目的 探讨慢性阻塞性肺疾病(COPD)并Ⅱ型呼衰血气分析指标变化对预后的影响。方法 回顾性分析我院2013年至 2015年收治的85例60岁以上的老年COPD并Ⅱ型呼衰患者临床资料，将其分成好转组(66例)和死亡组(19例)两组。 病人入院后作动脉血气分析(未吸氧前)，并同步测定静脉血电解质。比较两组病人PH、PaCO2的情况，并对其死 亡率进行比较。结果 ①血气分析结果PH≥7.25时，死亡率明显升高；PaCO2≥80mmHg，(死亡率也明显升高，P ＜0.01)；②呼吸性酸中毒合并其他类型酸碱平衡紊乱时死亡率明显升高(P＜0.05)，尤其当合并其他两种类型时升 高更明显(P＜0.05)。结论 ①老年慢性阻塞性肺疾病并Ⅱ型呼衰患者血气分析PH值和PaCO2对预后有显著影响，可 以在一定程度上预测预后；②合并二种或以上酸碱平衡紊乱时死亡率高于单独一种酸碱平衡紊乱。

Objective To investigate prognosis and parameter changes of blood gas analysis in elderly patients with chronic obstructive pulmonary disease (COPD) and type Ⅱ respiratory failure. Methods Form 2013 to 2015 in our hospital, the clinical data of 85 cases of COPD in elderly patients over the age of 60 and type II respiratory failure were retrospective analysis, which were divided into improved group (66 cases) and the death group (19 cases). All of the patients were underwent arterial blood gas analysis (oxygen not before) and venous blood electrolyte determination after admission, and PH, PaCO2, and the mortality rate were compared respectively. Results (1)When blood gas analysis PH≥7.25, mortality was significantly increased. PaCO2≥80mmHg, (mortality was significantly increased, P<0.01). (2)Respiratory acidosis associated with other types of acid-base balance disorders of mortality was significantly increased (P<0.05), in particular increased when combined with other two types is more obvious (P<0.05). Conclusion (1)PH value and PaCO2 of blood gas analysis have a significant impact on the prognosis in elderly patients with COPD and type Ⅱ respiratory failure, which prognosis can be predicted to some extent. (2)The mortality rate of two or more acid-base balance disorders were higher than single one.