无创血流动力学检测在心力衰竭患者心功能评价中的应用
|
摘要
目的探讨无创血流动力学指标在心力衰竭患者心功能评价中的应用。方法 71例心力衰竭患者分为A组(心功能Ⅱ级,27例)、B组(心功能Ⅲ级,22例)和C组(心功能Ⅳ级,22例),另选无心力衰竭者23例作为对照组(D组)。实施无创血流动力学监测,比较各组心功能指标的变化。结果与A、D组比较,B、C组心输出量、心脏指数、每搏输出量、每搏输出量指数、加速度指数和速度指数均降低,左心室射血时间缩短(P<0.05),外周血管阻力、外周血管阻力指数和收缩时间比率升高(P<0.05)。与D组比较,A、B、C组胸液水平和每搏输出量变异度升高(P<0.05)。结论无创血流动力学可为心力衰竭患者心功能提供客观、量化的评价指标。
Objective To discuss the application of noninvasive hemodynamic indicators in the evaluation of cardiac function in the patients with heart failure.Methods According to cardiac functional classification,71 patients with heart failure were divided into groups of A(class Ⅱ,27 cases),B(classⅢ,22 cases)and C(class Ⅳ,22 cases).Another 23 patients without heart failure were taken as the controls(group D).The noninvasive hemodynamic monitoring was performed and the indicators of cardiac function were compared among four groups.Results The cardiac output,cardiac index,stroke volume,stroke volume index,acceleration index and velocity index were lower,left ventricular ejection time was shorter and the systemic vascular resistance,systemic vascular resistance index and systolic time ratio were higher significantly in groups of B and C than those in groups of A and D(P<0.05).Compared with group D,the thoracic fluid content and stroke volume variation were elevated in groups of A,B and C(P<0.05).Conclusion Noninvasive hemodynamic monitoring can provide objective and quantitative indicators for the evaluation of cardiac function in the patients with heart failure.
Objective To discuss the application of noninvasive hemodynamic indicators in the evaluation of cardiac function in the patients with heart failure.Methods According to cardiac functional classification,71 patients with heart failure were divided into groups of A(class Ⅱ,27 cases),B(classⅢ,22 cases)and C(class Ⅳ,22 cases).Another 23 patients without heart failure were taken as the controls(group D).The noninvasive hemodynamic monitoring was performed and the indicators of cardiac function were compared among four groups.Results The cardiac output,cardiac index,stroke volume,stroke volume index,acceleration index and velocity index were lower,left ventricular ejection time was shorter and the systemic vascular resistance,systemic vascular resistance index and systolic time ratio were higher significantly in groups of B and C than those in groups of A and D(P<0.05).Compared with group D,the thoracic fluid content and stroke volume variation were elevated in groups of A,B and C(P<0.05).Conclusion Noninvasive hemodynamic monitoring can provide objective and quantitative indicators for the evaluation of cardiac function in the patients with heart failure.
引文
[1]陈伟伟,高润霖,刘力生,等.《中国心血管病报告2016》概要[J].中国循环杂志,2017,32(6):521-530.
[2]张晓敏,高蓉蓉,徐雪娟,等.血清sST2在评估心力衰竭严重程度及近期预后中的价值[J].江苏医药,2016,42(6):645-647.
[3]Murray CM,Agha SA,Rathi S,et al.The evaluation and monitoring of volume status in congestive heart failure[J].Congest Heart Fail,2008,14(3):135-140.
[4]NT-proBNP临床应用中国专家共识小组.NT-proBNP临床应用中国专家共识[J].中国心血管病研究,2011,9(6):401-408.
[5]王卓清,李永豪,李美慧,等.慢性心力衰竭不同时期患者无创血流动力学检测分析[J].医学理论与实践,2017,30(17):2497-2500.
[6]马立业.无创心脏血流动力学监测仪的工作原理、参数意义和临床价值[J].中国心血管杂志,2008,13(1):72-73.
[7]Raval NY,Squara P,Cleman M,et al.Multicenter evaluation of noninvasive cardiac output measurement by bioreactance technique[J].J Clin Monit Comput,2008,22(2):113-119.
