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目的：探讨静脉滴注硝酸甘油（ｎｉｔｒｏｇｌｙｃｅｒｉｎ， ＮＴＧ）对室间隔缺损合并充血性心力衰竭婴幼儿血流动力学影响。方法：１５ 例室间隔缺损合并充血性心力衰竭婴幼儿，在连续监测心率和血压的情况下，静脉滴注ＮＴＧ０ ．４～０ ．８ μｇ·ｋｇ－ １·ｍｉｎ －１ ，利用超声心动图在用药前、用药后１ ｈ、６ ｈ 分别测定左心室射血分数（ｅｊｅｃｔｉｏｎｆｒａｃｔｉｏｎ，ＥＦ） 、短轴缩短率（ｆｒａｃｔｉｏｎａｌｓｈｏｒｔｅｎｉｎｇ，ＦＳ）、肺动脉平均压（ｐｕｌｍｏｎａｒｙ ａｒｔｅｒｙ ｍｅａｎ ｐｒｅｓｓｕｒｅ，ＰＡＭＰ） 、肺毛细血管楔压（ｐｕｌｍｏｎａｒｙｃａｐｉｌｌａｒｙ ｗｅｄｇｅ ｐｒｅｓｓｕｒｅ，ＰＣＷＰ） 和左心室壁应力（ｌｅｆｔ ｖｅｎｔｒｉｃｕｌａｒ ｗａｌｌｓｔｒｅｓｓ，ＬＶＷＳ） 等。结果：ＰＣＷＰ用药前（２．８ ±０ ．４） ｋＰａ，用药后１ ｈ 降至（１．７ ±０ ．４） ｋＰａ，６ ｈ 降至（１．６±０．４） ｋＰａ（ Ｐ＜ ０ ．０５） ；ＬＶＷＳⅠ用药前（４－３２±０－５６） Ｎ／ｃｍ２ ，用药后１ ｈ 降至（３－６５ ±０－５９） Ｎ／ｃｍ２ ，６ ｈ 降至（３－８７ ±０－６０） Ｎ／ｃｍ２（ Ｐ＜ ０．０５） ；ＬＶＷ
Objective: To investigate the effects of intravenous nitroglycerin (NTG) on hemodynamics in infants with ventricular septal defect and congestive heart failure. Methods: 15 cases of ventricular septal defect with congestive heart failure infants, continuous monitoring of heart rate and blood pressure in the case of intravenous NTG0. 4 ~ 0. 8 μg · kg -1 · min -1. The left ventricular ejection fraction (EF), fractional shortening (FS) and pulmonary artery were measured by echocardiography at 1 h and 6 h after treatment. Pulmonary artery mean pressure (PAMP), pulmonary capillary wedge pressure (PCWP) and left ventricular wallstress (LVWS) and so on. Results: PCWP was (2.8 ± 0.4) kPa before treatment and decreased to (1.7 ± 0.4) kPa and (1.6 ± 0.4) kPa (P < 0.05). Before LVWSⅠ (4-32 ± 0-56) N / cm2, it dropped to (3-65 ± 0-59) N / cm2 at 1 hour and decreased to (3-87 ± 0 -60) N / cm2 (P <0.05); LVW