P_(ET)CO_(2)联合被动抬腿实验对高血压脑出血容量反应性的预测价值  

The predictive value of P_(ET)CO_(2)combined with passive leg raising for volume responsiveness in patients with hypertensive intracerebral hemorrhage

作　　者：杨征[1] 陈彦飞[1] 周斌[1] 李常伟[1] 罗晨[1] 王挺厅 YANG Zheng;CHEN Yanfei;ZHOU Bin;LI Changwei;LUO Chen;WANG Tingting(Department of Neurosurgery,Jiashan First People's Hospital,Jiashan 314100,China)

机构地区：[1]嘉善县第一人民医院神经外科,314100

出　　处：《心电与循环》2023年第5期485-488,共4页Journal of Electrocardiology and Circulation

摘　　要：目的探讨呼气末二氧化碳分压(P_(ET)CO_(2))联合被动抬腿实验(PLR)对高血压脑出血患者容量反应性的预测价值。方法选取2018年1月至2019年12月在嘉善县第一人民医院住院治疗的84例高血压脑出血患者为研究对象,根据补液后每搏量变化率(ΔSV%)判断有容量反应(≥10%)36例,无容量反应(<10%)48例。比较有、无容量反应患者PLR前后P_(ET)CO_(2)差值(P_(ET)CO_(2))、ΔSV%,采用ROC曲线分析这两项指标单独及联合检测对高血压脑出血患者容量反应性的预测效能。结果有容量反应患者PLR前后ΔP_(ET)CO_(2)、ΔSV%均明显高于无容量反应患者,差异均有统计学意义(均P<0.05)。PLR前后ΔP_(ET)CO_(2)、ΔSV%及两项联合预测高血压脑出血患者容量反应性的AUC分别为0.876、0.868和0.957,其中两项联合检测的预测效能明显高于ΔP_(ET)CO_(2)、ΔSV%单独检测,差异均有统计学意义(均P<0.05)。结论P_(ET)CO_(2)联合PLR对高血压脑出血患者容量反应性具有较高的预测价值。Objective To explore the predictive value of end-expiratory carbon dioxide partial pressure(P_(ET)CO_(2))combined with passive leg raising(PLR)for volume responsiveness in patients with hypertensive intracerebral hemorrhage(HICH).Methods Eithty-four HICH patients admitted to Jiashan First People's Hospital from January 2018 to December 2019 were selected as the study subjects.Among them,36 cases had volume response(≥10%)and 48 cases had no volume response(<10%)based on the percentage change in stroke volume per beat(ΔSV%)after fluid challenge.The difference of P_(ET)CO_(2)(ΔP_(ET)CO_(2))andΔSV%before and after PLR were compared between patients with and without volume response.ROC curve analysis was used to analyze the predictive efficacy of individual and combined detection of these two parameters on volume responsiveness in patients with HICH.ResultsΔP_(ET)CO_(2)andΔSV%were significantly higher after PLR in patients with volume response than patients without volume response(all P<0.05).The AUC ofΔP_(ET)CO_(2),ΔSV%and the combination of these two parameters for predicting volume response in patients with HICH were 0.876,0.868,and 0.957,respectively.The predictive efficacy of the combined test ofΔP_(ET)CO_(2)andΔSV%was significantly higher than that of each test(all P<0.05).Conclusion P_(ET)CO_(2)combined with PLR shows a higher predictive value for volume responsiveness in patients with HICH.

关 键 词：呼气末二氧化碳分压 被动抬腿实验 高血压脑出血 容量反应性 

分 类 号：R544.1[医药卫生—心血管疾病] R743.34[医药卫生—内科学]