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[肺心病患者血流动力学、血气及血液流变学监测的临床研究]

[Clinical study on hemodynamics, blood gases and hemorheologic monitoring of patients with cor pulmonale].

作者信息

Jin W Y

出版信息

Zhong Xi Yi Jie He Za Zhi. 1989 Sep;9(9):522-5, 514.

PMID:2598357
Abstract

14 patients of cor pulmonale in convalescent stage were studied with Swan-ganze catheter technique. The pulmonary arterial pressure, cardiac output, arterial blood gases, transcutaneous gases tension and hemorrheologic measurement were monitored simultaneously at definite intervals within 24 hours. The results showed that the mean value of the pulmonary arterial pressure (MPAP), arterial carbon dioxide tension (PaCO2), transcutaneous carbon dioxide tension (tcPCO2), hematocrit(H), whole blood viscosity (eta b) and plasma viscosity (eta p) were higher at night than those at daytime. While the value of cardiac output (CO), arterial oxygen tension (PaO2) and transcutaneous oxygen tension (tcPO2) showed a converse result, most of them showed more predominant at daytime and tended to be lowered at night. The MPAP in some of convalescent patients might decrease to normal, but in the pulmonary hypertension group [MPAP greater than or equal to 2.66 Kpa (20 mmHg)] the day and night measurements of MPAP, CO, PaO2, PaCO2, tcPO2, tcPCO2 were fluctuate more obviously than in normal group (P less than 0.01). The day and night hemorrheologic measurements such as H, eta b, eta p etc. showed that the blood viscosity increased more significantly at night than at daytime. The cardiac output (CO, CI) seemed to be a little bit lower in some patients especially in those with high pulmonary arterial pressure and at night. These results suggest that the variation of the day and night measurements of hemodynamics, blood gas, hemorrheologic changes have some rule.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

采用Swan - ganz导管技术对14例慢性肺心病康复期患者进行了研究。在24小时内每隔一定时间同时监测肺动脉压、心输出量、动脉血气、经皮血气张力和血液流变学指标。结果显示,夜间肺动脉平均压(MPAP)、动脉血二氧化碳分压(PaCO2)、经皮二氧化碳分压(tcPCO2)、血细胞比容(H)、全血粘度(ηb)和血浆粘度(ηp)均高于白天。而心输出量(CO)、动脉血氧分压(PaO2)和经皮血氧分压(tcPO2)则相反,多数指标白天更为突出,夜间趋于降低。部分康复期患者的MPAP可降至正常,但在肺动脉高压组[MPAP大于或等于2.66千帕(20毫米汞柱)]中,MPAP、CO、PaO2、PaCO2、tcPO2、tcPCO2的昼夜测量值波动比正常组更明显(P小于0.01)。H、ηb、ηp等血液流变学指标的昼夜测量结果显示,夜间血液粘度升高比白天更显著。部分患者的心输出量(CO、CI)似乎略低,尤其是肺动脉压高的患者及夜间情况。这些结果表明,血流动力学、血气、血液流变学变化的昼夜测量值变化具有一定规律。(摘要截选至250词)

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