经食管超声心动图评价七氟烷对Tei指数的影响

Effect of sevoflurane on Tei index evaluated by transesophageal echocardiography

目的对需择期非体外循环冠状动脉搭桥术(OPCABG)患者,应用经食管超声心动图(TEE)评价七氟烷对Tei指数的影响。方法选择OPCABG患者29例,其中男性19例,女性10例;年龄53～72岁,平均年龄61岁。于搭桥前未吸入七氟烷时(T1)、吸入1 MAC七氟烷后(T2)和搭桥后未吸入七氟烷时(T3)、吸入1 MAC七氟烷后(T4)时记录心率(HR)、平均动脉压(MAP)及中心静脉压(CVP);同时记录超声心动图指标:左心室射血分数(LVEF)、舒张早期充盈波(E波)、舒张晚期充盈波(A波)峰值,计算E波与A波峰值比(E/A)及Tei指数。结果与T1时比较,T2时MAP、LVEF降低(P<0.01),Tei指数未见明显变化;T3时HR、LVEF、E波、A波峰值升高(P<0.05或0.01),Tei指数降低(P<0.01);与T3时比较,T4时MAP、LVEF降低(P<0.05或0.01),Tei指数未见明显变化。结论对于OPCABG患者,术中吸入1MAC七氟烷对Tei指数无明显影响,术后左心室整体功能明显改善,Tei指数明显降低。

Objective To evaluate the effect of sevoflurane on Tei index for transesophageal echocardiography（TEE） in patients with off-pump coronary artery bypass grafting（OPCABG）.Methods A total of 29 OPCABG patients were enrolled,included 19 males and 10 females,who were 53-72 years old with a mean age of 61.The heart rate（HR）,mean arterial pressure（MAP） and central venous pressure（CVP） were recorded at non-inhaled sevoflurane before bypass（T1）,inhaled sevoflurane 1 MAC（T2）,noninhaled sevoflurane after bypass（T3） and inhaled 1 MAC sevoflurane（T4）,respectively.The TEE index,left ventricular ejection fraction（LVEF）,peak values of late diastolic wave（E） and late diastolic wave（A） were measured,the ratio of E/A and Tei index was calculated.Results Compared with T1,MAP and LVEF were decreased（P〈 0.01）,and there was no significant change in Tei index at T2.At T3,the HR,LVEF,peak values of E and A were increased（P〈 0.05 or 0.01）,and Tei index was decreased（P 〈0.01）.Compared with T3,MAP and LVEF were decreased（P〈 0.05 or 0.01） and there was no significant change in Tei index at T4.Conclusion It is demonstrated that the Tei index has no significant change in intra-operation inhalation of 1 MAC sevoflurane for OPCABG patient,the left ventricular function improved significantly at post operation,and Tei index decreased significantly.