目的 探讨老年人尿毒症合并心力衰竭(心衰)患者血流动力学改变. 方法 对241例尿毒症合并心衰者进行无创的血液循环动力学信息检测仪(CD)检查.老年组116例,平均年龄(71±6)岁,中青年组125例,平均年龄(38±10)岁.对两组患者的容量负荷、心肌收缩力、血压等进行统计分析. 结果 中心静脉压(CVP)[(26.7±11.3)cmH2O与(23.6±10.7)cmH2O,t=2.410,P=0.010]、有效循环血量[(4362±1340)ml与(3085±1001)ml,t=7.674,P=0.000]、每搏血量(SV)[(165±52)ml与(114±41)ml,t=7.803,P=0.000]、心输出量[(13.9±4.3) L/min与(11.2±3.6) L/min,t=4.802,P=0.000]、左室舒张末期容量(LDV)[(388±145)ml与(258±98)ml,t=7.673,P=0.000]、左室收缩末期容量(LSV)[(223±96)ml与(135±59)ml,t=7.186,P=0.000],老年组均高于中青年.射血压力[(178±29)mmHg与(183±24)mm0 Hg,t=2.323,P=0.012]、心肌负变力系数[(0.609±0.149)与(0.683±0.188),t=3.113,P=0.002]、射血分数[(0.433±0.034)与(0.445±0.031),t=2.451,P=0.010]、舒张压[(87±14)与(108±22)mm Hg,t=8.141,P=0.000]、系统总阻抗(SSR)[(952±207)gcm-4 s- 2与(1217±308)gcm-4s-2,t=7.143,P=0.000]、射血压力(EP)[(178±29)与(183±24),t=2.323,P=0.012]老年组低于中青年组.舒张压(x2=16.474,P=0.000,OR=0.752,95％CI:0.714～0.790)、收缩压(x2=11.913,P=0.000,OR=1.148.95％CI:1.091～1.205)、射血阻力(x2=17.892,P=0.000,OR=0.906,95％CI:0.861～0.951)、CVP(x2=14.672,P=0.000,OR=0.698,95％CI:0.663～0.733)、LDV(x2=21.080,P=0.000,OR=0.942,95％CI:0.895～0.989)均是影响老年尿毒症患者发生心衰的危险因素. 结论 老年尿毒症合并心衰患者容量负荷增加,心肌收缩力、心脏后负荷下降.
目的 探討老年人尿毒癥閤併心力衰竭(心衰)患者血流動力學改變. 方法 對241例尿毒癥閤併心衰者進行無創的血液循環動力學信息檢測儀(CD)檢查.老年組116例,平均年齡(71±6)歲,中青年組125例,平均年齡(38±10)歲.對兩組患者的容量負荷、心肌收縮力、血壓等進行統計分析. 結果 中心靜脈壓(CVP)[(26.7±11.3)cmH2O與(23.6±10.7)cmH2O,t=2.410,P=0.010]、有效循環血量[(4362±1340)ml與(3085±1001)ml,t=7.674,P=0.000]、每搏血量(SV)[(165±52)ml與(114±41)ml,t=7.803,P=0.000]、心輸齣量[(13.9±4.3) L/min與(11.2±3.6) L/min,t=4.802,P=0.000]、左室舒張末期容量(LDV)[(388±145)ml與(258±98)ml,t=7.673,P=0.000]、左室收縮末期容量(LSV)[(223±96)ml與(135±59)ml,t=7.186,P=0.000],老年組均高于中青年.射血壓力[(178±29)mmHg與(183±24)mm0 Hg,t=2.323,P=0.012]、心肌負變力繫數[(0.609±0.149)與(0.683±0.188),t=3.113,P=0.002]、射血分數[(0.433±0.034)與(0.445±0.031),t=2.451,P=0.010]、舒張壓[(87±14)與(108±22)mm Hg,t=8.141,P=0.000]、繫統總阻抗(SSR)[(952±207)gcm-4 s- 2與(1217±308)gcm-4s-2,t=7.143,P=0.000]、射血壓力(EP)[(178±29)與(183±24),t=2.323,P=0.012]老年組低于中青年組.舒張壓(x2=16.474,P=0.000,OR=0.752,95％CI:0.714～0.790)、收縮壓(x2=11.913,P=0.000,OR=1.148.95％CI:1.091～1.205)、射血阻力(x2=17.892,P=0.000,OR=0.906,95％CI:0.861～0.951)、CVP(x2=14.672,P=0.000,OR=0.698,95％CI:0.663～0.733)、LDV(x2=21.080,P=0.000,OR=0.942,95％CI:0.895～0.989)均是影響老年尿毒癥患者髮生心衰的危險因素. 結論 老年尿毒癥閤併心衰患者容量負荷增加,心肌收縮力、心髒後負荷下降.
