本文選題：慢性阻塞性肺疾病　切入點(diǎn)：亞極量運(yùn)動(dòng)　出處：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2017年10期

【摘要】：目的:評價(jià)運(yùn)動(dòng)指脈氧(pulse oxygen saturation,SpO_2)監(jiān)測在穩(wěn)定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)中的管理價(jià)值。方法 :選取23例穩(wěn)定期COPD患者,同時(shí)選取20例既往無呼吸系統(tǒng)疾病的受試者作為對照組,在接受運(yùn)動(dòng)平板試驗(yàn)時(shí)監(jiān)測指脈氧并比較兩組間差異,分析COPD組運(yùn)動(dòng)指脈氧與肺功能、COPD評估測試(COPD assessment test,CAT)評分、改良醫(yī)學(xué)委員會(huì)呼吸困難指數(shù)(modified medical research council dyspnea scores,m MRC)評分及過去1年急性加重次數(shù)的相關(guān)性。結(jié)果:(1)COPD組亞極量運(yùn)動(dòng)過程中最低指脈氧(SpO_2ML)低于對照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05);(2)COPD組SpO_2ML與第1秒用力呼氣容積(FEV1)、用力肺活量(FVC)及FEV1占預(yù)計(jì)值百分比(FEV1%pred)相關(guān),與FEV1/FVC、每分鐘最大通氣量(MVV)及每升肺泡容積的一氧化碳彌散量(DLCO/VA)無明顯相關(guān)性,與過去1年急性加重次數(shù)無明顯相關(guān)性;(3)COPD組運(yùn)動(dòng)過程中CAT評分與靜息SpO_2、SpO_2ML及SpO_2波動(dòng)值(ΔSpO_2)無相關(guān)性。m MRC評分與SpO_2ML及ΔSpO_2相關(guān),與靜息SpO_2無相關(guān)性。結(jié)論:(1)COPD患者更易發(fā)生運(yùn)動(dòng)相關(guān)的低氧血癥,且肺功能受損越重,運(yùn)動(dòng)中手指脈氧下降更顯著。(2)COPD患者排除心血管疾病后,SpO_2ML可作為COPD管理中一項(xiàng)有臨床意義的監(jiān)測指標(biāo),有望成為COPD篩查的一項(xiàng)檢測指標(biāo)。
[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.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院呼吸與危重癥醫(yī)學(xué)科;海門市人民醫(yī)院呼吸內(nèi)科;南京醫(yī)科大學(xué)附屬江蘇盛澤醫(yī)院呼吸內(nèi)科;
【基金】：江蘇省呼吸病臨床醫(yī)學(xué)研究中心項(xiàng)目(BL2012012) 網(wǎng)絡(luò)信息化多層次呼吸系統(tǒng)慢性病實(shí)時(shí)管理模式研究(WS201217)
【分類號(hào)】：R563.9

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