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目的探讨慢性阻塞性肺病(chronic obstructive pulm onary diseases,COPD)患者急性加重期与缓解期呼气末二氧化碳分压(PetCO2)与动脉血二氧化碳分压(PaCO2)的相关性及其临床意义。方法正常对照组20例(A组),COPD组30例,将COPD组按照治疗前后分为急性期组(B组)和缓解期组(C组)。同时测定患者PaCO2和PetCO2值,并计算PaCO2与PetCO2的差值(ADCO2)。结果1)B组和C组与A组比较,其PaCO2和ADCO2值均明显升高且差异有统计学意义(P均<0.01),B组与A组比较,其PetCO2明显降低且差异有统计学意义(P<0.01),C组与A组比较其PetCO2差异无统计学意义;C组PetCO2明显高于B组,PaCO2和ADCO2明显低于B组,且差异有统计学意义(P均<0.01)。2)A组和C组PaCO2与PetCO2显著相关(r值分别为0.95和0.56,P均<0.01)。结论PetCO2可以用来判断正常人和COPD缓解期患者体内PaCO2的变化,但在COPD急性加重期PetCO2的监测缺乏敏感性,不能作为直接判断机体PaCO2变化的指标。ADCO2是评价COPD急性加重期患者病情严重程度的有效指标。
Objective To investigate the relationship between end-tidal carbon dioxide (PetCO2) and arterial carbon dioxide (PaCO2) in patients with acute exacerbation and remission of chronic obstructive pulmonary disease (COPD) and its clinical significance. Methods Twenty patients in normal control group (group A) and 30 patients in COPD group were divided into acute group (group B) and remission group (group C) according to the treatment before and after treatment. PaCO2 and PetCO2 values were also determined and the difference between PaCO2 and PetCO2 (ADCO2) was calculated. Results 1) The PaCO2 and ADCO2 values in group B and group C were significantly higher than those in group A (P <0.01), and the values of PetCO2 in group B were significantly lower than those in group A (P <0.01). There was no significant difference in PetCO2 between group C and group A. PetCO2 in group C was significantly higher than group B, and PaCO2 and ADCO2 in group C were significantly lower than those in group B. The difference was statistically significant (P < 0.01). 2) There was a significant correlation between PaCO2 and PetCO2 in group A and group C (r = 0.95 and 0.56, respectively, P <0.01). Conclusion PetCO2 can be used to determine the change of PaCO2 in normal and COPD patients. However, the sensitivity of PetCO2 in acute exacerbation of COPD is not sensitive and can not be used as a direct indicator of PaCO2. ADCO2 is an effective measure of the severity of the condition in patients experiencing acute exacerbation of COPD.