影响脑血管血流动力学的因素分析

Analysis of Factors Affecting the Cerebrovascular Hemodynamics

目的：观测、比较麻醉前呼气末ＣＯ２ 分压（ＰＥＴＣＯ２） 、ＡＳＡ 分级等因素对脑血管血流动力学参数（ＣＶＤＩ） 影响的程度。方法：３２ 例择期手术患者，检测其麻醉前ＣＶＤＩ，再分别以ＣＶＤＩ各指标为因变量，以性别、年龄、体重、身高、术前空腹血糖浓度（Ｇｌｕ） 、ＡＳＡ分级、术前Ｈｃｔ 及ＰＥＴＣＯ２ 为自变量，进行逐步回归分析。结果：影响ＣＶＤＩ动力学指标的因素主要有年龄、Ｇｌｕ、ＡＳＡ分级，其复相关系数多在０－６８ 以上。此外，性别对脑血管阻力比，ＰＥＴＣＯ２ 对脑血管顺应性及零压顺应性，身高对脑血管动态阻力亦产生影响。结论：性别、体重、年龄、身高、Ｇｌｕ、Ｈｃｔ、ＰＥＴＣＯ２ 、ＡＳＡ 分级等因素均对ＣＶＤＩ产生不同程度的影响。其中，影响ＣＶＤＩ动力学指标的主要因素有年龄、Ｇｌｕ、ＡＳＡ 分级，而性别、ＰＥＴＣＯ２ 、身高及Ｈｃｔ 的影响相对较小。

Objective:To observe and compare how the factors such as end tidal CO 2(P ET CO 2)、ASA classes,etc.affect the cerebrovascular hemodynamic indices(CVDI).Methods:In 32 patients undergoing elective operations,CVDI were measured before anesthesia.Stepwise regression was done taking every CVDI as dependent variable individually and patients’ age,sex,body weight,height and concentrations of blood glucose(Glu),ASA class,hematocrit (Hct) and P ET CO 2 as independent variables.Results:The main factors effecting CVDI were patient’s age、Glu and ASA class with the multiple correlation coefficient of greater than 0 68.The ratio of cerebrovascular resistance was influenced by the sex,its compliance and zero pressure compliance by P ET CO 2 and its dynamic resistance by body height.Conclusion:All factors such as patient’s sex,body weight,age,Glu,Hct,P ET CO 2 and ASA class affect the CVDI at different degrees and the main factors are patient’s age,Glu and ASA class.