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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2019, Vol. 12 ›› Issue (04) : 416 -419. doi: 10.3877/cma.j.issn.1674-6902.2019.04.003

论著

基于光纤精准分析呼吸气体的临床应用
袁侨英1, 喻金龙1, 周琪1, 石霞1, 陈丽君2(), 熊玮3,†()   
  1. 1. 400038　重庆，陆军军医大学（第三军医大学）西南医院营养科
    3. 400038　重庆，陆军军医大学（第三军医大学）西南医院老年科
  • 收稿日期:2019-04-13 出版日期:2019-08-20
  • 通信作者: 陈丽君, 熊玮
  • 基金资助:
    国家自然科学基金面上项目(81271657); 重庆市社会民生科技创新专项科技创新专项(cstc2016shmszx130067)

Clinical study of accurate analysis of respiratory gas based on optical fiber

Qiaoying Yuan1, Jinlong Yu1, Qi Zhou1, xia Shi1, Wei Xiong2,†()   

  1. 1. Department of Nutrition, Southwest Hospital, Army Military Medical University, Chongqing 400038, China
    2. Department of Geriatrics, Southwest Hospital, Army Military Medical University, Chongqing 400038, China
  • Received:2019-04-13 Published:2019-08-20
  • Corresponding author: Wei Xiong
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袁侨英, 喻金龙, 周琪, 石霞, 陈丽君, 熊玮. 基于光纤精准分析呼吸气体的临床应用[J]. 中华肺部疾病杂志(电子版), 2019, 12(04): 416-419.

Qiaoying Yuan, Jinlong Yu, Qi Zhou, xia Shi, Wei Xiong. Clinical study of accurate analysis of respiratory gas based on optical fiber[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(04): 416-419.

目的

基于涡轮传感器及氧传感器测定呼吸机使用患者的呼吸代谢指标，探讨不同性别患者的呼吸代谢变化特征和影响因素。

方法

基于COSMED代谢车的气体分析器测定122例不同性别患者呼吸代谢，其中A组男84例，B组女38例；分析不同性别患者的吸入氧量、呼出二氧化碳量、氧通气当量、最大摄氧量，平均吸入、呼出氧气量、潮气量、肺泡通气量，平均吸入、呼出二氧化碳量、呼吸商、呼吸频率等指标的差别，分析BMI值对呼吸代谢值的影响。

结果

A、B两组间平均O2分压(O2exp)比较有统计学差异：分别为(161±38)vs.(142±29)和118±53)vs.(86±39)，男性患者明显高于女性患者(P<0.05)。2组间CO2产量无统计学差异(P>0.05)。氧通气当量(VE/VO2) (47.56±17.45)vs.(28.98±12.12)2组间有统计学差异。二氧化碳通气当量VE/VCO2、呼吸商R、每公斤摄氧量、平均呼出CO2量2组间比较均无统计学差别(P>0.05)。平均呼出O2量(33.98±10.71)vs.(29.26±11.12)2组间比较有差别(P<0.05)，潮气量VT(0.30±0.09) vs. (0.34±0.09)、摄氧量VO2(142±30)vs.(161±38)两组间有差别，男性患者均高于女性患者(P<0.05)。分钟通气量、平均CO2分压、CO2产量两组间比较均无差别(P>0.05)。

结论

基于传感器测定不同性别人群的呼吸代谢精确、安全，可以辅助分析呼吸代谢状况、评估肺功能，可针对性的满足临床重症患者的诊治需求。

关键词: 呼吸, 代谢, 肺功能, 传感器
Objective

To investigate the characteristics and the influencing factors of respiratory metabolic changes in the patients with different sexes based on the measurement of respiratory metabolic indexes by turbine sensor and oxygen sensor.

Methods

The respiratory metabolism of 122 patients of different sexes (84 males and 38 females) was measured by COSMED metabolic vehicle gas analyzer. The respiratory quotient and respiratory frequency were analyzed, too. The effects of body mass index (BMI) on respiratory metabolic value were also analyzed.

