下腔静脉塌陷指数+中心静脉压在右心功能不全评估中的价值  

Value of Inferior Vena Cava Collapse Index+Central Venous Pressure in the Evaluation of Right Ventricular Dysfunction

作　　者：陈虎[1] CHEN Hu(Department of Critical Care Medicine,the Sixth People's Hospital of Kunshan City,Kunshan,Jiangsu Province,215300 China)

机构地区：[1]昆山市第六人民医院重症医学科,江苏昆山215300

出　　处：《系统医学》2021年第19期51-53,126,共4页Systems Medicine

摘　　要：目的探讨下腔静脉塌陷指数+中心静脉压在右心功能不全评估中的价值。方法选取2018年1月-2020年6月该院收治的右心功能不全患者72例,均行床旁超声监测,其中轻度肺动脉高压患者归入对照组(n=34),中重度肺动脉高压患者归入观察组(n=38)。比较两组的超声检查结果,分析下腔静脉塌陷指数、中心静脉压与相关超声监测指标的相关性。结果观察组的下腔静脉塌陷指数(0.14±0.06)、呼气末内径(24.93±3.57)cm、三尖瓣环收缩期速度(8.65±1.24)cm/s、三尖瓣环收缩期位移(1.78±0.49)mm低于对照组的(0.17±0.04)、(27.08±2.69)cm、(9.23±1.16)cm/s、(2.09±0.46)mm,差异有统计学意义(t=2.465、2.859、2.042、2.758,P<0.05);观察组的中心静脉压(11.49±2.65)mmHg、肺动脉压力(34.06±9.53)mmHg、肺血管阻力(4.57±1.13)wood高于对照组的(9.87±2.14)mmHg、(29.52±7.48)mmHg、(3.86±1.09)wood,差异有统计学意义(t=2.832、2.230、2.706,P<0.05);观察组的吸气末内径(21.86±2.57)cm、左室射血分数(35.67±2.19)%与对照组的(22.04±2.73)cm、(35.94±2.43)%比较,差异无统计学意义(t=0.288、0.496,P>0.05)。下腔静脉塌陷指数与呼气末内径、三尖瓣环收缩期速度、三尖瓣环收缩期位移呈正相关(r=0.626、0.613、0.634,P<0.05),与肺动脉压力、肺血管阻力呈负相关(r=-0.741、-0.734,P<0.05);中心静脉压与呼气末内径、三尖瓣环收缩期速度、三尖瓣环收缩期位移呈负相关(r=-0.602、-0.751、-0.742,P<0.05),与肺动脉压力、肺血管阻力呈正相关(r=0.675、0.662,P<0.05)。结论下腔静脉塌陷指数+中心静脉压可为医师评估右心功能不全患者病情提供有力参照,具有重要的临床应用价值。Objective To explore the value of inferior vena cava collapse index+central venous pressure in the evaluation of right ventricular insufficiency.Methods A total of 72 patients with right heart insufficiency who were admitted to the hospital from January 2018 to June 2020 were selected and all underwent bedside ultrasound monitoring.Among them,patients with mild pulmonary hypertension were included in the control group(n=34),and patients with moderate to severe pulmonary hypertension were included in the control group(n=34).The patients were classified into the observation group(n=38),the ultrasound examination results of the two groups were compared,and the correlation between the inferior vena cava collapse index,central venous pressure and related ultrasound monitoring indicators was analyzed.Results In the observation group,the inferior vena cava collapse index(0.14±0.06),end-expiratory diameter(24.93±3.57)cm,tricuspid annulus systolic velocity(8.65±1.24)cm/s,tricuspid annulus systolic displacement(1.78±0.49)mm were lower than the control group(0.17±0.04),(27.08±2.69)cm,(9.23±1.16)cm/s,(2.09±0.46)mm,the difference was statistically significant(t=2.465,2.859,2.042,2.758,P<0.05);central venous pressure(11.49±2.65)mmHg,pulmonary artery pressure(34.06±9.53)mmHg,and pulmonary vascular resistance(4.57±1.13)wood in the observation group were higher than those in the control group(9.87±2.14)mmHg,(29.52±7.48)mmHg,(3.86±1.09)wood,the difference was statistically significant(t=2.832,2.230,2.706,P<0.05);the inhalation of the observation group The end inner diameter(21.86±2.57)cm and left ventricular ejection fraction(35.67±2.19)%compared with the control group(22.04±2.73)cm and(35.94±2.43)%,the difference was not statistically significant(t=0.288,0.496,P>0.05).Inferior vena cava collapse index was positively correlated with end-expiratory diameter,tricuspid annulus systolic velocity,and tricuspid annulus systolic displacement(r=0.626,0.613,0.634,P<0.05),it was negatively correlated with pulmonary artery

关 键 词：超声 中心静脉压 下腔静脉塌陷指数 右心功能不全 肺动脉高压 

分 类 号：R541[医药卫生—心血管疾病]