Veale D, Chailleux E, Taytard A, Cardinaud J P
Groupe Observatoire ANTADIR, CMTS, Paris, France.
Eur Respir J. 1998 Oct;12(4):780-4. doi: 10.1183/09031936.98.12040780.
Criteria for the prescription of long-term oxygen therapy (LTOT) have been published by academic societies and regulatory bodies, but many prescriptions for LTOT do not fulfil these criteria. Demographic, functional data and survival were compared in chronic obstructive pulmonary disease (COPD) patients with different levels of oxygenation, i.e. arterial oxygen tension (Pa,O2) < 8 kPa or > or = 8 kPa (60 mmHg), at the time of initial registration in the ANTADIR Observatory. Data were collected between 1984-1995. Selection criteria were a diagnosis of COPD or emphysema with forced expiratory volume in one second (FEV1) < 80% pred, FEV1/vital capacity (VC) < 70% and age between 18-75 yrs. Of 7,700 patients prescribed LTOT 18.5% had stable Pa,O2 > or = 8 kPa. While the FEV1 was the same they differed from the patients with more severe hypoxaemia in having a higher rate of diagnosis of primary emphysema and a lower arterial carbon dioxide tension (Pa,CO2). In this group of patients LTOT was more frequently administered as liquid oxygen than in other patients on LTOT. The survival of these patients was reduced compared to the general population of the same age and sex but comparable to that of patients with a Pa,O2 between 6.7-8 kPa (50-60 mmHg). Patients prescribed long-term oxygen therapy with an arterial oxygen tension > or = 8 kPa (60 mmHg) in the ANTADIR network were shown to have severe chronic obstructive pulmonary disease on the basis of spirometry and their survival was similar to that of more hypoxaemic patients. Randomized controlled trials of the effect of long-term oxygen therapy in patients with arterial oxygen tension > or = 8 kPa are needed.
学术团体和监管机构已公布了长期氧疗（LTOT）的处方标准，但许多LTOT处方并未符合这些标准。在ANTADIR观察站初始登记时，对不同氧合水平（即动脉血氧分压（Pa,O2）<8kPa或≥8kPa（60mmHg））的慢性阻塞性肺疾病（COPD）患者的人口统计学、功能数据和生存率进行了比较。数据收集于1984年至1995年之间。入选标准为诊断为COPD或肺气肿，一秒用力呼气容积（FEV1）<预测值的80%，FEV1/肺活量（VC）<70%，年龄在18至75岁之间。在7700例接受LTOT治疗的患者中，18.5%的患者Pa,O2稳定≥8kPa。虽然FEV1相同，但他们与低氧血症更严重的患者不同，原发性肺气肿的诊断率更高，动脉血二氧化碳分压（Pa,CO2）更低。在这组患者中，与其他接受LTOT治疗的患者相比，LTOT更常以液氧形式给药。与相同年龄和性别的普通人群相比，这些患者的生存率降低，但与Pa,O2在6.7至8kPa（50至60mmHg）之间的患者相当。在ANTADIR网络中，接受动脉血氧分压≥8kPa（60mmHg）的长期氧疗的患者，根据肺活量测定显示患有严重的慢性阻塞性肺疾病，其生存率与低氧血症更严重的患者相似。需要对动脉血氧分压≥8kPa的患者进行长期氧疗效果的随机对照试验。
