乙型病毒性肝炎继发低氧血症证候规律和相关指标的临床研究.pdfVIP

提 要 目的：通过对慢性乙型病毒性肝炎患者血氧饱和度水平的临床资料调查，探讨其 继发低氧血症时的证候规律及其血氧饱和度与血氧分压等系列指标的相关性。方法： 系统检测不同病变阶段慢性乙型病毒性肝炎患者的血氧饱和度、动脉血氧分压。收集 其临床资料与症状体征等相关临床数据，归纳总结慢性乙型病毒性肝炎发生低血氧症 的病变特点以及证候分布规律，观察血氧饱和度与动脉血氧分压等指标的相关性。结 果：慢性乙型病毒性肝炎患者发生低氧血症年龄分布上，45岁以上患者发病率明显 升高，且与年龄成正比，说明该病的发病与年龄相关；并且随病变的进展低氧血症的 发生率呈上升趋势，其各阶段之间存在显著性差异，P＜0.01；慢性乙型病毒性肝炎 不同病变阶段动脉血氧分压与血氧饱和度均呈曲线回归关系，P＜0.01；且继发低氧 血症患者门静脉增宽、杵状指、蜘蛛痣的发生率显著高于非低氧血症者；病变脏腑主 要涉及肝、脾、肺。证候要素以肝郁(100%)、毒(100%)、脾虚(92.80%)、血瘀(90.40%)、 阴虚(86.40%)为主。结论：慢性乙型病毒性肝炎患者低氧血症发病具有年龄相关性特 点，其基本病位在肝脾，涉及肺，三者之间密切相关。证型以肝郁脾虚、瘀血阻络、 肝肾阴虚三型为多。慢性乙型病毒性肝炎血氧饱和度水平随病情的发展呈梯形下降趋 势，慢乙肝患者出现门静脉增宽、杵状指，蜘蛛痣时应警惕肝肺综合征，血氧饱和度 测定可作为HPS诊断简单、易行地诊断参考指标。 关键词 慢性乙型病毒性肝炎；动脉血氧分压；血氧饱和度；低氧血症；肝肺综 合征；疾病证候演变规律 Hypoxemia secondary to hepatitis B-related Syndromes anClinical Research Indicators Speciality:Internal medicine of TCM. Author:xingmengmeng Tutor:professor Li Yong Abstract Objective: Chronic hepatitis B viral liver disease on oxygen saturation levels in patients with clinical investigation of the secondary law of the syndrome when hypoxemia and oxygen saturation and blood oxygen partial pressure, and other related indexes Sex .Methods: The system detects different pathological stages of chronic hepatitis B patients with oxygen saturation, arterial oxygen tension. Clinical data collected with the clinical symptoms and signs, and other related data, summarized chronic hepatitis B lesions hypoxemia occurred characteristics and distribution of syndromes observed oxygen saturation and arterial oxygen and other Indexes Results: Chronic hepatitis B viral liver disease in patients with hypoxemia age distribu tion of patients over 45 years the incidence increased significantly with age and is proportional t