老年慢性阻塞性肺疾病患者伴肺性缺氧与肝功能损害的相关性研究

目的探讨老年慢性阻塞性肺疾病（COPD）患者伴肺性缺氧、二氧化碳潴留与肝功能损害的相关性研究。方法测定患者治疗前后外周白细胞计数、肝功能及动脉血气分析，各参数值的组间采用t检验，动脉血气值与肝功能检测结果间作相关性直线回归分析。结果老年COPD患者治疗后动脉血氧分压（PaO2）、外周血白细胞、中性粒细胞计数和肝功能各参数值均有明显改善（P〈0．01）；患者治疗后PaO2比治疗前明显升高，动脉血二氧化碳分压（PaCO2）比治疗前明显下降（P〈0．01）；pH值、PaO2与谷氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）结果呈显著负相关；PaCO2与ALT、AST结果呈显著正相关（P均〈0．01）。结论老年COPD患者伴肺性缺氧或伴有二氧化碳潴留时合并酸中毒对肝脏功能损害明显加重；给予抗感染、保肝、支持疗法等治疗后肺性缺氧控制，肝功能可恢复正常。

Study on relationship between pulmonary hypoxia and lesion of liver function in elderly patients with chronic obstructive pulmonary disease

Objective To study the relationship between hypoxia and lesion of liver function in elderly patients with chronic obstructive pulmonary disease（COPD）. Methods The peripheral white blood cell count, liver function and arterial blood gas analysis were measured in elderly patients with COPD, and student verification of the parameters in every group were made. The association between the parameters of blood gases and liver function were analyzed by linear regression. Results These parameters of peripheral white blood cell count, liver function and arterial blood gas analysis were remarkably improved （P 〈0. 01 ） ; PaO2 was increased and PaCO2 was reduced in elderly patients with COPD after treatment （P 〈 0. 01 ）. The analysis of correlation in elderly patients with COPD suggested that pH, PaO2 had significant negative correlation with levels of ALT,AST;PaCO2 had significant positive correlation with levels of ALT, AST（P 〈 0.01 ）. Conclusions It is remarkably harmful for liver function of COPD combined with hypoxia or retention of carbon dioxide and acid intoxication in elderly patients ; Treatment of anti-infection, protection of liver function and support therapy of nutrition can control hypoxia.