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-  2015 

心功能指数和全心射血分数在评估左心收缩功能方面的应用

DOI: doi:10.7507/1671-6205.2015018

Keywords: 经肺热稀释法, 心功能指数, 全心射血分数, 左心室射血分数, 左心收缩功能

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Abstract:

目的探讨通过单指示剂经肺热稀释法获得的评估心脏收缩功能的参数——心功能指数(CFI)和全心射血分数(GEF)在评估危重患者左心收缩功能方面的临床应用价值。 方法采用前瞻性临床观察研究, 选取2012年1月至2013年12月广州医科大学附属第一医院重症医学科接受脉搏指示连续心排出量(PiCCO)监测的39例患者, 其中左心收缩功能不全组18例, 对照组21例。两组患者在进行经肺热稀释法测量的同时行经胸心脏超声检查, 并采集相关数据。相关性分析采用Pearson分析, 为左心室射血分数(LVEF)、CFI、GEF建立受试者工作特征(ROC)曲线并比较曲线下面积, 计算其预测左心功能不全的阈值。 结果相关性分析显示LVEF与CFI、GEF有良好相关性(r=0.553, r=0.468, P<0.005)。CFI、GEF、LVEF的ROC曲线下面积分别为0.885、0.862、0.903, 且LVEF与CFI、GEF的曲线下面积差异无统计学意义(P>0.05)。CFI<4.25/min预测左心功能不全的敏感性为77.8%, 特异性为88.9%;GEF<19.5%预测左心功能不全的敏感性为88.9%, 特异性为66.7%。 结论单指示剂经肺热稀释法测量的CFI、GEF与经胸心脏超声测量的LVEF之间存在良好相关性, 均可用于重症患者左心收缩功能的评估

References

[1]  1. Antonelli M, Levy M, Andrews PJ, et al.Hemodynamic monitoring in shock and implications for management:International Consensus Conference, Paris, France.Intensive Care Med, 2006, 33:575-590.
[2]  2. Poelaert JI, Schupfer G.Hemodynamic monitoring utilizing transesophageal echocardiography:The relationships among pressure, flow, and function.Chest, 2005, 127:379-390.
[3]  3. Sakka SG, Reinhart K, Meier-Hellmann A.Comparison of pulmonary artery and arterial thermodilution cardiac output in critically ill patients.Intensive Care Med, 1999, 25:843-846.
[4]  4. Jabot J, Monnet X, Bouchra L, et al.Cardiac function index provided by transpulmonary thermodilution behaves as an indicator of left ventricular systolic function.Crit Care Med, 2009, 37:2913-2918.
[5]  6. Ferrada P, Murthi S, Anand RJ, et al.Transthoracic focused rapid echocardiographic examination:real-time evaluation of fluid status in critically ill trauma patients.J Trauma, 2011, 70:56-62.
[6]  7. Gunst M, Sperry J, Ghaemmaghami V, et al.Bedside echocardiographic assessment for trauma/critical care:the BEAT exam.J Am Coll Surg, 2008, 207:e1-e3.
[7]  8. Combes A, Berneau JB, Luyt CE, et al.Estimation of left ventricular systolic function by single transpulmonary thermodilution.Intensive Care Med, 2004, 30:1377-1383.
[8]  9. Friedman Z, Berkenstadt H, Margalit N, et al.Cardiac output assessed by arterial thermodilution during exsanguination and fluid resuscitation:experimental validation against a reference technique.Eur J Anaesthesiol, 2002, 19:337-340.
[9]  10. Goedje O, Hoeke K, Lichtwarck-Aschoff M, et al.Continuous cardiac output by femoral arterial thermodilution-calibrated pulse contour analysis:comparison with pulmonary arterial thermodilution.Crit Care Med, 1999, 27:2407-2412.
[10]  11. Della Rocca G, Costa MG, Pompei L, et al.Continuous and intermittent cardiac output measurement:pulmonary artery catheter versus aortic transpulmonary technique.Br J Anaesth, 2002, 88:350-356.
[11]  12. Reuter DA, Huang C, Edrich T, et al.Cardiac output monitoring using indicator-dilution techniques:basics, limits, and perspectives.Anesth Analg, 2010, 110:799-811.
[12]  13. Huang CC, Chen NH, Li LF, et al.Effects of cardiac output levels on the measurement of transpulmonary thermodilution cardiac output in patients with acute respiratory distress syndrome.J Trauma Acute Care Surg, 2012, 73:1236-1241.
[13]  14. Poelaert J, Schmidt C, Colardyn F.Transoesophageal echocardiography in the critically ill.Anaesthesia, 1998, 53:55-68.
[14]  15. Poelaert J, Schmidt C, Van AH, et al.Transoesophageal echocardiography in critically ill patients.A comprehensive approach.Eur J Anaesthesiol, 1997, 14:350-358.
[15]  16. Shoemaker WC, Wo CC, Lu K, et al.Noninvasive hemodynamic monitoring for combat casualties.Mil Med, 2006, 171:813-820.
[16]  17. Shoemaker WC, Wo CC, Chien LC, et al.Evaluation of invasive and noninvasive hemodynamic monitoring in trauma patients.J Trauma, 2006, 61:844-853.
[17]  18. Gunst M, Sperry J, Ghaemmaghami V, et al. Bedside echocardiographic assessment for trauma/critical care:the BEAT exam. J Am Coll Surg, 2008, 2007:e1-e3.
[18]  19. Poelaert J, Mayo P.Education and evaluation of knowledge and skills in echocardiography:How should we organize? Intensive Care Med, 2007, 33:1684-1686.
[19]  5. McMurray JJ, Adamopoulos S, Anker SD, et al.ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012.Euro J Heart Fail, 2012, 14:803-869.

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