Results

There were significant differences in VO2 and the average partial pressure of O2 between the two groups, and they were significantly higher in male patients than in female ones (P<0.05). There was no significant difference in CO2 production between the two groups (P>0.05). The oxygen ventilation equivalent (VE/VO2) was significantly different between the two groups. There was no significant difference in the ventilation equivalent VE/VCO2, the respiratory quotient R, the oxygen uptake per kilogram and the average exhaled CO2 between the two groups (P>0.05). There were significant differences between the two groups in the average exhaled oxygen volume and the tidal volume and the oxygen uptake VO2, which was higher in male patients than in female ones (P<0.05). There was no difference in the minute ventilation volume and the average partial pressure of CO2 and the CO2 output between the two groups (P>0.05).

Conclusion

The sensor-based measurement of respiratory metabolism in different sex groups is accurate and safe. It can comprehensively understand the respiratory metabolism and assist the evaluation of the cardiopulmonary function of severe patients.

Key words: Respiration, Metabolism, Pulmonary function, Sensor
图1 2组患者摄氧量及平均O2分压比较，*P<0.05
图2 2组间氧通气当量、二氧化碳通气当量比较，*P<0.05
图3 2组间平均呼出O2量比较，*P<0.05
1
Van Zanten AR. Nutritional support and refeeding syndrome in critical illness[J]. Lancet Respir Med, 2015, 3(12): 904-905.
2
Kagan I, Singer P. Nutritional imbalances during extracorporeal life support[J]. World Rev Nutr Diet, 2013, 105: 154-159.
3
中华医学会呼吸病学分会感染学组. 中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南(2018年版)[J]. 中华结核和呼吸杂志，2018, 41(4): 255-280.
4
刘　峰，贾钦尧，曾　庆，等. 呼吸机相关性肺炎的危险因素[J]. 中国老年学杂志，2018, 38(10): 2382-2383.
5
胡志成，周树生. 呼吸机相关性肺炎的危险因素及病原学分析：县级医院ICU的3年病例分析[J]. 中华危重病急救医学，2018, 30(10): 933-938.
6
Aghai ZH, Saslow JG, Nakhla T, et al. Synchronized nasal in-termittent positive pressure ventilation ( SNIPPV ) decreases work of breathing (WOB) in premature infants with respiratory distress syndrome (RDS) compared to nasal continuous positive airway pressure(NCPAP)[J]. Pediatr Pulmonol, 2016, 41(16): 875-881.
7
陈一冰，陈良安. 呼出气可挥发性有机化合物在诊断疾病中的研究进展[J]. 国际呼吸杂志，2017, 37(22): 1750-1756.
8
陈　璐，刘　畅，康　涛，等. 呼出气体中部分可挥发性有机物用于诊断肺癌的预测模型[J]. 肿瘤，2015, 35(4): 404-413.
9
侯晓旭，李佳戈，任海萍. 呼吸气体监护仪的设计原理及检测方法介绍[J]. 中国医疗器械信息，2017, 23(13): 4-6.
10
徐恩五，朱启航，何　哲，等. 呼出气一氧化氮检测在肺癌诊断中的应用[J]. 广东医学，2016, 37(1): 83-85.
11
刘鹏飞，赵大辉，张杜超，等. 肺癌患者呼出气一氧化氮数值变化的临床意义[J]. 解放军医学院学报，2016, 37(2): 101-104.
12
沈巨信，秦　娥，周国忠，等. 呼出气冷凝液癌胚抗原检测在非小细胞肺癌诊断和分期中的意义[J]. 中国卫生检验杂志，2017, 27(12): 1719-1720, 1724.
13
秦　娥，沈巨信，周国忠，等. 呼出气冷凝液中胃泌素释放肽前体在小细胞肺癌诊断中的应用[J]. 中国卫生检验杂志，2017, 27(21): 3106-3107, 3110.
14
Stacewicz T, Bielecki Z, Wojtas J, et al. Detection of disease markers in human breath with laser absorption spectroscopy[J]. Opto-Electronics Review, 2016, 24(2): 82-94.
