The Characteristics Of Arterial Blood Gas Analysis In Patients With Chronic Obstructive Pulmonary Disease At High Altitude

Objective: To study the characteristics of blood gas analysis of chronic obstructive pulmonary disease（COPD）patients in plateau area by comparing the acute exacerbation stage of COPD patients with those in the plain area,the blood gas index of acute exacerbation stage and stable period of COPD patients in the plateau area and the type of acid-base imbalance,so as to provide a theoretical basis for the discussion of long-term family oxygen therapy in patients in the plateau area.Methods:Collected 94 patients in November 2018 to November 2019 plateau（1500-2500 m）acute exacerbation of chronic obstructive pulmonary disease period,plateau and plain,chronic obstructive pulmonary disease in patients with acute aggravating period,through the lung function divided the patients into GOLD 2,3,4,and lung function according to the classification to the proportion of 1:1 matching number of three groups of patients,to collect general information,blood gas analysis index,and pulmonary function in patients with indicators.The differences of blood gas analysis indexes in the acute exacerbation period,the acute exacerbation period and the stable period of COPD in plateau and plain were compared.Results: 1.There were significant differences in p H,Pa CO2,PaO₂,SaO₂,and HCO3-between the plain group and the plateau group（GOLD 2 and 3 patients with acute exacerbation of COPD）（P< 0.05）.There were significant differences in Pa CO2 and HCO3-of grade GOLD4 between the the plain group and the plateau group（P<0.05）.There were significant differences in the types of acid-base imbalance and the types of respiratory failure between the plain group and the plateau group（P< 0.05）.2.There was a significant difference in PaO₂ and SaO₂ between the plateau stage of acute exacerbation of COPD and the plateau stage of GOLD3（P< 0.05）.There was no significant difference in each index between GOLD4 groups（P> 0.05）.3.Using the blood gas analysis standard values of the plain and the formula for predicting theacid-base balance compensation and the plateau blood gas analysis to explore the standard and the formula for predicting the acid-base balance imbalance,the acid-base balance imbalance and the type of respiratory failure under the two standards were compared.:There are significant differences in acid-base balance types and types of respiratory failure（P< 0.05）.Conclusion:1.The hypoxia of acute exacerbation of chronic obstructive pulmonary diseasepatients in the plateau is more significant than that in the plain,but the degree of carbon dioxide retention in the plateau patients is far lower than that in the plain;2.The degree of hypoxia in plateau acute exacerbation of chronic obstructive pulmonary disease patients is more serious than that in patients with COPD in the stable period,but the degree of carbon dioxide retention is not worse than that in the stable period;3.Arterial blood gas analysis criteria suitable for plateau should be further explored;4.It may be inappropriate to use the plain standard for long-term home oxygen therapy in the plateau.