间歇热稀释法与间接Fick法测定肺动脉高压患者心排出量结果的比较

摘要

Objective: To canpare the consistency of the cardiac outputs between intermittent therm odilution method and indirect Fick method in patients with pulmonary hypertension.Methods: Cardiac outputs were measured by both intermittent thermodilution method and indirect Fick method in79 patients includingl8 male and 61 female with the mean age of(36±10) years The correlation between two methods was determined with Pearson correlation coefficient the consistency of two methods was analyzed as described by Bland and Altman According to the result of Fick method, the patients were divided into Low cardiac output group, n=23, with cardiac output≤3L/min and Normal cardiac output group,n=56, with cardiac output＞3 L/min for further investigation.Results: The cardiac output was3. 60±l. 16(1.88 -7.05)L/min as measured by thermodilution method and3. 56±1. 12 (1. 90 ～6. 88) L/min by Fick method, the difference between two methods was (0. 04 ±0. 70) L/min and the correlation coeffi-cientr=0. 81 ,P＜0. 01. The patients in Low cardiac output group had 2. 76±0. 65(1. 9 ～ 4. 5)L/min by thermodilution method and 2. 46±0. 26(1. 9 ～3.0) L/min by Fick method, the difference between two methods was(0. 3±0. 59) L/min, r=0. 45, P＜0.01. The patient inNormal cardiac output group had 3.95±l. 15 (2. 23～7. 05)L/min by thermodilution method and 4.01± 1.01(3. 01 ～6. 88) L/min by Fick method, the difference between two methods was (-0. 07±0. 73 ) L/min,r=0. 78,P＜0. 01.Conclusion: The caidiac outputs measured by intermittent thermodilution method and indirect Fickmethod was not so consistent in patients with pulmonary hypertension.%目的:比较间歇热稀释法与间接Fick法测定肺动脉高压患者心排出量结果的一致性.方法:79例患者,男性18例,女性61例,平均年龄(36±10)岁.其中特发性肺动脉高压41例,先天性心脏病相关性肺动脉高压12例,结缔组织病相关性肺动脉高压12例,慢性血栓栓塞性肺动脉高压5例,其他肺动脉高压9例.上述患者同时采用间歇热稀释法与间接Fick法测定心排出量,对两种方法的测定结果进行了相关分析及Bland-Altman一致性分析.然后根据间接Fick法测定结果将患者分为低心排出量组和正常心排出量组,并重新进行上述相关分析及一致性分析.结果:间歇热稀释法心排出量3.60±1.16(1.88～7.05)L/min,间接Fick法心排出量3.56±1.12(1.90～6.88)L/min,差值(间歇热稀释法-间接Fick法)为(0.04±0.70)L/min;两种方法心排出量相关分析得r=0.81(P<0.01).低心排出量组(n=23,心排出量≤3 L/min):间歇热稀释法心排出量2.76±0.65(1.9～4.5)L/min,间接Fick法心排出量2.46±0.26(1.9～3.0)L/min,差值为(0.3±0.59)L/min;两种方法心排出量相关分析得r=0.45(P<0.01).正常心排出量组(n=56,心排出量>3 L/min):间歇热稀释法心排出量3.95±1.15(2.23～7.05)L/min,间接Fick法心排出量4.01±1.01(3.01～6.88)L/min;差值为(-0.07±0.73)L/min;两种方法心排出量相关分析得r=0.78(P<0.01).结论:间歇热稀释法与间接Fick法测定肺动脉高压患者的心排出量一致性欠佳.两种方法测定结果不能互换.