下腔静脉塌陷指数(cIVC)与循环衰竭患者的容量反应相关性

Correlation between Collapse Indes of Inferior Vena Cava(cIVC)and Volume Responsiveness in Circulatory Failure Patients

目的 探讨下腔静脉塌陷指数（cIVC）预测急性循环衰竭患者容量反应性的应用价值。方法 将115例自主呼吸急性循环衰竭患者资料,分为对照组（65例）主动脉流速时间指数（VIT）〈15%,即无变化;研究组（50例）VIT≥15%,即有变化。再根据相应cIVC绘制出两组患者ROC曲线,评估cIVC对患者的容量反应性的预测价值。结果 两组患者补液实验后VIT与cIVC平均值对比差异均具有统计学意义（P〈0.05）;cIVC预测急性循环衰竭患者容量反应性ROC曲线面积为0.84（95%CI 0.62~0.84）,最佳界值为40%,特异性、敏感度分别为72%、69%。结论 用cIVC预测急性循环衰竭患者的容量反应性具有重要应用价值,当cIVC≥40%时,提示可能发生容量反应,应积极给予液体复苏治疗,当cIVC〈40%,在补液过程需提高警惕,以防发生意外。

Objective To investigate the application value of collapse index of inferior vena cava （eIVC） in acute circulatory failure patients＇ volume responsiveness. Methods The data of 115 patients suffered from spontaneous breathing with acute circulatory failure were divided into two groups. The group with no change was re- garded as control group （65 cases） VIT 〈 15% , while the group with certain change was regarded as study group （50 cases） VIT≥ 15%. Then, the corresponding cIVC of two groups were drew according to the ROC curve, and the predictive value of cIVC patient volume responsiveness was assessed. Results The difference of mean cIVC and VIT in two groups was statistically significant （ P 〈 0.05 ） after rehydration experiment. The ROC curve area of cIVC predict volume responsiveness in patients with acute circulatory failure was 0.84 （95% CI 0.62 -0.84） , in which the best boundary value was 40% besides. The specificity and sensitivity was 72% and 69% , respectively. Conclusion cIVC predicting volume responsiveness in patients with acute circulatory failure has important val- ue. When cIVC ≥40% , it may prompt reaction capacity, which should be actively given fluid resuscitation. When cIVC 〈 40% , it should be vigilant in the rehydration process of prevent accidents.