论文部分内容阅读
目的探讨容量负荷、压力负荷及神经体液调节对血液透析(HD)患者心力衰竭的影响。方法应用血液循环动力学信息检测仪对HD患者透析前进行血流动力学参数测定,比较充血性心力衰竭(CHF)组与无充血性心力衰竭(NCHF)组左室前、后负荷及血压等的变化。结果CHF组中心静脉压(CVP)、左室舒张末期容量(LDV)、心输出量(CO)、射血阻抗(ER)、主动脉弹性模量(OM)、收缩压(SBP)显著高于NCHF组,心肌顺应性、综合反射系数(SEC)明显低于NCHF组[(37.6±13.9)cm H2Ovs(18.4±6.3)cm H2O、(378±207)mlvs(279±114)ml、(15.5±6.2)L.min-1vs(10.8±3.1)L.min-1、(207±42)g.cm-4.s-1vs(176±36)g.cm-4.s-1、(14.3±5.3)N.cm-2vs(9.6±2.3)N.cm-2、(174±27)mmHgvs(155±26)mmHg、(16.9±9.1)vs(22.9±10.2)、(1.07±0.11)vs(1.17±0.10),P均<0.01]。结论CHF患者LDV、ER、OM升高,心肌顺应性降低,微循环障碍是导致CHF的重要因素。
Objective To investigate the effects of volume load, pressure load and neurohumoral regulation on heart failure in hemodialysis (HD) patients. Methods Hemodynamic parameters were used to measure the hemodynamic parameters before HD in HD patients. The left ventricular preload, postload and blood pressure were compared between CHF group and non-congestive heart failure group (NCHF) The change. Results The central venous pressure (CVP), left ventricular end diastolic volume (LDV), cardiac output (CO), ejection resistance (ER), aortic elastic modulus (OM) and systolic blood pressure (SBP) In the NCHF group, myocardial compliance and total reflectance (SEC) were significantly lower than those in the NCHF group [(37.6 ± 13.9) cm H2Ovs (18.4 ± 6.3) cm H2O, (378 ± 207) mlvs 6.2) lmin-1vs (10.8 ± 3.1) L.min-1, (207 ± 42) g.cm-4.s-1vs (176 ± 36) g.cm-4.s-1, (14.3 ± 5.3) Ncm-2vs (9.6 ± 2.3) N.cm-2, (174 ± 27) mmHg vs (155 ± 26) mmHg, (16.9 ± 9.1) vs (22.9 ± 10.2), (1.07 ± 0.11) vs 1.17 ± 0.10), all P <0.01]. Conclusion CHF patients with elevated LDV, ER, OM, decreased myocardial compliance, microcirculation is an important factor leading to CHF.