玉树大地震高原肺水肿患者肺内氧交换效率的观察

目的观察高原肺水肿（HAPE）患者肺内氧交换效率。方法对22例HAPE患者在治疗前后测定呼吸指数（R I）,R I=肺泡-动脉血氧分压差[P（A-a）O2]与动脉血氧分压（PaO2）比值,即P（A-a）O2/PaO2,并与30例当地健康人作对比。结果 HAPE患者治疗前P（A-a）O2、R I（分别为46.22±3.45、1.11±0.14）显著高于治愈后（分别为10.03±1.47、0.14±0.10）和对照组（分别为9.25±1.55、0.13±0.08）,（均P〈0.01）;PaO2[（42.37±4.50）mmHg]显著低于治愈后[（68.88±4.82）mmHg]和对照组[（69.60±5.11）mmHg],（均P〈0.01）;治愈后与对照组之间比较无统计学意义（均P〉0.05）。HAPE患者治疗前R I与P（A-a）O2呈显著正相关（r=0.936,P〈0.01）。结论 HAPE患者存在明显的肺内氧交换障碍,R I可作为评价HAPE患者肺内氧交换效率的有效指标之一。

Efficiency of pulmonary oxygen exchange of in patients with high altitude pulmoary edema

Objective To investigate the efficiency of pulmonary oxygen exchange of in patients with high altitude pulmonary edema（HAPE）.Methods The respiratory index（RI）,alveolar-arterial oxygen tension difference[P（A-a）O2] and partial pressure of oxygen in arterial blood（PaO2）were measured before and after treatment among 22 cases of paticnts with HAPE,and 30 local healthy volunteers served as controll.Results The P（A-a）O2 and RI（46.22±3.45,1.11±0.14,respectively）were significantly higher in patient group before treatment than after treatment（10.03±1.47,0.14±0.10,respectively）and those in control group（9.25±1.55、0.13±0.08,respectively）（all P〈0.01））,while the PaO2[（42.37±4.50）mmHg]was significantly lower in patient group before treatment than after treatment[（68.88±4.82）mmHg] and that in control group[（69.60±5.11）mmHg],（all P〈0.01）.The RI and P（A-a）O2 were not different between patient group after treatment and the control group（all P〉0.05）.RI was significantly positive correlated with P（A-a）O2 before treatment in paticnts with HAPE.Conclusion The results showed that efficiency of pulmonary oxygen exchange was significantly diceased in patients with HAPE.RI is helpful for evaluating the efficiency of pulmonary oxygen exchange in patients with HAPE.