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高白细胞急性白血病患者血氧饱和度检测方法比较

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目的:探讨高白细胞急性白血病(HAL)患者进行血氧检测时应用动脉血氧饱和度(SaO2)和指尖脉氧仪检测的脉搏血氧饱和度(SpO2)哪种指标更有优势.方法:前瞻性分析18例HAL患者(观察组)和14例患者(对照组)SaO2、SpO2值之间的差异以及其差异与白细胞数之间的关系.结果:观察组的SaO2值低于SpO2值(P<0.05),SpO2-SaO2的差值与白细胞计数呈正相关(r=0.47);对照组的SaO2值和SpO2值之间无统计学差异(P>0.05).观察组SaO2、氧分压(PO2)值随着动脉血离体时间延长有下降趋势,但未显示统计学差异(P>0.05),对照组SaO2、PO2值随着动脉血离体时间延长无下降趋势(P>0.05).结论:HAL患者存在SaO2值低于SpO2值的现象,即假性低氧血症,该现象可能是过高的白血病细胞在体外进一步耗氧所致.SpO2可以床旁实时监测,且为无创操作,是检测HAL患者血氧状态的更好方法.
Comparison of Blood Oxygen Saturation Detection Methods in Patients with Hyperleukocytic Acute Leukemia
Objective:To investigate which indicator is more advantageous when using arterial oxygen saturation(SaO2)and fingertip pulse oxygen saturation(SpO2)for blood oxygen detection in patients with hyperleukocytic acute leukemia(HAL).Methods:In this prospective research,the difference between SaO2 and SpO2 of 18 HAL patients(observation group)and 14 patients(control group),as well as the relationship between the difference and white blood cell(WBC)counts were analyzed.Results:SaO2 was lower than SpO2 in the observation group(P<0.05),and SpO2-SaO2 difference was positively correlated with WBC counts(r=0.47).However,there was no statistical difference between SaO2 and SpO2 in the control group.SaO2 and PO2 showed a downward trend with the prolongation of detection time after arterial blood was collected in the observation group,but there was no statistical difference.There was no downward trend of SaO2 and PO2 in the control group.Conclusion:HAL patients have a phenomenon where SaO2 is lower than SpO2,that is pseudohypoxemia,and this phenomenon may be caused by excessive consumption of oxygen by the leukemia cells in vitro.SpO2 can be monitored bedside in real time and is non-invasive,it is a better way to detect the blood oxygen status of HAL patients.

hyperleukocytic acute leukemiapseudohypoxemiaSaO2SpO2

郭慧霞、曹淑雅、陈以娟、李茜、武悦、尚禹汐、王立茹

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首都医科大学附属复兴医院血液内科,北京 100038

深圳市龙华区中心医院血液内科,广东深圳 518110

高白细胞急性白血病 假性低氧血症 动脉血氧饱和度 脉搏血氧饱和度

北京市西城区卫生健康委员会青年科技人才(科技新星)培养项目

XWKX2020-24

2024

中国实验血液学杂志
中国病理生理学会

中国实验血液学杂志

CSTPCD北大核心
影响因子:0.988
ISSN:1009-2137
年,卷(期):2024.32(4)