体外反搏的血流动力学、血浆心钠素水平的观察

The observation of hemodynamics and plasma atrial atriuretic factor level in external counterpulsation

本文采用右心导管法对接受ECP治疗的病人进行血流动力学监测,结果显示AMI组和60岁以上病人组反搏中PAP和PAWP升高(P<0.05),而NMI组和60岁以下病人组则不明显,说明心功能状态可能影响ECP时PAP和PAWP的反应。ECP时CVP升高,提示当心功能差时监测CVP在ECP治疗中非常有意义。采用Fick法计算CO与CI,发现ECP时可能并不增加CO与CI。用放射免疫法动态观察右心房血浆ANF水平,结果显示ECP可促进心脏释放ANF,且与CVP呈轻度正相关,说明ANF释放增加可能与压力对心房的作用有关。

Hemodynamics was monitored by right side heart cacheter in patients who were treated with external counterpulsation(ECP). Increasing of PAP and PAMP were observed in patients with acute myocardial infarction and patients over 60 years of age (P<0.05). It suggested that che state of heart function might have an effect on the response of PAP and PAWP to ECP. ECP increased central venous pressure (CVP). It indicates that it is very important to monitor CVP during ECP when the heart function of patients is no good. ECP might not be able to increase CO and CI in our observation with Fick's method. The level of plasna atrial natriuretic faccor(ANF) in right atrium was consecutiv-ly monitored by radioimmunoassay. The result indicated that the release of ANF in heart might be promoted by ECP. It was also observed that there was a slightly positive correlation between plasma ANF and CVP. This suggested that the increase of ANF release could be related with the effect of pressure on atrium.