桡动脉内压力波的微创伤测定法及其意义的探讨

A less-invasive method for measuring intraradial artery pressure wave and its significance

我们应用22号血管套管针穿刺桡动脉、留置微导管,描记压力波形,研究正常青年组(Ⅰ)、肺心病Ⅱ型呼衰的老年组(Ⅱ)及老年对照组(Ⅲ)桡动脉压力波,对比桡动脉内压力波与脉象图。结果表明,Ⅰ组多呈三峰波形、Ⅱ组呈单峰高尖波,Ⅲ组呈主波宽园、园钝波形。Ⅰ组与Ⅲ组波形图主要参数h_4/h_1、w/t_4、A_d/A_T差别显著或非常显著(分别P<0.05,P<0.001,P<0.001),A_T差别不显著。两组动脉血气分析pH、PaCO_2无显著差别,PaO_2均在正常范围。Ⅱ组与Ⅲ组h_4/h_1、w/t_4、A_T、A_d/A_T差别均非常显著(P<O.01或P<0.001);pH、PaCO_2、PaO_2差别亦非常显著(P<0.001);两组中h_4/h_1、w/t_4、A_T与PaO_2呈非常显著的正相关,与PaCO_2则呈非常显著的负相关(P分别小于0.001),Ⅱ组内h_4/h_1、w/t_4与PaO_2、PaCO_2亦分别呈显著的正相关和负相关(P<0.05)。桡动脉压力波形与脉象图形基本一致。

The radial artery were catheterized with 22G angiocath to trace the pulse wave forms of radial artery pressure in normal young group (group 1), elderly control group (group 3), and elderly patients with cor pulmonale and type 2 respiratory failure (group 2), and compared the pressure wave form with sphygmology of chinese medicine. Group 1 showed a tricrotic or dicrotic pulse wave, group 2-- a sharp single peak wave, and group 3 -- a wide round peak wave. The major parameters of wave, such as h_4/h_1, w/t_4, A_d/A_T between group 1 and 3 were significantly different (P<0.05, P<0.01, and P<0.001 respectively), but the difference of A_T and that of arterial blood pH, PaCO_2 between the two groups were not significant. The PaO_2 of these two grous were all in normal ranges. In group 2 and 3, the differences of h_4/h_1 w/t_2, A_t, A_d/A_T were signifi- cant (P<0.01 or P<0.001). There were significant negative correlations between h_4/h_1, w/t_4, A_T and PaCO_2 (P<0.01) and positive correlations between them and PaO_2 (P< 0.01). The radial artery pressure wave was simular to pulsilogram.