目的：探讨下腔静脉塌陷指数（ cIVC）预测自主呼吸条件下急性循环衰竭患者的容量反应性。方法选取60例有自主呼吸的急性循环衰竭患者，根据补液后主动脉流速时间指数（ VTI）的变化分组，VTI≥15％为有反应组（30例），VTI＜15％为无反应组（30例），根据相应的 cIVC 绘制受试者工作特征曲线（ ROC曲线），然后再使用ROC曲线评估cIVC对容量反应性的预测价值。结果有反应组和无反应组补液前后VTI分别为（12.5±4.2） cm、（15.9±4.1） cm；补液前 IVC的呼吸变异度分别为（23.1±18.3）％、（24.7±19.1）％，两组比较差异均有统计学意义（P ＜0.01）。 cIVC 预测急性循环衰竭患者容量液体反应性的 ROC 曲线下的面积为0.843（95％CI 0.62～0.84），最佳界值为40％，特异度为68％，灵敏度为71％。结论对于有自主呼吸的急性循环衰竭患者，cIVC ＞40％可能提示有容量反应性，可予积极液体复苏。而cIVC＜40％，补液需慎重。%Objective To discuss using the collapse index of inferior vena cava ( cIVC ) to predict capacity responsiveness in patients with acute circulatory failure under spontaneous respiration .Methods A total of 60 patients with acute circulatory failure under spontaneous respiration were included in this study . They were grouped according to the volume time index ( VTI) of aorta after fluid infusion,VTI≥15% as responsive group(30 cases),VTI <15%,as non-responsive group(30 cases),and then receiver operating characteristic ( ROC) curve was drawn according to cIVC,and the ROC was used to evaluate the predictive value of cIVC for capacity responsiveness.Results VTI of the responsive group and non-responsive group before and after the fluid infusion were (12.5 ±4.2) cm,(15.9 ±4.1) cm respectively;IVC respiration variations before fluid infusion were (23.1 ±18.3)%,(24.7 ±19.1)% respectively,and the difference between the two groups was statistically significant(P<0.01).The area below the ROC curve of cIVC pre-dicting capacity responsiveness in patients with acute circulatory failure was 0.843 (95%CI 0.62-0.84), with an optimal field value of 40%, a specificity of 68%, and a sensitivity of 71%.Conclusion In the patients of acute circulatory failure with spontaneous breathing , capacity responsiveness may be positive if cIVC >40%,in which cases,active fluid infusion can be used .If cIVC is <40%,fluid infusion needs to be cautious.
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