基于集中参数模型的左心室辅助装置血流动力学仿真  

Hemodynamic recovery from heart failure with left ventricular assist device: a lumped-parameter simulation

作　　者：肖大伟[1] 徐博翎 

机构地区：[1]苏州大学机电工程学院,江苏苏州215001

出　　处：《北京生物医学工程》2016年第4期367-373,380,共8页Beijing Biomedical Engineering

基　　金：国家自然科学基金(81471754)资助

摘　　要：目的新一代植入式心室辅助装置(ventricular assist device,VAD)采用旋转式血泵(rotary blood pumps)技术,目前已成为治疗严重心力衰竭的重要手段,因而研究VAD与人体间的生理相互作用机制有着重要的意义。本研究通过在Matlab Simulink环境中建立人体心血管循环系统的集中参数数学模型,模拟左心衰患者在植入左心室辅助装置(left ventricular assist device,LVAD)后,循环系统的血流动力学特性。方法通过弹性腔和电路原理建立集中参数模型,主要包括心脏、肺循环、体循环、冠状动脉循环。调整模型的输入值使得模型的仿真结果符合设定的目标值。结果仿真结果证实LVAD可以使心衰患者的总心排量恢复正常,同时对于心脏有明显的除负荷效果、增加冠脉血流量并降低肺动脉楔压,因此可以缓解心衰末期患者重要器官供血不足、心肌缺氧以及肺水肿等并发症。同时通过改变左心室辅助装置的转速,末期左心衰患者可以恢复一定的运动能力。结论 CAMSIM集中参数模型符合人体血液循环特点。模型仿真结果证实了LVAD对心衰的辅助作用。Objective Implantable left ventricular assist devices （LVAD） are mostly rotary blood pumps and have become a viable therapeutic option for end-stage heart failure patients in developed countries at present. It is important to understand the global hemodynamic response of the LVAD and the human cardiovascular system. Therefore, a lumped-parameter model has been established in Matlab Simulink environment to simulate the hemodynamic response of a heart failure patient with an LVAD. Methods The baseline （ healthy and severe heart failure） results of the model are verified with clinical data in literature. The post-LVAD-implantation results demonstrate the recovery of cardiac output and coronary perfusion,unloading of the left ventricle, and reduction in pulmonary wedge pressure. Results The LVAD can effectively offer blood perfusion to the vital organs and alleviate the risk of pulmonary edema. Furthermore,by increasing pump speed, the exercise capability of the patient subject can be recovered. Conclusions CAMSIM lumped-parameter model is in line with the hemodynamie characteristics. Model simulation results confirm an LVAD auxiliary function of heart failure.

关 键 词：左心室辅助装置 集中参数模型 仿真 血流动力学 

分 类 号：R318.04[医药卫生—生物医学工程]