目的 观察慢阻肺合并呼吸衰竭患者血气指标水平,并分析其与肺功能、免疫指标和炎症因子水平的相关性。方法 选取2016年10月-2018年10月在我院接受治疗的100例慢阻肺患者为研究对象,根据其是否合并呼吸衰竭分为慢阻肺组和慢阻肺合并呼吸衰竭组。观察两组血气指标、免疫球蛋白、炎症因子和肺功能指标的差异,分析慢阻肺合并呼吸衰竭患者血气指标与免疫球蛋白、炎症因子和肺功能的相关性。结果 COPD合并呼衰组患者的PaO2、SaO2水平低于COPD组患者,PaCO2水平高于COPD组患者(P<0.001)；COPD合并呼衰组患者的IgA、IgG、IgM水平分别为245.23±12.78、956.36±22.19、76.28±6.27,高于COPD组患者；COPD合并呼衰组患者的FVC、MMEF和PEF水平分别为2.24±0.52、2.02±0.48、6.16±0.42,低于COPD组(P<0.001)；COPD合并呼衰组患者的IL-18、IL-6和hs-CRP水平分别为94.15±8.04、18.17±3.01、11.55±2.42,高于COPD组(P<0.001)；相关分析结果显示,慢阻肺合并呼吸衰竭患者的PaO2、SaO2与免疫球蛋白、细胞因子负相关,与肺功能正相关；PaCO2与免疫球蛋白、细胞因子正相关,与肺功能负相关。结论 慢阻肺合并呼吸衰竭患者PaO2、SaO2水平较低,PaCO2水平较高,且与细胞因子和肺功能指标密切相关。

Objective To observe the level of blood gas index in COPD patients with respiratory failure, and to analyze its correlation with pulmonary function, immune index and inflammatory factor level. Methods 100 patients with COPD who were treated in our hospital from October 2016 to October 2018 were selected as the research objects. According to whether they had respiratory failure or not, they were divided into COPD group and COPD with respiratory failure group. Observe the difference of blood gas index, immunoglobulin, inflammatory factor and pulmonary function index between the two groups, and analyze the correlation between blood gas index and immunoglobulin, inflammatory factor and pulmonary function in COPD patients with respiratory failure. Results The levels of PaO2 and SaO2 in COPD patients with respiratory failure were lower than those in COPD patients, and PaCO 2 levels were higher than those in COPD patients (P < 0.001). The levels of IgA, IgG and IgM in COPD patients with respiratory failure were 245.23±12.78, 956.36±22.19, 76.28±6.27, respectively, higher than those in COPD patients. The levels of FVC, MMEF and P EF in COPD patients with respiratory failure were 2.24±0.52, 2.02±0.48, 6.16±0.42, lower than those in COPD patients (P < 0.001), while the levels of IL-18, IL-6 and hs-CRP in COPD patients with respiratory failure were 94.15±8.04, 18.17±3.01, 11.55±2.42, higher than those in COPD patients (P < 0.001). Relevant analysis showed that PaO 2 and SaO 2 were negatively correlated with immunoglobulin and cytokines, positively correlated with pulmonary function, positively correlated with immunoglobulin and cytokines, and negatively correlated with pulmonary function in COPD patients with respiratory failure. Conclusion PaO 2 and SaO 2 levels are low and PaCO 2 levels are high in COPD patients with respiratory failure, which are closely related to cytokines and pulmonary function indicators.