中国人移植的乳内动脉平均流量测定及影响因素

Mean flow in internal mammary artery graft and its influencing factors in the Chinese

目的 确定中国人非体外循环冠状动脉旁路移植术 ( OPCAB)中移植的左乳内动脉 ( L IMA)平均流量参考范围及其影响因素。 方法 对 180例冠心病患者施行 OPCAB,术中采用即时血流测量仪 ( TTFM)直接测量并记录 L IMA血流波形、搏动指数 ( PI)、平均流量、收缩期峰流量、舒张期峰流量、血管阻力、心率和平均动脉压等 ,并分析平均流量与其他因素之间的关系。 结果 180例患者移植的 L IMA流量为 2 8.19± 2 .89ml/ min,分布范围较广 ( 6～178ml/ m in) ,其中在 2 0～ 2 5 ml/ min区间内有最大分布频数 ( 39/ 180 ,2 1.7% ) ,绝大部分分布在 10～ 30 ml/ m in( 116 /180 ,6 4 .4 % )。平均流量与收缩期峰流量、舒张期峰流量和血管阻力之间有一定的相关性 ( r=0 .75 ,0 .94 ,- 0 .95 ) ,与其它因素无明显的相关性。 结论 中国人 L IMA的平均流量应 >10 ml/ min,较满意的平均流量应 >2 2 ml/ min,而舒张期峰流量与血管阻力是影响平均流量的重要因素。

Objective To analyze the mean flow in left internal m am mary artery ( L IMA) graft and the influencing factors in off- pump coronary artery bypass grafting ( OPCAB) in the Chinese. Methods One hundred and eighty patients with OPCAB were studied.Transit- tim e flowmeter( TTFM) was utilized to measure and record the L IMA's blood flow wave,pulsatility index( PI) ,value of mean flow,systolic and diastolic peak flow,vascular resistance,insufficiency ratio and mean blood pressure and to analyze the relationship between mean flow of LIMA and other factors. Results Total mean flow calculated from that of all patients was2 8.19± 2 .89ml/ min( 6 - 178 ml/ m in) .Majority m ean value ( 6 4 .4 % ) was in the range of 10 - 30 ml/ min.Statistics showed that mean flow was significantly related to systolic and diastolic peak flow and vascular resistance rather than the other factors( r=0 .75 , 0 .94 ,- 0 .95 ) . Conclusions For the Chinese,over 10 ml/ min mean flow of L IMA graftis acceptable and over 2 2 ml/ min is satisfactory.The diastolic peak flow and vascular resistance are two most important factors in influencing mean flow.