无创血流动力学监测对老年隐性心力衰竭的诊断意义

摘要

Objective To study the significance of noninvasive hemodynamic monitoring in elderly recessive heart failure diagnosis.Methods Fifty hospitalized elderly patients were selected.The plasma brain natriuretic peptide precursor(NT-ProBNP) concentration was measured.NT-ProBNP 450 ng/L was regarded as a critical value for typical heart failure group and subclinical heart failure group.The stroke volume(SV),stroke index(SI),cardiac output(CO),cardiac index (CI),acceleration index (ACI),velocity index (VI),thoracic fluid content (TFC),systolic time ratio(STR) were measured.Results Typical heart failure group were significantly lower than the subclinical heart failure group in SV,SI,CO,CI,ACI,VI [(59 ± 6) ml vs (83 ± 5) ml,(32 ± 3) ml/m2 vs (51 ±4)ml/m2,(3.1 ±0.8)L/min vs (5.7 ± 1.2)L/min,(2.0 ±0.5)L/(min · rn2) vs (3.2 ±0.8)L/(min · m2),(58 ± 15) vs (76 ±28),(30 ± 13) vs (45 ± 10)],and the SVRI,SVR,TFC,STR were higher than those in subclinical heart failure group[(3145 ± 1100) dyn/(s · cm5 · m2) vs (2018 ± 298) dyn/(s · cm5 · m2),(1802 ± 654) dyn · s/(cm5 · m2) vs (1234 ± 321) dyn · s/(cm5 · m2),(54 ± 7) kΩ vs (33 ± 6) kΩ,(0.50 ± 0.22) vs (0.31±0.21)],and there were significant differences (all P ＜ 0.05).Conclusion Noninvasive hemodynamic monitoring in elderly recessive heart failure diagnosis has an important value.%目的 探讨无创血流动力学监测对老年隐性心力衰竭的诊断意义.方法 选择住院老年患者50例,测量其血浆脑钠肽前体(NT-ProBNP)浓度,以NT-ProBNP 450 ng/L作为典型心力衰竭组与隐性心力衰竭组的临界值.采用无创血流动力学监测系统测量2组患者每搏输出量(SV)、每搏指数(SI)、每分输出量(CO)、心脏指数(CI)、加速指数(ACI)、速度指数(VI)、胸腔体液水平(TFC)、收缩时间比(STR)等并加以比较.结果 典型心力衰竭组SV、SI、CO、CI、ACI、VI值明显低于隐性心力衰竭组[(59±6)ml比(83±5) m1,(32±3)ml/m2比(51 ±4)ml/m2,(3.1 ±0.8)L/min比(5.7±1.2)L/min,(2.0 ±0.5)L/(min ·m2)比(3.2 ±0.8)L/(min·m2),(58±15)比(76±28),(30±13)比(45±10)],SVRI、SVR、TFC、STR明显高于隐性心力衰竭组[(3145±1100)dyn/(s·cm5· m2)比(2018±298) dyn/(s·cm5· m2),(1802±654) dyn· s/(cm5· m2)比(1234±321)dyn·s/(cm5·m2),(54±7)kΩ比(33±6)kΩ,(0.50±0.22)比(0.31±0.21)],差异均有统计学意义(均P＜0.05).结论 无创血流动力学监测对评价老年隐性心力衰竭具有重要价值.