[8]Perkins RE,Hollingsworth KG,Eggett C,et al.Relationship between bioreactance and magnetic resonance imaging stroke volumes[J].Br J Anaesth,2016,117(1):134-136.
[9]苏伟,杨智,傅永鸿,等.经肺热稀释法与胸腔阻抗法测定血流动力学参数的相关性研究[J].实用医学杂志,2016,32(5):781-783.
[10]洪虹,金雪娟,潘翠珍,等.无创心脏血流动力学监测仪与超声心动图检测心功能指标的相关性分析[J].中国医疗器械杂志,2009,33(5):328-331.
[11]Parrott CW,Burnham KM,Quale C,et al.Comparison of changes in ejection fraction to changes in impedance cardiography cardiac index and systolic time ratio[J].Congest Heart Fail,2004,10(2Suppl 2):11-13.
[12]Gielerak G,Piotrowicz E,Krzesiński P,et al.The effects of cardiac rehabilitation on haemodynamic parameters measured by impedance cardiography in patients with heart failure[J].Kardiol Pol,2011,69(4):309-317.
[13]Gielerak G,Krzesiński P,Piotrowicz E,et al.The usefulness of impedance cardiography for predicting beneficial effects of cardiac rehabilitation in patients with heart failure[J].Biomed Res Int,2013,2013:595369.
[14]Fedele F,Mancone M,Adamo F,et al.Heart failure with preserved,mid-range,and reduced ejection fraction:the misleading definition of the new guidelines[J].Cardiol Rev,2017,25(1):4-5.
[2]张晓敏,高蓉蓉,徐雪娟,等.血清sST2在评估心力衰竭严重程度及近期预后中的价值[J].江苏医药,2016,42(6):645-647.
[3]Murray CM,Agha SA,Rathi S,et al.The evaluation and monitoring of volume status in congestive heart failure[J].Congest Heart Fail,2008,14(3):135-140.
[4]NT-proBNP临床应用中国专家共识小组.NT-proBNP临床应用中国专家共识[J].中国心血管病研究,2011,9(6):401-408.
[5]王卓清,李永豪,李美慧,等.慢性心力衰竭不同时期患者无创血流动力学检测分析[J].医学理论与实践,2017,30(17):2497-2500.
[6]马立业.无创心脏血流动力学监测仪的工作原理、参数意义和临床价值[J].中国心血管杂志,2008,13(1):72-73.
[7]Raval NY,Squara P,Cleman M,et al.Multicenter evaluation of noninvasive cardiac output measurement by bioreactance technique[J].J Clin Monit Comput,2008,22(2):113-119.
[8]Perkins RE,Hollingsworth KG,Eggett C,et al.Relationship between bioreactance and magnetic resonance imaging stroke volumes[J].Br J Anaesth,2016,117(1):134-136.
[9]苏伟,杨智,傅永鸿,等.经肺热稀释法与胸腔阻抗法测定血流动力学参数的相关性研究[J].实用医学杂志,2016,32(5):781-783.
[10]洪虹,金雪娟,潘翠珍,等.无创心脏血流动力学监测仪与超声心动图检测心功能指标的相关性分析[J].中国医疗器械杂志,2009,33(5):328-331.
[11]Parrott CW,Burnham KM,Quale C,et al.Comparison of changes in ejection fraction to changes in impedance cardiography cardiac index and systolic time ratio[J].Congest Heart Fail,2004,10(2Suppl 2):11-13.
[12]Gielerak G,Piotrowicz E,Krzesiński P,et al.The effects of cardiac rehabilitation on haemodynamic parameters measured by impedance cardiography in patients with heart failure[J].Kardiol Pol,2011,69(4):309-317.
[13]Gielerak G,Krzesiński P,Piotrowicz E,et al.The usefulness of impedance cardiography for predicting beneficial effects of cardiac rehabilitation in patients with heart failure[J].Biomed Res Int,2013,2013:595369.
[14]Fedele F,Mancone M,Adamo F,et al.Heart failure with preserved,mid-range,and reduced ejection fraction:the misleading definition of the new guidelines[J].Cardiol Rev,2017,25(1):4-5.