목적 탐토노년인뇨독증합병심력쇠갈(심쇠)환자혈류동역학개변. 방법 대241례뇨독증합병심쇠자진행무창적혈액순배동역학신식검측의(CD)검사.노년조116례,평균년령(71±6)세,중청년조125례,평균년령(38±10)세.대량조환자적용량부하、심기수축력、혈압등진행통계분석. 결과 중심정맥압(CVP)[(26.7±11.3)cmH2O여(23.6±10.7)cmH2O,t=2.410,P=0.010]、유효순배혈량[(4362±1340)ml여(3085±1001)ml,t=7.674,P=0.000]、매박혈량(SV)[(165±52)ml여(114±41)ml,t=7.803,P=0.000]、심수출량[(13.9±4.3) L/min여(11.2±3.6) L/min,t=4.802,P=0.000]、좌실서장말기용량(LDV)[(388±145)ml여(258±98)ml,t=7.673,P=0.000]、좌실수축말기용량(LSV)[(223±96)ml여(135±59)ml,t=7.186,P=0.000],노년조균고우중청년.사혈압력[(178±29)mmHg여(183±24)mm0 Hg,t=2.323,P=0.012]、심기부변력계수[(0.609±0.149)여(0.683±0.188),t=3.113,P=0.002]、사혈분수[(0.433±0.034)여(0.445±0.031),t=2.451,P=0.010]、서장압[(87±14)여(108±22)mm Hg,t=8.141,P=0.000]、계통총조항(SSR)[(952±207)gcm-4 s- 2여(1217±308)gcm-4s-2,t=7.143,P=0.000]、사혈압력(EP)[(178±29)여(183±24),t=2.323,P=0.012]노년조저우중청년조.서장압(x2=16.474,P=0.000,OR=0.752,95％CI:0.714～0.790)、수축압(x2=11.913,P=0.000,OR=1.148.95％CI:1.091～1.205)、사혈조력(x2=17.892,P=0.000,OR=0.906,95％CI:0.861～0.951)、CVP(x2=14.672,P=0.000,OR=0.698,95％CI:0.663～0.733)、LDV(x2=21.080,P=0.000,OR=0.942,95％CI:0.895～0.989)균시영향노년뇨독증환자발생심쇠적위험인소. 결론 노년뇨독증합병심쇠환자용량부하증가,심기수축력、심장후부하하강.
Objective To investigate hemodynamie change in uremia complicating heart failure of elderly patients. Methods Totally 241 cases with uremia complicating heart failure received measurement of circulation dynamic detection(CD).The volume load,myocardial contractility and blood pressure were analyzed in the elderly group aged(71±6)years (n=116) and young and middleaged group aged(38± 10)years(n =125). Results The central venous pressure(CVP)[(26.7±11.3)cmH2O vs.(23.6 ± 10.7) cm H2O,t=2.410,P =0.010],effective circulation volume (ECV)[(4362± 1340)ml vs.(3085 ± 1001 ) ml,t =7.674,P =0.000],stroke volume(SV) [(185 ± 52) ml vs.(114±41)ml,t=7.803,P=0.000],cardiac output (CO)[( 13.9±4.3)L/min vs.(11.2±3.6)L/min,t=4.802,P=0.000],left ventricular end diastolic volume (LVD)[(388± 145)ml vs.(258±98)ml,t =7.673,P =0.000],left ventricular end systolic volume ( LSV ) [( 223 ± 95 ) ml vs.( 135 ± 59) ml,t =7.186,P=0.000] were significantly higher group than in young and middle-aged group.The ejection pressure (EP)[(178±29)mm Hg vs.(183±24)mm Hg,t=2.323,P=0.012],myocardium negative inotropic(MNC) [(0.609±0.149)vs.(0.683±0.188),t=3.113,P=0.002],ejection fraction (EF) [(0.433± 0.034) vs.(0.445 ± 0.031 ),t =2.451,P =0.010],diastolic blood pressure (DBP) [( 87 ±14)mm Hg vs.(1.08±22)mm Hg,t=8.141,P=0.000],systematic vascular resistance(SSR)[(952±207)gcm-4 s-2 vs.(1217± 308) gcm-4 s-2,t =7.143,P=0.000],ejection resistence(ER) [( 178± 29)vs.( 183 ± 24),t =2.323,P =0.012] were lower in elderly group than in young and middle-aged group.DBP(x2 =16.474,P=0.000,OR=0.752,95％CI:0.714-0.790),SBP(x2 =11.913,P=0.000,OR=1.148,95％CI:1.091-1.205),ER(x2 =17.892,P=0.000,OR=0.906,95％CI:0.861-0.951),CVP(x2 =14.672,P=0.000,OR=0.698,95％CI:0.663-0.733) and LDV(x2 =21.080,P=0.000,OR=0.942.95％ CI:0.895-0.989) were dangerous factors of uremia complicating heart failure.Conclnsions The increased volume load,decreased myocardial contractility and cardiac afterload may appear in the elderly patients with uremia complicating heart failure.
