风心病病人心功能与血液动力学的关系

Correlation of the Clinical Cardiac Functional Status and Hemodynamics Changes in Preoperative Patients with Combined Rheumatic Mitral Valvular Diseases

探讨风湿性心脏病病人术前临床心功能与血液动力学和左室功能的关系。随机将风湿性二尖瓣病变病人３９例，按ＮＹＨＡ标准分为ＩＶ级组（１８例）和＜ＩＶ级组（２１例）两组。通过术前Ｓｗａｎ－Ｇａｎｚ导管、彩色多普勒超声心动图检查、Ｘ线心脏测量及临床资料进行研究。结果显示ＩＶ级心功能组血液动力学和左室功能改变普遍重于＜ＩＶ级组。表明风湿性二尖瓣病变术前临床心功能与三个方面改变密切相关：（１）心脏的增大程度；（２）心脏的泵血能力；（３）肺血管和相关的病理生理改变，进一步证实临床心功能仍是二尖瓣替换术有效的预测因子。

The aim of this paper is to explore the correlation of the preoperative clinical cardiac functional status(NYHA Lassification)with hemodynamic changes and left ventricular function preoperative patients with rheumatic mitral valvula diseases。Thirtyninepre-MVR patients with combined rheumatic mitral valvular lesions were divided into two groups at random according to the cardiac func tional status group l class IV and group 2 class III orless.The preoperative clinical data oftained by pulmonary artery catheterization(Swan-Ganz catheter),color doppler echocardiography and roentgeno logical measurement of heart size were analyzed.The study shows that hemodynamic changes were worse in patients of group 1 than group 2.It is cincluded that:NYHA cardiac functional classification in rheumatic mitral valvular disease has intimate correlation with(1)cardiac enlargement,(2)cardiac pumping effect,(3)pulmonary vascular changes and related pathophysiological consequences。