慢性阻塞性肺疾病患者的氧疗：当前证据和长期氧疗试验。
Oxygen therapy for patients with COPD: current evidence and the long-term oxygen treatment trial.
机构信息
Respiratory Institute, Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
出版信息
Chest. 2010 Jul;138(1):179-87. doi: 10.1378/chest.09-2555.
Long-term use of supplemental oxygen improves survival in patients with COPD and severe resting hypoxemia. However, the role of oxygen in symptomatic patients with COPD and more moderate hypoxemia at rest and desaturation with activity is unclear. The few long-term reports of supplemental oxygen in this group have been of small size and insufficient to demonstrate a survival benefit. Short-term trials have suggested beneficial effects other than survival in patients with COPD and moderate hypoxemia at rest. In addition, supplemental oxygen appeared to improve exercise performance in small short-term investigations of patients with COPD and moderate hypoxemia at rest and desaturation with exercise, but long-term trials evaluating patient-reported outcomes are lacking. This article reviews the evidence for long-term use of supplemental oxygen therapy and provides a rationale for the National Heart, Lung, and Blood Institute Long-term Oxygen Treatment Trial. The trial plans to enroll subjects with COPD with moderate hypoxemia at rest or desaturation with exercise and compare tailored oxygen therapy to no oxygen therapy.
长期使用补充氧气可改善 COPD 患者和严重静息低氧血症患者的生存率。然而，对于在静息时存在中度低氧血症和活动时出现血氧饱和度下降但有症状的 COPD 患者，以及对于氧疗的作用尚不清楚。在这组患者中，少数关于补充氧气的长期报告规模较小，不足以证明有生存获益。短期试验表明，在静息时存在中度低氧血症的 COPD 患者中，除了生存之外，氧疗还有其他有益效果。此外，补充氧气似乎可改善小样本短期 COPD 患者和静息时存在中度低氧血症及运动时出现血氧饱和度下降患者的运动表现，但缺乏评估患者报告结局的长期试验。本文综述了长期使用补充氧气疗法的证据，并为美国国立心肺血液研究所长期氧疗试验提供了理论依据。该试验计划招募静息时存在中度低氧血症或运动时出现血氧饱和度下降的 COPD 患者，比较个体化氧疗与不吸氧治疗。
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