患者，男，70岁。既往慢性阻塞性肺疾病病史，长期家庭氧疗，近半月反复出现呼吸困难、心前区憋闷感、双下肢凹陷性水肿，遂至门诊就诊。査:Pa02为65mmHg，PaC02为40mmHg。下列最具有指导意义的检査是

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