静息与充血状态下主动脉血流动力学指标定量关系的研究  

The quantitative relationship between resting and hyperemic aortic hemodynamic parameters

作　　者：马俊玲 李娜 吴若婷 李鲍 刘健[3] 刘有军[1] MA Junling;LI Na;WU Ruoting;LI Bao;LIU Jian;LIU Youjun(College of Chemistry and Life Science,Beijing University of Technology,Beijing 100124;College of Radiology,Shandong First Medical University&Shandong Academy of Medical Sciences,Taian,Shandong Province 271016;Department of Cardiology,Peking University People’s Hospital,Beijing 100044)

机构地区：[1]北京工业大学化学与生命科学学院,北京100124 [2]山东第一医科大学(山东省医学科学院)放射学院,山东泰安271016 [3]北京大学人民医院心血管内科,北京100044

出　　处：《北京生物医学工程》2024年第6期584-591,共8页Beijing Biomedical Engineering

基　　金：国家自然科学基金(11832003、32271361、12202022、12102014)资助。

摘　　要：目的探究静息与充血状态下主动脉血流动力学指标的定量关系可以为血流储备分数(fractional flow reserve,FFR)无创数值计算中充血状态的模拟提供理论支持。方法入组109名冠心病患者,经FFR导管检查,提取静息与充血状态下5个周期的主动脉压力波形,并记录平均动脉压(mean arterial pressure,MAP)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)及心率(heart rate,HR)4个主动脉血流动力学指标。随后将患者随机分为测试组(89人)和验证组(20人),测试组通过方差分析方法检验静息与充血状态下MAP、SBP、DBP、HR均值的差异显著性。静息与充血状态下各指标间的关系表示为充血指标与静息指标的比率。验证组通过均方误差分析对测试组统计结果加以验证。最后通过仿真计算FFR值来验证统计结果的可靠性。结果充血状态下,测试组MAP、SBP、DBP分别降低了(18.79±10.51)mmHg(1 mmHg=133.3 Pa)、(25.30±14.84)mmHg、(13.69±7.76)mmHg,HR升高了(9.82±10.95)次/min。MAP、SBP、DBP、HR充血与静息状态下的比率分别为0.82、0.82、0.82、1.1。验证组MAP、SBP、DBP、HR均方误差分别为0.08、0.05、0.09、0.03(均<10%)。采用本研究统计结果来模拟充血状态计算FFR准确性为86.7%。结论研究结果可以为FFR无创数值计算中建模提供理论支持。Objective To study the quantitative relationship between aortic hemodynamic parameters in resting and hyperemic states can provide theoretical support for the simulation of hyperemia in non-invasive numerical calculation of fractional flow reserve(FFR).Methods 109 patients with coronary heart disease were enrolled in the study.After FFR catheterization,aortic pressure waveforms were extracted for five cycles under resting state and hyperemia state,and four aortic hemodynamic parameters including mean arterial pressure(MAP),systolic blood pressure(SBP),diastolic blood pressure(DBP) and(heart rate) HR were recorded.Patients were randomly divided into a test group(89 patients) and a validation group(20 patients),and the significance of the differences in MAP,SBP,DBP and HR mean values between resting state and hyperemia state in the test group was tested by analysis of variance.The relationship between the four physiological indexes in the state of resting and hyperemia was expressed as the ratios of hyperemia indexes to resting indexes.The validation group used mean square error analysis to verify the results of the test group.Finally,the FFR value was calculated by simulation to verify the reliability of the statistical results.Results Under the condition of hyperemia,MAP,SBP,DBP decreased by(18.79±10.51) mmHg,(25.30±14.84) mmHg,(13.69±7.76) mmHg respectively,and HR increased by(9.82±10.95) times/min in the test group.The ratios of MAP,SBP,DBP and HR at hyperemia and rest were 0.82,0.82,0.82 and 1.1,respectively.The mean square error of MAP,SBP,DBP and HR in the validation group were 0.08,0.05,0.09 and 0.03(all within 10%).The accuracy of FFR calculated using the statistical results of this study to simulate the hyperemic state was 86.7%.Conclusions The results can provide theoretical support for the modeling in non-invasive numerical calculation of FFR.

关 键 词：主动脉血流动力学指标 静息状态 充血状态 血流储备分数 无创数值计算 

分 类 号：R318[医药卫生—生物医学工程]