儿茶酚胺左心房给药对左心房压与肺毛细血管楔压线性关系的影响

摘要

Objective To investigate the effect of left atrial catecholamine administration on the linear correlation of left atrium pressure (LAP) and pulmonary capillary wedge pressure (PCWP). Methods Thirty-two patients undergoing open heart operation were randomly allocated to two groups with 16 cases each. At the beginning of rewarming,dopamine and epinephrine were infused via left atriaKgroup A) or central vein (group B). The LAP, PCWP, mean arterial blood pressure (MAP), cardiac output(CO), pulmonary vascular resistance(PVR) and mean PAR (PAPm) were recored at 5 min(T1),10 min(T2),20 min(T3) and 40 min(T4) catacholamines pumping. Results The linear regression analysis showed that the r2 values of group A at T1, T2, T3 and T4 were all close to one (0.818,0.835,0.815 and 0.814),which of group B were remarkablly less than one(0.117,0.191, 0.178 and 0. 175). The MAP and CO were significantly higher, but PVR was lower, in group A than those in group B at Tl (P<0. 05). Conclusion Compared to infusion via central vein, left atrial catecholamine administration has less effect on the linear correlation of LAP and PCWP, which benefits to maintain stable hemodynamics.%目的 探讨心血管手术后儿茶酚胺给药途径对左心房压(LAP)与肺毛细血管楔压(PCWP)线性关系的影响.方法 32例心内直视手术患者随机均分为两组,复温时开始经左心房给药(A组)或中心静脉给药(B组).记录泵注儿茶酚胺类药后5 min(T1)、10 min(T2)、20 min(T3)和40 min(T4)时的LAP和PCWP、平均动脉压(MVP)、心排血量(C())、肺血管阻力(PVR)和肺动脉平均压(PAPM).结果 线性回归分析显示,A组T1、T2、T3和T4时的决定系数(r2)分别为:0.818、0.835、0.815和0.814,明显接近于1；而相应时间点B组的,分别为:0.117、0.191、0.178和0.175,明显小于1.T1时,A组MAP、CO明显高于B组(P＜0.05),PVR低于B组(P＜0.05).结论 经左心房途径给儿茶酚胺类药对LAP与PCWP的线性关系影响小,有利于维持血流动力学的稳定.