二期Fontan术术前HGB、HCT和SpO_2与肺血管阻力的相关性

Correlations of preoperative HGB,HCT and SpO_2 with pulmonary vascular resistance in patients pending two-stage Fontan procedure

目的分析二期Fontan术术前肺血管阻力(PVR)与血红蛋白浓度(HGB)、红细胞比容(HCT)及经皮氧饱和度(SpO2)的关系,建立无创评价PVR的方法。方法选择35例准备施行二期Fontan手术的患儿,测定静脉血HGB、HCT和安静时不吸氧状态下的SpO2,同时行心导管检查,测定和计算PVR。分别将HGB、HCT和SpO2作为自变量,PVR作为因变量,进行直线相关分析,并分别计算HGB、HCT和SpO2与PVR的直线回归方程。结果35例患儿术前HGB和HCT与SpO2均呈显著的负相关(r=-0.685,P<0.01;r=-0.634,P<0.01);HGB、HCT和SpO2与PVR也存在显著的相关性(r=0.562,P<0.01;r=0.579,P<0.01;r=-0.392,P<0.05)。HGB、HCT和SpO2与PVR的直线回归方程分别为y=0.268x-2.093,y=0.108x-2.976和y=11.951-0.117x。结论二期Fontan术术前HGB、HCT和SpO2与PVR均高度相关,可根据计算的直线回归方程,由术前测得的HGB、HCT和SpO2值计算PVR估计值,用以评价肺血管阻力。

Objective To investigate the correlations of pulmonary vascular resistance （PVR） with hemoglobin （HGB） concentration, hematocrit （HCT） and percutaneous oxygen saturation （ SpO2 ） in the patients pending two-stage Fontan procedure, and to find out a non- invasive method in assessing PVR for the patients. Methods Thirty-five pediatric candidates for two-stage Fontan procedure were selected, and venous blood was drawn to measure the HGB and HCT, while SpO2was recorded at the resting state without oxygen inhala- tion. Meanwhile, the cardiac catheterization was performed and PVR was calculated. The linear correlation analysis was then done, with HGB, HCT and SpO2 as independent variables and PVR as dependent variable. Besides, the linear regression equations for PVR estima- tion were calculated respectively. Results All the preoperative HGB and HCT of 35 patients were negatively correlated with SpO2（r= -0.685, P〈0.01;r= -0.634,P〈0.01）. The HGB, HCT and SpO2 were also highly correlated with PVR（r=0.562, P〈 0.01 ; r = 0. 579 ,P 〈 0.01 ; r = - 0. 392,P 〈 0.05 ）. Further calculation revealed that the regression equations of HGB, HCT and SpO2 with PVR were y =0. 268x - 2. 093, y = 0. 108x - 2. 976 and y = 11. 951 - 0. 117x, respectively. Conclusion The preoperative HGB, HCT and SpO2 in candidates pending two-stage Fontan procedure have high correlations with PVR. The estimated PVR could be obtained by linear regression equation with preoperative HGB, HCT and SpO2.