15
Jiang CY, Sun MX, Li YX, et al. Breath Analysis Using Laser Spectroscopy Techniques: Development and Future[J]. Chin J Lasers, 2018, 45(2): 0207015.
16
Kaur J, Adamchuk VI, Whalen JK, et al. Development of an NDIR CO2 sensor-based system for assessing soil toxicity using substrate-induced respiration[J]. Sensors (Basel), 2015，15(3)：4734-4748.
17
Gao GZ, Cai TD, Hu B, Jia TJ, et al. Measurement of oxygen concentration using multimode diode laser absorption spectroscopy[J]. Guang Pu Xue Yu Guang Pu Fen Xi, 2015, 35(1): 34-37.
18
高彦伟，张玉钧，陈　东，等. 基于可调谐半导体激光吸收光谱的氧气浓度测量研究[J]. 光学学报，2016, 36(3): 0330001.
19
Liu X, Zhang G, Huang Y, et al. Two-dimensional temperature and carbon dioxide concentration profiles in atmospheric laminar diffusion flames measured by mid-infrared direct absorption spectroscopy at 4.2 μm[J]. Applied Physics B, 2018, 124(4): 61.
20
Hartmann A, Strzoda R, Schrobenhauser R, et al. CO2 sensor for mainstream capnography based on TDLAS[J]. Applied Physics B, 2014, 116(4): 1023-1026.
21
Hartmann A, Strzoda R, Schrobenhauser R, et al. Ultra-compact TDLAS humidity measurement cell with advanced signal processing[J]. Applied Physics B, 2014, 115(2): 263-268.
22
Xiong B, Du Z, Liu L, et al. Hollow-waveguide-based carbon dioxide sensor for capnography[J]. Chinese Optics Letters, 2015, 13(11): 111201.
23
Tutuncuü E, Kokoric V, Wilk A, et al. Fiber-Coupled Substrate-Integrated Hollow Waveguides: An Innovative Approach to Mid-infrared Remote Gas Sensors[J]. ACS sensors, 2017, 2(9): 1287-1293.
24
Li H, Rieker GB, Liu X, et al. Extension of wavelength-modulation spectroscopy to large modulation depth for diode laser absorption measurements in high-pressure gases[J]. Appl Opt, 2006, 45(5): 1052-1061.
25
Liu JT, Jeffries JB, Hanson RK. Large-modulation-depth 2f spectroscopy with diode lasers for rapid temperature and species measurements in gases with blended and broadened spectra[J]. Appl Opt, 2004, 43(35): 6500-6509.
26
Rieker GB, Jeffries JB, Hanson RK.Calibration-free wavelength-modulation spectroscopy for measurements of gas temperature and concentration in harsh environments[J]. Appl Opt, 2009, 48(29): 5546-5560.
27
Upadhyay A, Chakraborty AL. Calibration-free 2f WMS with in situ real-time laser characterization and 2f RAM nulling[J]. Opt Lett, 2015, 40(17): 4086-4089.
28
Farooq A, Jeffries JB, Hanson RK. Measurements of CO(2) concentration and temperature at high pressures using 1f-normalized wavelength modulation spectroscopy with second harmonic detection near 2.7 microm[J]. Appl Opt, 2009, 48(35): 6740-6753.
29
吴　涛，张怀林，孔维平，等. 基于2.73 μm DFB激光器的呼吸气体中CO2和水汽的同时在线测量[J]. 光学学报，2018, 38(12): 1230001.
30
安　宁，邹见刚，徐　风. 血清肿瘤分子标记物联合动态检测对肺癌诊疗的临床应用[J/CD]. 中华肺部疾病杂志(电子版), 2019, 11(2): 181-186.
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