右心房压力升高对上腔静脉血流参数影响的实验研究

目的探讨右心房压力升高时上腔静脉血流参数随呼吸运动变化的规律。方法通过静脉快速输注高渗盐水的方法升高杂种犬的右心房压力,右心房压力通过股静脉穿刺右心导管置入术监测。经右侧锁骨上窝切面探查上腔静脉,分别记录灌注前后右心房压力正常及升高时上腔静脉频谱随呼吸及心动周期的变化,检查仪器采用Sequoia512彩色电脑声像仪,探头频率3.5MHz。观察不同右心房压力时上腔静脉频谱形态并测量各波峰值及速度时间积分(VTI),计算上腔静脉频谱各波峰值、速度时间积分的呼吸性变化率,采用统计软件SPSS11.0进行均数比较的t检验。结果右心房压力正常时,上腔静脉频谱S波、D波峰值及VTI呼吸变化率均较大;随着右心房压力的升高,S波、D波峰值及VTI呼吸变化率明显减低(P<0.05)。相关分析表明S波、D波峰值呼吸变化率与右心房压力呈负相关(P<0.05)。结论上腔静脉频谱S波、D波的呼吸变化率随右心房压力升高而减低,这种现象有助于临床工作中右心房压力的辅助判断。

Influence of high pressure in right atrium on flow parameters of superior vena cava: experimental study

Objective To study the rule of respiratory changes of flow parameters of superior vena cava when right atrium pressure increased. Methods Canine models of different right atrium pressure were constructed by infusing hypertonic saline rapidly, and right atrium pressures were monitored by right heart catheter. Through right supraclavicular fossa view, the spectra of superior vena cava under different right atrium pressure were recorded, and the respiratory changes of wave S and wave D were calculated. Results Peak values and velocity time integral (VTI) of wave S and wave D changed prominently during respiration cycle under normal right atrium pressure. When right atrium pressure increased, respiratory changes of wave S and wave D decreased (P<0.05), and respiratory changes of peak values of wave S and wave D were correlated negatively with pressure of right atrium (P<0.05). Conclusion Respiratory changes of wave S and wave D decreased when right atrium pressure heightened, which could be used as an indicator of right atrium pressure.