目的探讨下腔静脉塌陷指数及右室长轴应变与肺动脉高压(PAH)的相关性。方法选取94例PAH患者(观察组)和35例健康体检者(对照组),其中观察组根据肺动脉收缩压进一步分为轻度组32例(30~49 mm Hg,1 mm Hg=0.133 kPa)、中度组32例(50~69 mm ...目的探讨下腔静脉塌陷指数及右室长轴应变与肺动脉高压(PAH)的相关性。方法选取94例PAH患者(观察组)和35例健康体检者(对照组),其中观察组根据肺动脉收缩压进一步分为轻度组32例(30~49 mm Hg,1 mm Hg=0.133 kPa)、中度组32例(50~69 mm Hg)、重度组30例(≥70 mm Hg),比较各组下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差、肺动脉平均压(mPAP)、肺毛细血管阻力(PVR)、肺毛细血管楔压(PCWP)的差异;分析下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差与肺动脉收缩压、mPAP、PVR、PCWP的相关性。结果观察组下腔静脉塌陷指数、右室长轴应变、PCWP均低于对照组,mPAP、PVR、三尖瓣反流压差均高于对照组,差异均有统计学意义(均P<0.05)。重度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻、中度组,mPAP、PVR、三尖瓣反流压差均高于轻、中度组,中度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻度组,mPAP、PVR、三尖瓣反流压差均高于轻度组,差异均有统计学意义(均P<0.05)。相关性分析显示,下腔静脉塌陷指数、右室长轴应变与肺动脉收缩压均呈负相关(r=-0.796、-0.895,均P<0.05);三尖瓣反流压差与肺动脉收缩压呈正相关(r=0.541,P<0.05);下腔静脉塌陷指数、右室长轴应变与PVR均呈负相关(r=-0.410、-0.454,均P<0.05),与PCWP均呈正相关(r=0.262、0.288,均P<0.05);三尖瓣反流压差与mPAP、PVR、PCWP均呈正相关(r=0.589、0.657、0.653,均P<0.05)。结论PAH患者下腔静脉塌陷指数和右室长轴应变均明显降低,两者均与肺动脉收缩压呈负相关。展开更多
Objective: To investigate the variation of functions of the heart and lung during orthotopic liver transplan- tation (OLT). Methods: Pulmonary artery cannula and right radial artery cannula were indewelled before anae...Objective: To investigate the variation of functions of the heart and lung during orthotopic liver transplan- tation (OLT). Methods: Pulmonary artery cannula and right radial artery cannula were indewelled before anaesthesia and the parameters of hemodynamics in different pe- riods were monitored. Analysis of variance was used to reveal the variation among the groups. T hypothe- sis test in paired data was used to compare the preop- erative parameters with those in each period during operation and after operation respectively, and to compare the parameters immediately after operation with those in each period after operation respective- ly. Results: During the operation, heart rate increased, but blood pressure decreased significantly at the be- ginning of no-liver period, increased again in a short period and then increased progressively 12 h after op- eration. Pulmonary artery pressure (PAP) increased from before the no-liver period to 60 h after opera- tion. Pulmonary wedge pressure changed in accord- ance with the variation of PAP. Cardiac output was maintained at a high-output level from before opera- tion to 60 h after operation. Systemic vascular resist- ance (SVR) was within the normal limits before op- eration, whereas pulmonary vascular resistance (PVR) was lower than normal. In the no-liver peri- od during the operation, SVR decreased significant- ly. Both SVR and PVR increased progressively and returned to normal postoperatively. Conclusions: The patients undergoing OLT have a high cardiac output and Iow resistance obstacle be- fore and during the operation, and will recover grad- ually after operation. Monitoring hemodynamics during the peri-operative period is of significance in the prevention and treatment of pneumonedema and cardiac functional insufficiency.展开更多
文摘目的探讨下腔静脉塌陷指数及右室长轴应变与肺动脉高压(PAH)的相关性。方法选取94例PAH患者(观察组)和35例健康体检者(对照组),其中观察组根据肺动脉收缩压进一步分为轻度组32例(30~49 mm Hg,1 mm Hg=0.133 kPa)、中度组32例(50~69 mm Hg)、重度组30例(≥70 mm Hg),比较各组下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差、肺动脉平均压(mPAP)、肺毛细血管阻力(PVR)、肺毛细血管楔压(PCWP)的差异;分析下腔静脉塌陷指数、右室长轴应变、三尖瓣反流压差与肺动脉收缩压、mPAP、PVR、PCWP的相关性。结果观察组下腔静脉塌陷指数、右室长轴应变、PCWP均低于对照组,mPAP、PVR、三尖瓣反流压差均高于对照组,差异均有统计学意义(均P<0.05)。重度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻、中度组,mPAP、PVR、三尖瓣反流压差均高于轻、中度组,中度组下腔静脉塌陷指数、右室长轴应变、PCWP均低于轻度组,mPAP、PVR、三尖瓣反流压差均高于轻度组,差异均有统计学意义(均P<0.05)。相关性分析显示,下腔静脉塌陷指数、右室长轴应变与肺动脉收缩压均呈负相关(r=-0.796、-0.895,均P<0.05);三尖瓣反流压差与肺动脉收缩压呈正相关(r=0.541,P<0.05);下腔静脉塌陷指数、右室长轴应变与PVR均呈负相关(r=-0.410、-0.454,均P<0.05),与PCWP均呈正相关(r=0.262、0.288,均P<0.05);三尖瓣反流压差与mPAP、PVR、PCWP均呈正相关(r=0.589、0.657、0.653,均P<0.05)。结论PAH患者下腔静脉塌陷指数和右室长轴应变均明显降低,两者均与肺动脉收缩压呈负相关。
文摘Objective: To investigate the variation of functions of the heart and lung during orthotopic liver transplan- tation (OLT). Methods: Pulmonary artery cannula and right radial artery cannula were indewelled before anaesthesia and the parameters of hemodynamics in different pe- riods were monitored. Analysis of variance was used to reveal the variation among the groups. T hypothe- sis test in paired data was used to compare the preop- erative parameters with those in each period during operation and after operation respectively, and to compare the parameters immediately after operation with those in each period after operation respective- ly. Results: During the operation, heart rate increased, but blood pressure decreased significantly at the be- ginning of no-liver period, increased again in a short period and then increased progressively 12 h after op- eration. Pulmonary artery pressure (PAP) increased from before the no-liver period to 60 h after opera- tion. Pulmonary wedge pressure changed in accord- ance with the variation of PAP. Cardiac output was maintained at a high-output level from before opera- tion to 60 h after operation. Systemic vascular resist- ance (SVR) was within the normal limits before op- eration, whereas pulmonary vascular resistance (PVR) was lower than normal. In the no-liver peri- od during the operation, SVR decreased significant- ly. Both SVR and PVR increased progressively and returned to normal postoperatively. Conclusions: The patients undergoing OLT have a high cardiac output and Iow resistance obstacle be- fore and during the operation, and will recover grad- ually after operation. Monitoring hemodynamics during the peri-operative period is of significance in the prevention and treatment of pneumonedema and cardiac functional insufficiency.
