CAJ | 학술논문

目的利用超声心动图技术观察呼吸影响心功能力学模型受模拟胸压变化影响的规律,揭示呼吸影响心功能的力学原理.方法模型1用来观察呼吸性胸压变化(respiratory intrathoracic pressure change,RIPC)对体静脉回流系统(systemic venous return system,SVR)及肺静脉回流系统(pulmonary venous return system,PVR)的不同影响.模型2(即室间隔摆动的等效力学模型)用来观察RIPC对室间隔运动的影响.结果模型1说明RIPC对模拟SVR和PVR的影响完全不同,它改变了模拟右心的容积但其内压不变,对左心则相反.模型2说明了RIPC与模拟室间隔之间存在相对应的压力—位置关系.结论由于两个静脉回流系统相对于胸腔的解剖位置不同,导致RIPC对左右心内压力产生不同影响,进而产生了跨室间隔的压力差,使其随呼吸左右摆动,交替性地改变两侧心室短径及充盈,影响心功能.
목적 이용초성심동도기술관찰호흡영향심공능역학모형수모의흉압변화영향적규률,게시호흡영향심공능적역학원리.방법 모형1용래관찰호흡성흉압변화(respiratory intrathoracic pressure change,RIPC)대체정맥회류계통(systemic venous return system,SVR)급폐정맥회류계통(pulmonary venous return system,PVR)적불동영향.모형2(즉실간격파동적등효역학모형)용래관찰RIPC대실간격운동적영향.결과 모형1설명RIPC대모의SVR화PVR적영향완전불동,타개변료모의우심적용적단기내압불변,대좌심칙상반.모형2설명료RIPC여모의실간격지간존재상대응적압력—위치관계.결론 유우량개정맥회류계통상대우흉강적해부위치불동,도치RIPC대좌우심내압력산생불동영향,진이산생료과실간격적압력차,사기수호흡좌우파동,교체성지개변량측심실단경급충영,영향심공능.
Objective To reveal the exact mechanical principle of the respiration-driven variation of cardiac function by observing the effect of respiratory intrathoracic pressure change (RIPC) on the mechanical models using echocardiography.Methods Model 1 was designed to observe the influence of RIPC on systemic and pulmonary venous return systems (SVR and PVR) respectively.Model 2,as an equivalent mechanical model of septal swing,was used to study the influence of RIPC on the motion of the interventricular septum (IVS).Results Model 1 demonstrated that the simulated RIPC had totally different influences on the simulated SVR and PVR.It increased the volume of the simulated right ventricle when the internal pressure was kept constant (8.16 cm H2O),while it had the opposite effect on PVR.Model 2demonstrated that there was a corresponding relationship between RIPC and the position of the simulated IVS which might be called pressure-position relationship.Conclusions The different anatomical arrangement of the two venous return systems leads to a different effect of RIPC on right and left ventricles,and thus generates a pressure gradient across IVS that tends to shift IVS left-and right-wards with respiration.The swing of the IVS changes the short axis diameters of the ventricles,thus their fillings and then their functions reciprocally.