Flick M R, Block A J
Ann Intern Med. 1977 Jun;86(6):725-30. doi: 10.7326/0003-4819-86-6-725.
We monitored arterial oxygen saturation (SaO2) in 10 patients with severe chronic obstructive lung disease during 24 h of breathing room air followed by 24 h of breathing two litres of oxygen per minute. Three subjects without chronic obstructive lung disease were monitored while breathing room air. Greatest declines in SaO2 occurred during sleep, with intermittent decreases as great as 44% saturation (range, 12% to 44% saturation. Baseline SaO2 was significantly higher while patients breathed low-flow oxygen (94% versus 86% saturated), and declines in SaO2 during sleep were less noteworthy (1% to 27% saturation). Subjects without chronic obstructive lung disease showed declines in SaO2 of much lesser magnitude (3% to 11% saturation) with sleep. These declines were not primarily due to alveolar hypoventilation. Our data indicate that there are patients with chronic airways obstruction who suffer profound intermittent desaturation at night that can readily be relieved with low-flow oxygen administration.
我们对10例重度慢性阻塞性肺疾病患者进行了监测,让他们先在室内空气中呼吸24小时,然后每分钟呼吸两升氧气,再持续24小时。对3例无慢性阻塞性肺疾病的受试者在呼吸室内空气时进行了监测。动脉血氧饱和度(SaO2)的最大降幅出现在睡眠期间,饱和度间歇性下降高达44%(范围为12%至44%)。患者呼吸低流量氧气时,基线SaO2显著更高(94%饱和对86%饱和),睡眠期间SaO2的下降不太明显(饱和度下降1%至27%)。无慢性阻塞性肺疾病的受试者睡眠时SaO2下降幅度小得多(饱和度下降3%至11%)。这些下降并非主要由于肺泡通气不足。我们的数据表明,有慢性气道阻塞的患者夜间会出现严重的间歇性血氧饱和度下降,通过低流量给氧可轻易缓解。