心脏患者左心室收缩末期压力─容积关系的特性及其无创化检测方法的探讨

Studies on the character of left ventricular end-systolic pressure-volume relation and its non-invasive method

目的通过对比高血压和心肌梗死对收缩期心肌力学参数Emax、Vop及EF的影响,借以探讨左心室收缩末期压力─容积关系的特性及其无创化检测方法的问题。方法利用心动超声、心音、心电图同幕显示和同步监测血压技术,测定正常组、单梗组、单高组和复合组患者不同血压时的左室收缩末期长短径、壁厚度、面积和血压值,经计算机程序处理,求得各组患者的Emax、Vop和EF值;同时取10例单梗组患者用心导管测左室内压。结果Vop和Emax:单梗组和复合组明显低于正常组和单高组(P<0.01),而单高组与正常组、单梗组与复合组比较差异均无统计学意义(P>0·05)。泵血功能EF:单梗组和复合组明显低于正常组(P<0.01),单梗组与复合组比较差异无统计学意义(P>0.05),单高组却介于正常组与单梗组或复合组之间,依次为正常组>单高组>单梗组>复合组。左室收缩末期压和平均动脉血压之间相关性好。结论本研究建立了无创检测心肌力学参数的方法,并借以说明Emax、Vop和EF的物理学特性和临床诊断意义。

Objective To discuss the character of left ventricular （IN） end - systolic pressure - volume relation and its non - invasive method by observing the effect of hypertension and myocardial infarction（ MI） on the systolic myocardial mechanical parameters （Emax, Vop and EF） , and to compare the invasive LV pressure and blood pressure （BP） of fight arm. Methods By use of simultaneous screen demonstration of echocardiography, phonocardiography and electrocardiography and synchronously monitoring BP skills, the values of LV end - systolic long and short - axis dimensions, wall thickness and area sizes and synchronous BP were measured in the normal group, MI group, hypertension group, compound group before the treatment and when blood pressure was different degrees. The values of Emax and Vop and EF were calculated by computer programmed process. Invasive LV pressure and BP of fight arm were monitored synchronously. Results In the four groups, Emax and Vop values of MI and compound groups were lower than those in normal group（P 〈0.01 ） ; Emax and Vop values of hypertension group were the highest. The EF values of MI and compound groups were lower than that of normal（P 〈0. 01 ） and their order was normal group 〉 hypertension group 〉 MI group 〉 compound group. LV end - systolic pressure and mean arterial pressure correlated with each other very well. Conclusion The study has established a noninvasive method of examining myocardial mechanical parameters and illustrating the physical importance and the diagnosis values of Emax and Vop and EF in patients with heart diseases.