胃肠镜麻醉前评估病人的连续心脏指数与左心室射血分数相关性

doi:10.16139/j.1007-9610.2023.02.12

摘要/Abstract

摘要：

目的：研究无创连续心脏指数(continuous cardiac index, CCI)、冠心病危险因素与左心室射血分数(left ventricular ejection fraction, LVEF)的相关性。方法：回顾性分析2022年1月至3月本院特需门诊拟行无痛胃肠镜检查的90例麻醉前评估病人。使用无创实时动脉血压及血流动力学监测系统测定CCI。收集3组冠心病危险因素。根据心脏超声检查测量的LVEF结果将病人分为3组：40%~49%组(n=15)、50%~59%组(n=38)和>60%组(n=37)。结果：与其他2组相比，LVEF 40%~49%组病人的吸烟史(60.0%)、高血压(80.0%)、糖尿病(73.3%)、高脂血症(86.6%)、肥胖症(53.3%)、早发心血管疾病家族史(33.3%)，以及冠心病危险因素≥3个(80.0%)的比例均为最高(P<0.05)。LVEF 40%~49%组病人的CCI值在3组中最低(P<0.05)，CCI值与LVEF值呈显著正相关(r>0.95, P<0.05)。结论：应用无创实时动脉血压及血流动力学监测系统行麻醉评估显示，CCI与LVEF相关，有利于提高麻醉安全性。

关键词: 连续心脏指数, 左心室射血分数, 心脏超声, 麻醉前评估

Abstract:

Objective To study both non-invasive continuous cardiac index (CCI) and risk factors of coronary heart disease related with left ventricular ejection fraction (LVEF). Methods Retrospective study was done at VIP Health Center with 90 patients with preanesthesia assessment for gastrointestinal endoscopy under intravenous anesthesia between January and March 2022 in our hospital. CCI was measured using non-invasive real-time arterial blood pressure and hemodynamic monitoring system. Risk factors of coronary heart disease were collected. There were three groups of patients according to the results of LVEF gotten from echocardiography examination including group of LVEF 40%-49% (n=15), group of LVEF 50%-59% (n=38) and group of LVEF >60% (n=37). Results The group of LVEF 40%-49% had the highest rate of smoking (60.0%), hypertension (80.0%), diabetes (73.3%), hyperlipidemia (86.6%), obesity (53.3%), family history of early onest cardiovascular disease (33.3%) and the highest rate of ≥3 risk factors of coronary heart disease (80.0%)(P<0.05). The CCI in the group of LVEF 40%-49% was the lowest among three groups (P<0.05). There was a significant positive correlation between CCI and LVEF (r>0.95, P<0.05). Conclusions It was suggested that non-invasive real-time arterial blood pressure and hemodynamic monitoring system could be used for preanesthesia assessment, and CCI related to LVEF, which improves the safety of anesthesia for patients.

Key words: Continuous cardiac index, Left ventricular ejection fraction, Echocardiography, Preanesthesia assessmemt

中图分类号:

R614.2

陆玮, 李叙婷, 虞蔚滨, 夏一梦, 范秋维. 胃肠镜麻醉前评估病人的连续心脏指数与左心室射血分数相关性[J]. 外科理论与实践, 2023, 28(02): 152-156.

LU Wei, LI Xuting, YU Weibin, XIA Yimeng, FAN Qiuwei. Continuous cardiac index in patients related with left ventricular ejection fraction in preanesthesia assessment for gastroenteroscopy[J]. Journal of Surgery Concepts & Practice, 2023, 28(02): 152-156.

图/表 2

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Item	LVEF 40%-49%	LVEF 50%-59%	LVEF>60%	P value	^*P value	^#P value
Cases	15	38	37
Age (year)(x±s)	60.5±12.3	62.1±11.7	61.3±12.5	0.401
Male/female	8/7	20/18	19/18	0.774
Body mass index(BMI)(x±s)	32.3±1.9	27.3±2.1^*	22.3±1.7^＃		0.003	0.001
Smoking history	9(60.0)	14(36.8)^*	9(24.3)^＃		0.003	0.015
Hypertension	12(80.0)	24(63.2)^*	7(18.9)^＃		0.003	0.006
Diabetes mellitus	11(73.3)	18(47.3)^*	6(16.2)^＃		0.002	0.003
Hyperlipidemia	13(86.6)	19(50.0)^*	4(10.8)^＃		0.001	0.003
Obesity /Overweight with obstructive sleep apnea-hypopnea syndrome	8(53.3)	4(10.5)^*	0(0)^＃		0.001	0.001
Family history of early onset cardiovascular disease	5(33.3)	4(10.5)^*	1(2.7)^＃		0.002	0.003
≥3 risk factors of coronary heart disease	12(80.0)	12(31.6)^*	1(2.7)^＃		0.001	0.002

Item	LVEF40%-49%	LVEF50%-59%	LVEF>60%	^P* value	^#P value
Left ventricular hypertrophy	12(80.0)	24(63.2)^*	6(16.2)^＃	0.026	0.029
Abnormal electrocardiogram	13(86.6)	20(52.6)^*	2(5.4)^＃	0.017	0.026
CCI[L/(min·m²)]	1.7±0.2	2.2±0.3^*	3.7±0.5^＃	0.001	0.002