McDonald C F, Blyth C M, Lazarus M D, Marschner I, Barter C E
Department of Respiratory Medicine, Heidelberg Hospital, Australia.
Am J Respir Crit Care Med. 1995 Nov;152(5 Pt 1):1616-9. doi: 10.1164/ajrccm.152.5.7582304.
It is unclear whether short-term benefits from supplemental oxygen translate into improved quality of life in patients with severe COPD. In a 12 wk double-blind randomized crossover study, we assessed the effects of supplemental air and oxygen on exercise performance (step tests and 6 min walking distance [6MWD]) initially and after two 6 wk periods at home using exertional cylinder air or oxygen. We measured quality of life at baseline and after the two 6 wk domiciliary periods. The 26 patients (24 males) had a mean age of 73 +/- 6 yr; mean FEV1, 0.9 +/- 0.4 L; mean DLCO, 10.6 +/- 2.4 ml/min/mm Hg; mean resting PO2, 69 +/- 8.5 (range 58 to 82) mm Hg; mean PCO2, 41 +/- 3.3 mm Hg; and mean resting SaO2, 94 +/- 2.1 (mean +/- SD). Laboratory tests were performed breathing intranasal air or oxygen at 4 L/min, and measurements were made of SaO2 and Borg dysnea scores. Supplemental oxygen increased 6MWD and steps by small, statistically significant increments acutely at baseline and after 6 and 12 wk, without corresponding falls in Borg score. Degree of desaturation at baseline did not correlate with increase in 6MWD or steps achieved at baseline or at 6 or 12 wk, nor with the domiciliary gas used. There was no difference in 6MWD or steps achieved while breathing supplemental oxygen after 6 wk of domiciliary oxygen compared with domiciliary air. Small improvements in quality of life indices were found after domiciliary oxygen, and mastery also improved after domiciliary air. There were no differences in quality of life, however, when domiciliary oxygen was compared with domiciliary air. Although oxygen supplementation induced small acute increments in laboratory exercise performance, such improvements had little impact on the patients' daily lives.
对于重度慢性阻塞性肺疾病（COPD）患者而言，补充氧气带来的短期益处是否能转化为生活质量的改善尚不清楚。在一项为期12周的双盲随机交叉研究中，我们最初以及在居家使用压缩空气或氧气两个6周阶段后，评估了补充空气和氧气对运动能力（台阶试验和6分钟步行距离[6MWD]）的影响。我们在基线以及两个6周居家阶段结束后测量了生活质量。26例患者（24例男性）的平均年龄为73±6岁；平均第一秒用力呼气容积（FEV1）为0.9±0.4升；平均一氧化碳弥散量（DLCO）为10.6±2.4毫升/分钟/毫米汞柱；平均静息动脉血氧分压（PO2）为69±8.5（范围58至82）毫米汞柱；平均二氧化碳分压（PCO2）为41±3.3毫米汞柱；平均静息动脉血氧饱和度（SaO2）为94±2.1（均数±标准差）。在以4升/分钟的速度经鼻呼吸空气或氧气的情况下进行实验室检测，并测量了SaO2和Borg呼吸困难评分。补充氧气使6MWD和步数在基线、6周和12周时急性增加，幅度较小但具有统计学意义，且Borg评分没有相应下降。基线时的去饱和程度与基线、6周或12周时6MWD或步数的增加无关，也与居家使用的气体无关。与居家使用空气相比，居家使用氧气6周后呼吸补充氧气时，6MWD或步数没有差异。居家使用氧气后生活质量指数有小幅改善，居家使用空气后掌控感也有所改善。然而，将居家使用氧气与居家使用空气进行比较时，生活质量没有差异。尽管补充氧气在实验室运动能力方面引起了小幅急性增加，但这种改善对患者的日常生活影响很小。
