常活动指脉氧监测在区分COPD稳定期与急性加重期中的价值。方法:选取COPD稳定期64例,急性加重期54例,同时选取24例既往无呼吸系统疾病的受试者作为对照组,收集基本资料,在日常活动过程中监测指脉氧及脉率变化,比较各组的指脉氧及脉率是否具有差异,并分析稳定期COPD组指脉氧及脉率与肺功能的关系。结果:①日常活动过程中,COPD急性加重期指脉氧指标,包括:静息SpO2、平均SpO2、最低指脉氧(SpO2L)、指脉氧波动值(ΔSpO2)、ΔSpO2百分比、SpO2L/ΔSpO2,与稳定期或对照组相比,差异均有统计学意义(P<0.05);②ΔSpO2 ≥6.50%、ΔSpO2百分比≥6.20%对COPD急性加重期具有一定诊断价值;③重度及以上稳定期COPD与轻中度相比,日常活动中SpO2L/ΔSpO2差异具有统计学意义;④COPD稳定期平均脉率与FVC%pred呈负相关,平均SpO2与FEV1呈正相关,其余指标与肺功能无明显相关。结论:①急性加重期COPD患者更易发生日常活动过程中的低氧血症,且指脉氧下降幅度明显;②COPD患者排除心血管疾病及其他肺部疾病后,ΔSpO2、ΔSpO2百分比可作为COPD管理中早期识别急性加重的监测指标;③稳定期COPD患者日常活动指脉氧的下降可能与肺功能受损有关。
英文摘要:
      Objective:To study the relationship between the changes of pulse oxygen saturation(SpO2),pulse rate,and pulmonary function in daily activity of patients with chronic obstructive pulmonary disease(COPD),and to evaluate the value of pulse oxygen saturation monitoring during daily activity in distinguishing stable COPD and acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods:A total of 64 patients with stable COPD and 54 patients with AECOPD were enrolled,and 24 subjects without respiratory diseases were selected as control group. Basic data were collected and the changes of SaO2 and pulse rate were monitored during daily activity. The difference of SpO2 and pulse rate in each group was compared,and the correlation between SpO2,pulse rate and pulmonary function in the stable COPD group was analyzed. Results:①During daily activity,the difference of SaO2 index(including the rest SpO2,the average SpO2,the lowest SpO2(SpO2L),the variation of SpO2(ΔSpO2),ΔSpO2 percentage,SpO2L/ΔSpO2)between AECOPD group and stable COPD group or control group was significant(P < 0.05). ②ΔSpO2 ≥6.50%,ΔSpO2 percentage ≥ 6.20% had a certain diagnostic value for AECOPD. ③The difference of SpO2L/ΔSpO2 between severe COPD and mild to moderate was statistically significant. ④The average pulse rate of stable COPD was negatively correlated with FVC%pred. The average SpO2 was positively correlated with FEV1,but the other indexes were not significantly correlated with pulmonary function. Conclusion:①Patients with AECOPD were more likely to experience hypoxemia during daily activity,and the SpO2 drop is obvious. ②After excluding cardiovascular diseases and other lung diseases in patients with COPD,ΔSpO2 and ΔSpO2 percentage could be used as monitoring indicators for early AECOPD management. ③The decline in pulse oxygen saturation during daily activity in patients with stable COPD may be related to lung function impairment.
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