Mohammad Ali Ghayumi Seiyed, Nikeghbalian Saman, Kakaei Farzad, Nejatollahi Mohammad Reza, Mohammad Taghi Ayatoliahi Seiyed
Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Hepatogastroenterology. 2011 Sep-Oct;58(110-111):1700-2. doi: 10.5754/hge10132. Epub 2011 Jul 15.
BACKGROUND/AIMS: Hypoxia is common in patients with chronic liver disease. Screening guidelines for detecting the presence of arterial hypoxemia do not exist. The aim of this study was to investigate the accuracy and utility of pulse oxymetry in the detection of hypoxemia (PaO2<65) in a group of patients with liver cirrhosis who were candidate for liver transplantation.
Two hundred and ninety-five transplant candidates enrolled in this study. Arterial oxyhemoglobin saturation was obtained by pulse oxymetry (SpO2) and compared with simultaneous arterial blood gas (ABG) oxyhemoglobin values (SaO2). Bias, the overestimation or underestimation of one method compared with another, is defined as the difference between SpO2 and SaO2.
SpO2 overestimated SaO2 in 78.3% (n=231) and underestimated in 18.6% (n=54) cases. The bias was over 4% or less than -4% (Bias4) in 11.6% (n=34) of the cases and significantly different between the patients with SaO2 =94%. PaO2 =65 mmHg (p=0.000) and SpO2 =94% (p=0.003). Also, when we used the cut-off level of A-a O2 gradient =20 and =15, the bias was significantly different between the patients (p=0.000).
Pulse oximetry is a useful screening test to detect hypoxemia in patients with liver disease.
背景/目的：低氧血症在慢性肝病患者中很常见。目前尚无用于检测动脉低氧血症的筛查指南。本研究的目的是调查脉搏血氧饱和度测定法在一组肝移植候选肝硬化患者中检测低氧血症（动脉血氧分压<65）的准确性和实用性。
295名移植候选者参与了本研究。通过脉搏血氧饱和度测定法（SpO2）获得动脉血氧血红蛋白饱和度，并与同时测定的动脉血气（ABG）血氧血红蛋白值（SaO2）进行比较。偏差是指一种方法相对于另一种方法的高估或低估，定义为SpO2与SaO2之间的差值。
SpO2在78.3%（n = 231）的病例中高估了SaO2，在18.6%（n = 54）的病例中低估了SaO2。11.6%（n = 34）的病例偏差超过4%或低于-4%（偏差4），且在动脉血氧饱和度（SaO2）=94%、动脉血氧分压（PaO2）=65 mmHg（p = 0.000）和SpO2 = 94%（p = 0.003）的患者之间存在显著差异。此外，当我们使用肺泡-动脉氧分压差（A-a O2梯度）=20和=15的临界值时，患者之间的偏差也存在显著差异（p = 0.000）。
脉搏血氧饱和度测定法是检测肝病患者低氧血症的一种有用的筛查试验。
