氧疗时间对老年慢性阻塞性肺病患者心肺功能的影响

Impact of time durations of oxygen therapy on heart and lung function in elderly patients with chronic obstructive pulmonary disease

关键词:  氧疗  老年人  慢性阻塞性肺病  心钠素  6  min步行试验

Key words:  oxygen therapy  aging  chronic obstructive pulmonary disease  atrial natriuretic peptide  6 min walk test

摘要:

目的探讨氧疗时间的长短对老年慢性阻塞性肺病患者心肺功能及血液黏度的影响。方法老年患者136例，男79例，女57例，根据吸氧时间随机分为4组，每日吸氧8h组、每日吸氧12h组、每日吸氧16h组、每日吸氧近24h组。氧疗2周后复查患者动脉血气、肺功能、心脏超声、6min步行试验，测定BNP值、血黏度。多组间各指标比较采用方差分析（ANOVA）。结果与氧疗8h组患者比较，另三组患者动脉血CO2分压明显增高；但动脉血pH值各组间差异无统计学意义。与氧疗12h组患者比较，氧疗16h及24h组患者PaO2明显增高；氧疗16h组患者血BNP值明显下降；氧疗16h组患者6min步行试验结果明显延长（P〈0．05）。与氧疗12h组患者比较，氧疗16h组患者全血黏度200、全血黏度5、全血黏度1显著降低，与氧疗8h组患者比较，氧疗16h组患者血浆黏度100显著降低（P〈0．05）。结论合理氧疗，对改善慢性阻塞性肺病患者的心肺功能，降低其血液黏滞度有益。临床上推荐每日氧疗时间以16～24h为佳。

Abstract:

Objective To investigate the impact of time duration of oxygen therapy on heart and function in elderly patients with chronic obstructive pulmonary disease （COPD）. Methods lung One hundred and thirty six elderly patients with COPD, including 79 cases males and 57 females, were randomly divided into four groups： patients in each group received oxygen therapy for 8,12,16 and 24 hours per day respectively. The arterial blood gas, lung function, heart ultrasonography, 6 rain walk test, blood B-type natriuretic peptide （BNP） levels and blood viscosity were examined after two weeks of oxygen therapy. Indicators between groups were compared using analysis of variance （ANOVA）. Results Compared to 8 h group, the arterial CO2 partial pressure was significantly higher in patients of other 3 groups. There were no significant differences in arterial pH values among 4 groups. Compared to 12 h group, patients in 16 h and 24 h groups had higher arterial O2 partial pressure; the blood BNP levels were decreased in patients of 16 h group; the distance of 6 min walk test was remarkably extended in 16 h group （ P 〈 0.05 ）. Compared to 12 h group, the whole blood viscosity 200, 5 and 1 in 16 h group was significantly decreased. Compared to 8 h group, patients in 16 h group had significantly lower plasma viscosity 100 （P 〈 0.05 ）. Conclusion Oxygen therapy can improve the cardiopulmonary function of COPD patients and reduce the blood viscosity; results from this study suggest 16-24 h daily as the time duration of oxygen therapy.