慢性阻塞性肺疾病夜间低氧血症相关预测因素的临床研究

目的探讨慢性阻塞性肺疾病夜间低氧血症相关因素及其预测价值。方法选择COPD稳定期患者57例,进行日间血气分析、肺功能检查检测和夜间睡眠监测。结果夜间低氧血症发生率为12.28%。病情严重程度、日间SaO2可作为夜间低氧血症的危险因素(OR=2.167、4.548,P<0.05)。轻度、中度、重度、极重度组MSaO2、LSaO2、SIT90%、ODI均存在显著性差异(P<0.05),SIT90%与病情严重程度呈正相关(r=0.52,P<0.05),MSaO2、SIT90%与日间SaO2分别呈负相关和正相关(r=-0.43、0.61,P<0.05),FEV1%、日间SaO2对夜间低氧血症有预测价值(P<0.05),当日间SaO2为93.78%时,敏感性和特异性最高,分别为0.75、0.69。结论监测日间SaO2可作为预测COPD稳定期患者夜间低血氧饱和度状态及低氧血症的发生指标,病情严重程度与夜间低氧血症发生有关,但无明显预测价值。

Clinical study of chronic obstructive pulmonary disease-related predictors of nocturnal hypoxemia

Objective To investigate the chronic obstructive pulmonary disease-related factors and nocturnal hypox- emia predictive value. Methods A total of 57 patients with stable COPD for daytime blood gas analysis, pulmonary function tests to detect and nighttime sleep monitoring. Results The detection rate of nighttime sleep monitoring was 12.28%. Nocturnal hypoxemia was 12.28%. Severity, daytime SaO2 nocturnal hypoxemia as a risk factor （OR= 2.167, 4.548, P〈0.05）. Mild, moderate, severe, very severe group MSaO2, LSaO2, SIT90%, ODI, there were significant differ- ences（P〈0.05）, SIT90% with disease severity was positively correlated（r= 0.52, P〈0.05）, MSaO2, SIT90% and daytime SaO2 were negatively correlated and positively correlated （r= -0.43,0.61, P〈0.05）, FEV 1%, daytime SaO2 on the predic- tive value of nocturnal hypoxemia（P〈0.05）, when the day SaO2 was 93.78%, the sensitivity and specificity were highest, respectively, 0.75,0.69. Conclusion Monitor daytime SaO2 as a predictor of nocturnal stable COPD and low oxygen sat- uration state hypoxemia index, disease severity and occurrence of nocturnal hypoxemia but no significant predictive value.