脑创伤病人心脏应激反应的临床研究

Study on heart stress response in patients with brain injuries

目的 研究脑创伤时心脏的应激反应 ,并探讨其发生机制。 方法 141例各型脑创伤病人 ,采用血液循环动力学信息检测仪检测其心肌耗氧量 (MVO)、心肌缺血阈值 (MIT)、射血分数 (EF)、左室机械效率 (LME)、心肌变力系数 (MIC)、心肌负变力系数 (MNC)等 ,并设 141例正常健康人为对照组。 结果 创伤病人MVO、MNC比对照组明显增高 (P <0 .0 1) ,EF、MIT、LME、MIC较对照组显著降低 (P <0 .0 1)。 结论 脑创伤病人有明显的心脏应激反应 ,表现为MVO增加、心肌供血障碍、心脏效率低下、心肌负变力效应增加等 ,具有潜在的危险性。长期、严重的心脏应激反应 ,必将影响心脏功能 。

Objective To study heart stress response in brain injuries and to discuss the possible mechanism. Methods Hemodynamic parameters were detected in 141 patients with brain injuries by using circulation dynamics (CD) detection. The parameters of systematic hemodynamics included myocardium consume volume oxygen (MVO),myocardium ischemic threshold(MIT),ejection fraction (EF),left ventricular mechanic efficiency(LME),myocardium inotropic coefficiency(MIC) and myocardium negative inotropic coefficiency(MNC). One hundred and forty one healthy people were selected for the control group. Results MVO and MNC increased evidently( P <0.01). EF, MIT, LME, and MIC decreased significantly( P <0.01). Conclusions Patients with brain injuries have evident heart stress response, showing increase of myocardium oxygen consumption, myocardium negative inotropic coefficiency, decrease of myocardium perfusion and low heart efficiency. Long term and severe heart stress response can affect heart function.