漂浮导管和猪尾导管测量肺血管血流动力学参数的比较  

Comparative study of pulmonary vascular hemodynamic parameters measured by Swan-Ganz catheter and pigtail catheter

作　　者：金旗[1] 赵智慧[1] 罗勤[1] 曾绮娴[1] 杨涛[1] 禹雪[1] 晏露 张毅[1] 熊长明 柳志红[1] JIN Qi;ZHAO Zhi-hui;LUO Qin;ZENG Qi-xian;YANG Tao;YU Xue;YAN Lu;ZHANG Yi;XIONG Changming;LIU Zhi-hong(Center for Pulmonary Vascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院阜外医院肺血管病中心,北京100037

出　　处：《岭南心血管病杂志》2021年第1期99-104,共6页South China Journal of Cardiovascular Diseases

基　　金：国家自然科学基金面上项目(项目编号:81370326,81641005)。

摘　　要：目的比较漂浮导管和猪尾导管测量肺血管血流动力学参数的差异及一致性。方法入选2018年9月21日至2018年11月30日中国医学科学院阜外医院肺血管病中心疑诊"肺动脉高压"的患者64例,比较漂浮导管和猪尾导管先后测量肺血管血流动力学参数的差异,并进行相关性分析和Bland-Altman一致性分析。结果漂浮导管测量的右心房压a波[(7.8±4.6)mmHg vs.(8.8±4.4)mmHg,P=0.018](1 mmHg=0.133 kPa)、右心室收缩压[(69.3±21.4)mmHg vs.(81.3±22.6)mmHg,P<0.001]和肺动脉收缩压[(71.7±21.6)mmHg vs.(80.6±23.6)mmHg,P<0.001]数值均比猪尾导管测量的数值低,而右心房平均压[(5.9±4.0)mmHg vs.(5.0±3.8)mmHg,P=0.01]、右心室舒张压[(10.1±7.2)mmHg vs.(-3.6±6.4)mmHg,P<0.001]、右心室舒张末压[(14.2±8.5)mmHg vs.(10.1±5.9)mmHg,P<0.001]、肺动脉舒张压[(38.7±14.2)mmHg vs.(31.6±12.7)mmHg,P<0.001]和肺动脉平均压[(52.2±16.4)mmHg vs.(48.2±15.5)mmHg,P<0.001]数值均比猪尾导管测量的数值高,差异有统计学意义;两者测量的肺动脉平均压相关性最强(R^(2)=0.946,P<0.001),但两者测量结果一致性较差。结论漂浮导管和猪尾导管测量的肺血管血流动力学参数间存在显著性差异,尽管相关性较好,但一致性差,结果不能互换。Objectives To compare the differences and consistency of pulmonary vascular hemodynamic parameters measured by Swan-Ganz catheters and pigtail catheters.Methods Sixty-four patients suspected of pulmonary hypertension in the Center for Pulmonary Vascular Diseases,Fuwai Hospital from September 21 st,2018 to November 30 th,2018 were enrolled.Pulmonary hemodynamic parameters measured by Swan-Ganz catheters and pigtail catheters were compared,and correlation analysis and Bland-Altman consistency analysis were also performed.Results The values of a-wave of right atrial pressure[(7.8±4.6)mmHg vs.(8.8±4.4)mmHg,P=0.018](1 mmHg=0.133 kPa),right ventricular systolic pressure[(69.3±21.4)mmHg vs.(81.3±22.6)mmHg,P<0.001],and pulmonary artery systolic pressure[(71.7±21.6)mmHg vs.(80.6±23.6)mmHg,P<0.001]measured by Swan-Ganz catheters were lower than those measured by pigtail catheters,while mean right atrial pressure[(5.9±4.0)mmHg vs.(5.0±3.8)mmHg,P=0.01],right ventricular diastolic pressure[(10.1±7.2)mmHg vs.(-3.6±6.4)mmHg,P<0.001],right ventricular end-diastolic pressure[(14.2±8.5)mmHg vs.(10.1±5.9)mmHg,P<0.001],pulmonary artery diastolic pressure[(38.7±14.2)mmHg vs.(31.6±12.7)mmHg,P<0.001]and mean pulmonary artery pressure[(52.2±16.4)mmHg vs.(48.2±15.5)mmHg,P<0.001]were significantly higher than those measured by pigtail catheters.The correlation between mean pulmonary arterial pressure was the strongest(R^(2)=0.946,P<0.001),but the consistency between measurements was poor.Conclusions There are significant differences in pulmonary hemodynamic parameters measured by Swan-Ganz catheters and pigtail catheters.Although the correlation is relatively good,their consistency is poor,thus the results are not interchangeable.

关 键 词：漂浮导管 猪尾导管 肺动脉高压 血流动力学 

分 类 号：R540.46[医药卫生—心血管疾病]