容积型指脉波图监测及评价体外反搏效果的对照研究

对２０ 名男性健康志愿者采用经桡动脉穿刺置管主动脉根部测压的方法，分别研究不同反搏工作参数对主动脉压力和指脉波的影响。结果反搏时主动脉舒张压随储气罐压力的增加升高（最高可达１６８．５６ ｍ ｍ Ｈｇ）；主动脉舒张波的ｄｐ／ｄｔ值均逐渐上升，但收缩波的ｄｐ／ｄｔ值则呈下降趋势；指脉舒张波起点与主动脉舒张波起点比较平均滞后（１０８．２０±２５．７０） ｍ ｓ，而指脉收缩波起点则平均滞后（９６．６９±３８．７０） ｍ ｓ；指脉波的Ｄ／Ｓ比值与主动脉压力波的Ｄ／Ｓ比值随反搏储气罐压力的增加而同步增加，并由直线回归分析得出动脉Ｄ／Ｓ比值（Ｙ）与指脉Ｄ／Ｓ比值（Ｘ）的回归方程式Ｙ＝ ０．３７６＋ ０．４５７Ｘ。本研究指示体外反搏对动脉压力波的Ｄ／Ｓ比值、舒张压及其ｄｐ／ｄｔ值均有显著影响，指脉波仍然是目前调节反搏工作参数及监测反搏效果的较为安全、可靠的方法

A Comparative Study of Finger Plethysmography and Aortic Pressure for Monitoring the Effect of External Counterpulsation

Invasive pressure detecting and monitoring of aortic root was conducted in 20 volunteers so as to study the effect of Enhanced External Counterpulsation (EECP) on aortic pressure and finger plethysmography. The results demonstrated that the changes of aortic diastolic pressure linearly related to the counterpusation's bladder pressure, and the aortic augmentation increased to the top of 168.56 mmHg with a D/S ratio of 2.75(amplitude ratio of diastolic waveform and systolic waveform, D/S ratio) following the bladder pressure of 0.45 Kg/cm2. With the increase of bladder pressure, the dp/dt of aortic augmentation elevated gradually, but a down-regulating trend was seen in systolic waveform. During EECP, the starting time of plethysmographic augmentation had a mean delay of 108.20 +/- 25.70 ms comparing with that of aortic augmentation. The duration between the starting time of aortic systolic waveform and that of finger plethysmogram was arround 96.69 +/- 38.70 ms. When the bladder pressure changed, no significant difference was observed among them. The D/S ratio of finger plethysmographic waveform changed in concord with that of aortic pressure with the promotion of bladder pressure. Therefore, a relationship between aortic D/S ratio (Y) and plethysmographic D/S ratio (x) was constructed by the linear regression analysis: Y = 0.376 + 0.457X. It can be concluded that EECP has significant effects on aortic D/S ratio, aortic peak augmentation and its dp/dt value. Finger plethysmography, to date, still plays important roles in monitoring and controlling EECP work safely and effectively.