Górecka D, Czajkowska-Malinowska M, Jedrzejczak M, Filipowska M, Sokołowska L, Sporna E, Nykiel E, Małosek D, Tobiasz M, Sliwiński P, Pułka M J
Kliniki Chorób Płuc, Instytutu Gruźlicy i Chorób Płuc w Warszawie.
Pneumonol Alergol Pol. 1996;64(9-10):544-53.
Long-term sequential evolution of pulmonary function, blood gas, body mass index (BMI) and oxygen breathing time was observed in 266 COPD patients with advanced airway obstruction (FEV1 = 0.80 L), and severe respiratory failure (PaO2 = 52 mmHg, PaCO2 = 49 mmHg) undergoing LTOT. There were significant differences between survivors and non-survivors at entry and during the treatment. Patients dying during LTOT had at entry lower BMI and more advanced airway limitation than survivors. They did not differ in blood gas values. During the follow-up (between 1-4 years) different trends in evolution of studied variables were observed in survivors (over 4 years on LTOT) and patients dying during LTOT (up to 4 years). Long term stabilization of spirometric and blood gas values as well as in mean oxygen breathing time (14 hours) were observed in survivors. In non-survivors a significant progression in airway limitation and respiratory failure coupled with better compliance with LTOT (oxygen use increased from 15 to 17 hours/ day) was observed especially in the last year before death. In survivors BMI increased significantly during the treatment, whereas in non-survivors no change was observed.
对266例晚期气道阻塞(FEV1 = 0.80 L)且重度呼吸衰竭(PaO2 = 52 mmHg,PaCO2 = 49 mmHg)并接受长期家庭氧疗(LTOT)的慢性阻塞性肺疾病(COPD)患者,观察其肺功能、血气、体重指数(BMI)和吸氧时间的长期序贯演变。在入组时和治疗期间,存活者与非存活者之间存在显著差异。在LTOT期间死亡的患者在入组时BMI较低,气道受限程度比存活者更严重。他们的血气值没有差异。在随访期间(1至4年),在存活者(接受LTOT超过4年)和LTOT期间死亡的患者(最长4年)中观察到所研究变量的不同演变趋势。存活者的肺活量测定值、血气值以及平均吸氧时间(14小时)长期稳定。在非存活者中,尤其是在死亡前的最后一年,观察到气道受限和呼吸衰竭显著进展,同时对LTOT的依从性更好(吸氧时间从每天15小时增加到17小时)。存活者在治疗期间BMI显著增加,而非存活者未观察到变化。