李想,刘兴德,袁志柳
LI Xiang,LIU Xingde,YUAN Zhiliu

• 1:贵州医科大学内科教研室
• 2:贵州省人民医院干医科

摘要(Abstract)：

目的:探讨无创血流动力学指标在高血压及其合并症患者中的应用价值。方法:447例老年受检者根据所患疾病分别为高血压组、非高血压组、高血压合并糖尿病组、高血压合并冠心病组及高血压合并冠心病与糖尿病组,记录无创血流动力学监测仪测定各组患者的血流动力学指标心指数(CI)、每分钟输出量(CO)、射血分数(EF)、射血前期(PEP)、收缩指数(IC)、等容舒张期(A2-O)、房缩波幅度(AMPA)、主动脉顺应性(AC)、总外周阻力(TPR)、毛细血管嵌压(PCWP)及左室舒张末压(LVEDP)并比较,探讨无创血流动力学指标在高血压及其合并症患者中的应用价值。结果:与正常对照组比较,高血压组PEP降低,TPR升高,非高血压组EF、PEP、AC降低,高血压合并糖尿病组CI、EF、PEP降低,TPR升高;高血压合并冠心病组与正常对照组相比CI、CO、EF、IC降低,TPR升高;高血压合并冠心病与糖尿病组CI、CO、EF、IC及AC降低,AMPA、TPR、PCWP及LVEDP升高;以上差异有统计学意义(P<0.05);与高血压组比较,非高血压IC、AC降低,高血压合并糖尿病组IC降低,TPR升高;高血压合并冠心病组CI、CO、EF、IC、AC降低,TPR升高;高血压合并冠心病与糖尿病组CI、CO、EF、IC、AC降低,TPR、PCWP、LVEDP升高;以上差异有统计学意义(P<0.05)。结论:高血压及其合并症患者无创血流动力学指标大多低于单纯高血压患者。
Objective: To explore the application value of noninvasive hemodynamic monitoring method in patients with hypertension and its complications. Methods: 447 elderly subjects were divided into normal control group,hypertension group,non-hypertension group,hypertension complicated with diabetes mellitus( DM),hypertension patients complicated with coronary heart disease( CHD) and hypertension complicated with DM and CHD. A noninvasive hemodynamic monitoring system was used to detect hemodynamic indices including CI,CO,EF,PEP,IC,A2-O,AMPA,AC,TPR,PCWP and LVEDP. The indices in each group were compared and the application value of noninvasive hemodynamic indices were explored and evaluated in patients with hypertension and its complications. Results: Compared with normal control group,PEP decreased and TPR increased in hypertension group;EF,PEP and AC decreased in non-hypertension group; CI,EF,PEP decreased and TPR increased in hypertension complicated with DM; CI,CO,EF,IC decreased and TPR increased in hypertension patients complicated with CHD; CI,CO,EF,IC and AC decreased while AMPA,TPR,PCWP and LVEDP increased in hypertension complicated with DM and CHD. All differences were statistically significant( P < 0. 05). Conclusions: Cardiac function is worse in patients with hypertension complicated with CHD and( or) DM than in patients with hypertension only.

关键词(KeyWords)： 血流动力学;高血压;糖尿病;心脏功能试验;老年人;共病
hemodynamic;hypertension;diabetes mellitus;cardiac function test;the elderly;multimorbidity

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技计划[黔科合SY(2010)3104]

作者(Author): 李想,刘兴德,袁志柳
LI Xiang,LIU Xingde,YUAN Zhiliu

DOI: 10.19367/j.cnki.1000-2707.2016.05.020

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