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[海拔500米和1500米处慢性肺病患者的呼吸情况]

[Respiration of patients with chronic lung disease at 500 and 1500 meter above sea level].

作者信息

Karrer W, Schmid T, Wüthrich O, Baldi W, Gall E, Portmann H R

机构信息

Luzerner Höhenklinik Montana.

出版信息

Schweiz Med Wochenschr. 1990 Oct 27;120(43):1584-9.

PMID:2123560
Abstract

There is plentiful literature on respiration at high altitude (3000-8000 m above sea level) and its cardiopulmonary sequelae. But little is known about changes in ventilation and in pulmonary gas exchange at altitudes of 1,000-2,000 m above sea level. We studied 68 patients 500 and 1,500 m above sea level. On the arrival of the patients at 534 m above sea level we measured the arterial blood gases, pulse rate, respiratory rate and a breathing score. The same measurements were repeated on arrival at 1,500 m above sea level. A lung function test (FEV1, FVC, PEF, MEF 25-75) was also performed. The patients were divided into three groups: asthmatics, chronic bronchitics and restrictive patients. A control group was formed of patients without lung disease. Within all groups, the pO2 and the pCO2 diminishes significantly, no significant difference between the groups was found. In patients with lung disease oxygen saturation changes from 94.1% to 91.8% (COPD) and from 95.3% to 93.4% (restrictive patients). Age, smoking habits, lung function test and blood gases at 534 m are not predictors of the blood gases at altitude in COPD patients. But patients with restrictive lung disease show a positive correlation between age and change in pO2, as well as between severity of the restrictive disease and the change in oxygen saturation. The change of pO2 in COPD patients is not relevant clinically, as there is only minimal change in oxygen saturation. We conclude that patients of all degrees of COPD and patients with light to moderate restrictive lung disease can safely tolerate a difference in altitude from 534 to 1,500 m.

摘要

关于高海拔地区(海拔3000 - 8000米)的呼吸及其心肺后遗症,已有大量文献。但对于海拔1000 - 2000米高度时通气和肺气体交换的变化却知之甚少。我们对68名患者在海拔500米和1500米处进行了研究。患者抵达海拔534米时,我们测量了动脉血气、脉搏率、呼吸频率和呼吸评分。到达海拔1500米时重复进行相同测量。还进行了肺功能测试(第一秒用力呼气容积、用力肺活量、呼气峰值流速、25% - 75%用力呼气中期流速)。患者分为三组:哮喘患者、慢性支气管炎患者和限制性疾病患者。由无肺部疾病的患者组成对照组。在所有组中,氧分压和二氧化碳分压均显著降低,组间未发现显著差异。患有肺部疾病的患者中,氧饱和度从94.1%降至91.8%(慢性阻塞性肺疾病患者),从95.3%降至93.4%(限制性疾病患者)。在慢性阻塞性肺疾病患者中,海拔534米时的年龄、吸烟习惯、肺功能测试和血气并非海拔处血气的预测指标。但患有限制性肺部疾病的患者,年龄与氧分压变化之间以及限制性疾病严重程度与氧饱和度变化之间呈正相关。慢性阻塞性肺疾病患者的氧分压变化在临床上并无关联,因为氧饱和度仅有微小变化。我们得出结论,所有程度的慢性阻塞性肺疾病患者以及轻度至中度限制性肺部疾病患者都能安全耐受海拔从534米到1500米的差异。

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