阻抗心动描记法对急性ST段抬高型心肌梗死患者心功能的评价  

Evaluate the cardiac function of patients with acute ST segment elevation myocardial infarction by using impedance cardiography

作　　者：梁日明[1] 余亚仁 梁茜[1] 蔡炜标[1] 张健瑜[1] 岑锦明[1] 杨希立[1] LIANG Ri-ming(Department of Cardiology,the first affiliated hospital of Foshan,Foshan,Guangdong,528000,China)

机构地区：[1]佛山市第一人民医院心内科,广东佛山528000

出　　处：《齐齐哈尔医学院学报》2020年第17期2174-2176,共3页Journal of Qiqihar Medical University

基　　金：2016年佛山市医学类科技攻关项目(2016AB001901)。

摘　　要：目的观察心阻抗血流图(ICG)对急性ST段抬高型心肌梗死(STEMI)患者心功能的反映能力。方法选择2018年1月—2019年6月本院急诊科收治的诊断为急性ST段抬高型心肌梗死的患者132例作为研究对象,应用无创血流动力学监测仪测量术后24 h心率(HR)、血压(BP)、心排量(CO)心指数(CI)、搏出量(SV)、搏出指数(SI)、外周血管阻力(SVR)、外周血管阻力指数(SVRI)、左心做功(LCW)、左心做功指数(LCWI)、胸腔液体水平(TFC)、加速指数(ACI)、速度指数(VI)、预射血时间(PEP)、左心室射血时间(LVET)、收缩时间比率(STR)以及患者血清的氨基末端脑钠肽前体(NT-proBNP)、心肌肌钙蛋白T(cTnT)。结果NT-proBNP与SV、SI、CO、CI、LVET呈负相关而SVR、SVRI、PEP和STR呈正相关。cTnT与SV、SI、CO和LVET呈负相关,但与SVR和SVRI呈正相关。结论急性心肌梗死患者早期可出现心功能减退,ICG数据可以反映急性心肌梗死患者早期心功能情况,结合血液NT-proBNP、cTnT以及ICG更能准确得评估心功能。Objective To evaluate the capability of impedance cardiography(ICG)in reflecting the cardiac functions of patients with acute ST segment elevation myocardial infarction(STEMI).Methods 132 cases of patients those admitted to department of emergency of our hospital during the period January 2018 to June 2016 and were diagnosed as acute STEMI were enrolled as study subjects.The heart rate(HR),blood pressure(BP),cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke index(SI),systemic vascular resistance(SVR),systemic vascular resistance index(SVRI),left heart work(LCW),left heart work index(LCWI),thorax fluid capacity(TFC),acceleration index(ACI),velocity index(VI),pre-ejection period(PEP),left ventricular ejection time(LVET)and systolic time ratio(STR)were measured 2 days after surgery by using Non-invasive hemodynamic monitor,and the concentrations of N-terminal brain-type natriuretic peptide(NT-proBNP)and c troponin-T(cTnT)in serum were detected.Results Our results indicated NT-proBNP was negatively correlated to SV,SI,CO,CI and LVET,while it was positively correlated to SVR,SVRI,PEP and STR.cTnT was negatively correlated to SV,SI,CO,and LVET,however,it was positively correlated to SVR and SVRI.Conclusions Early cardiac dysfunction could be monitored in patients with acute myocardial infarction,ICG data could reflect the early cardiac functions of AMI patients,and the accuracy of evaluating cardiac functions will be raised by combining the detection of blood NT-proBNP,cTnT and ICG.

关 键 词：阻抗心动描记法 急性心肌梗死 脑钠素 无创血流动力学检测 

分 类 号：R541.4[医药卫生—心血管疾病]