无创血流动力学与衰弱的相关性研究  

Correlation between non-invasive hemodynamics and frailty

作　　者：贺林锋 戚本玲[1] 刘丽华[1] 白丽娟[1] 王瑞云 刘赟 王倩[1] 王耀羚 HE Linfeng;QI Benling;LIU Lihua;BAI Lijuan;WANG Ruiyun;LIU Yun;WANG Qian;WANG Yaoling(Department of Geriatrics,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院老年病科,武汉430022

出　　处：《临床心血管病杂志》2021年第12期1133-1136,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金面上项目(No:81571373);国家自然科学基金青年项目(No:81601217、82001491);湖北省自然科学基金(No:2017CFB627);武汉协和医院科学研究基金(No:2019)。

摘　　要：目的:探讨阻抗微分心动图(ICG)评价衰弱患者心功能的价值及血流动力学参数与衰弱的相关性。方法:收集2017年6月—2017年9月于我院老年病科住院,同时进行过衰弱评估、超声心动图(CCU)及ICG检查的69例患者的临床资料。根据衰弱评估结果,将患者分为无衰弱组、衰弱前期组及衰弱组,评价3组间的心输出量(CO)、心脏指数(CI)、每搏输出量(SV)、每搏输出指数(SVI)、每搏外周阻力(SSVR)、每搏外周阻力指数(SSVRI)、左心做功(LSW)、左心做功指数(LSWI)、左心室射血分数(LVEF)以及B型钠尿肽(BNP)。结果:无衰弱组、衰弱前期组、衰弱组间CO[(4.96±1.93)、(3.28±1.04)、(2.69±0.78)L/min,P<0.01]与SSVR[(287.56±82.57)、(382.09±88.57)、(551.29±209.40)dyne·cm^(-5)·m^(-2),P<0.01]差异具有统计学意义,LVEF[(64.29±3.50)%、(63.43±5.48)%、(60.13±10.98)%,P=0.19]差异无统计学意义。Pearson相关分析显示,CO(r=-0.30,P=0.01)、CI(r=-0.34,P<0.01)、SVI(r=-0.33,P<0.01)、LSW(r=-0.26,P=0.04)、LSWI(r=-0.29,P=0.02)与FRAIL评分呈负相关,SSVR(r=0.40,P<0.01)、SSVRI(r=0.36,P<0.01)与FRAIL评分呈正相关,LVEF(r=-0.17,P=0.17)与FRAIL评分相关性差。结论:ICG参数与FRAIL评分显著相关,无创血流动力学具有评价衰弱患者心功能的作用,并且优于CCU。Objective:To investigate the value of impedance cardiography(ICG)in evaluating cardiac function in patients with frailty and the correlation between hemodynamic parameters and frailty.Methods:The clinical data of 69 patients who were admitted to Department of Geriatrics in our hospital from June 2017 to September 2017 and underwent frailty assessment,echocardiography(CCU),and ICG examination were collected.Patients were divided into the non-frailty group,pre-frailty group,and frailty group according to the frailty assessment results.Cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke volume index(SVI),stroke systemic vascular resistance(SSVR),stroke systemic vascular resistance index(SSVRI),left stroke work(LSW),left stroke work index(LSWI),left heart ejection fraction(LVEF),and brain natriuretic peptide(BNP)were compared among the three groups.Results:Among the non-frailty group,pre-frailty group,and frailty group,there were significant differences in CO([4.96±1.93],[3.28±1.04],[2.69±0.78]L·min^(-1),P<0.01)and SSVR([287.56±82.57],[382.09±88.57],[551.29±209.40]dyne·cm^(-5)·m^(-2),P<0.01),while there was no significant difference in LVEF([64.29±3.50]%,[63.43±5.48]%,[60.13±10.98]%,P=0.19).Pearson correlation analysis revealed that CO(r=-0.30,P=0.01),CI(r=-0.34,P<0.01),SVI(r=-0.33,P<0.01),LSW(r=-0.26,P=0.04),and LSWI(r=-0.29,P=0.02)were negatively correlated with FRAIL score,while SSVR(r=0.40,P<0.01)and SSVRI(r=0.36,P<0.01)were positively correlated with FRAIL score,LVEF(r=-0.17,P=0.17)had poor correlation with FRAIL score.Conclusion:ICG parameters are significantly correlated with FRAIL score,while non-invasive hemodynamics has a role in evaluating cardiac function in patients with frailty,which is better than echocardiography.

关 键 词：衰弱 无创血流动力学 阻抗微分心动图 超声心动图 

分 类 号：R541[医药卫生—心血管疾病]