无创血流动力学检测在冠心病及其合并症患者中的应用

Application of impedance cardiography in patients with coronary heart disease and its complications

目的无创血流动力学检测方法的临床应用范围渐广,文中旨在评估该方法在冠心病及其合并症患者中的应用价值。方法应用无创血流动力学检测仪对110名冠状动脉造影患者进行检测,检测指标包括心排血量(cardiac output,CO)、心排血指数(cardiac index,CI)、每搏输出量(stroke volume,SV)、搏出指数(stroke index,SI)、外周血管阻力(systemicvascular resistance,SVR)、外周血管阻力指数(systemic vascular resistance index,SVRI)、胸腔液体水平(thoracic fluid content,TFC)、加速指数(acceleration index,ACI)及速度指数(velocity index,VI)。结果①冠心病、无冠心病患者与正常对照组相比无明显差异,两者之间亦无显著差异。冠心病合并心功能不全患者CO较正常对照组明显减低(P<0.05);SVR、SVRI较正常对照组明显升高(P<0.05)。②冠心病合并高血压患者较正常对照组及冠心病无高血压患者CI、CO明显减低(P<0.05),SVR、SVRI明显升高(P<0.05)。③冠心病伴有糖尿病患者较正常对照组及冠心病无糖尿病患者CI、CO、SI、SV、VI、ACI明显减低(P<0.05)。结论无创心功能检测方法可用来初步判断冠心病患者的心功能状况。同时冠心病合并高血压或糖尿病患者的心功能较单纯冠心病患者为差。

Objective Impedance cardiography has been widely used clinically.This article was to assess the utility of this method in patients with coronary heart disease（CHD） and its complications.Methods We performed impedance cardiography for 110 patients undergoing coronary angiography to evaluate their cardiac function,including cardiac output/index（CO/CI）,stroke volume/index（SV/SI）,systemic vascular resistance/index（SVR/SVRI）,velocity index（VI）,acceleration index（ACI） and thoracic fluid content（TFC）.Results The patients with and without CHD showed no significant differences from the normal subjects.In comparison with the healthy controls,CO was markedly decreased（P0.05）,while SVR and SVRI obviously increased（P0.05） in the CHD patients complicated by heart failure（HF）.CI and CO were decreased（P0.05）,but SVR and SVRI increased significantly（P0.05） in the CHD patients complicated by hypertension as compared with those with CHD but without hypertension and the normal subjects.CI,CO,VI and ACI were decreased（P0.05） while SVR and SVRI were increased significantly（P0.05） in those with both CHD and diabetes mellitus（DM） compared with the CHD patients without DM and the health controls.Conclusion Impedance cardiography can be used for primary evaluation of cardiac function in patients with CHD.And the cardiac function is worse in patients with CHD complicated by hypertension or DM than in those with CHD only.