PICCO监测下全心舒张末容积指数与血浆NTproBNP含量的关系探讨  

Exploration on the relationship between plasma concentration of NTproBNP and global end diastolic volume index under pulse indicator continuous cardiac output monitoring

作　　者：沈亚伟[1] 纪宗淑[2] 张玲[2] 

机构地区：[1]安徽医科大学第四附属医院,安徽230000 [2]安徽医科大学第一附属医院

出　　处：《内科急危重症杂志》2014年第2期103-105,共3页Journal of Critical Care In Internal Medicine

基　　金：安徽医科大学校基金资助项目(No:2012xkj094)

摘　　要：目的:探讨脉搏指示连续心输出量监测系统(PICCO)监测下全心舒张末容积指数与血浆NTproBNP含量的相关性及干扰因素。方法:利用PICCO记录36例全心舒张末容积指数(GEDVI)、胸腔内血容量(ITBVI)、血管外肺水(EVLWI)等血流动力学指标,在进行液体管理前后测定血浆NTproBNP含量,与相应的血流动力学指标比较。结果:36例患者血浆NTproBNP含量与对应的GEDVI无显著相关性(r=0.247,P=0.146),但ΔNTproBNP(2次血浆NTproBNP含量差值)与对应的ΔGEDVI(2次GEDVI差值)存在显著相关性(r=0.444,P=0.007)。非机械通气状态下血浆NTproBNP含量与对应的GEDVI则存在显著相关性(r=0.48,P=0.007)。年龄、APACHEⅡ、HR、ΔEVLWI、ΔSVRI与ΔNTproBNP无显著相关性。ΔITBVI、ΔSVI、ΔCFI、ΔCVP与ΔNTproBNP存在显著相关性。结论:连续监测血浆NTproBNP含量的变化将更能准确反映血容量状态。Objective ： To explore the relationship between plasma concentration of NTproBNP and global end diastolic volume index （GEDVI） under pulse indicator continuous cardiac output （PICCO） monitoring and its interference factors. Methods： GEDVI, intrathoracic blood volume index （ITBVI） and extravascular lung water index （EVLWI） were recorded under PICCO system in 36 cases. Plasma concentration of NTproBNP were detected, and compared with those correlated hemodynamic indexes. Results ： Plasma concentration of NTproBNP was not correlated with GEDVI （r =0.247, P =0. 146）, but the changes in NTproBNP （ANTproBNP） showed significant correlation with changes in GEDVI （AGEDVI） （ r = 0. 444, P = 0. 007）. Plasma concentration of NTproBNP showed significant correlation with GEDVI in patients without mechanical ventilation （ r= 0.48, P = 0. 007）. Variables including Age, APACHE 1I , HR, AEVLWI and ASVRI were not correlated with ANTproBNP. Other variables such as AITBVI, ASVI,ACFI and ACVP were significantly correlated with ANTproBNP. Conclusion： Plasma concentration of NTproBNP can indicate the blood volume, and continuous detections of plasma concentration of NTproBNP may be an accurately tool for monitoring volume status.

关 键 词：N端脑钠肽前体 全心舒张末容积指数 血容量 

分 类 号：R541[医药卫生—心血管疾病]