呼吸と重力の影響は,正常な患者とフォントンの患者の赤外膜静脈流動に作用する
T Y Hsia1, S Khambadkone, A N Redington
1Great Ormond Street Hospital for Children NHS Trust, London, UK. hsia@welchlink.welch.jhu.edu
Circulation
|November 18, 2000
まとめ
呼吸効果 血液循環のヘモダイナミクスを促進し,特に全腔肺連結 (TCPC) 患者では,肝臓の静脈流れを増やすことにより,循環のヘモダイナミクスを促進します. 重力は静脈リターンに負の影響を及ぼし,特に心肺動脈接続 (APC) の患者ではそうである.
科学分野:
- ペディアトリック・カルディオロジー
- 血管生理学 血管生理学
- 生まれながらの心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,先天性心臓病 (Congenital Heart Disease) とは,
背景:
- フォントンの循環は,ユニークな連続肺および全身血管抵抗を示しています.
- フォンタンの患者の赤外線状静脈の生理学は,まだ完全に理解されていません.
研究 の 目的:
- ファンタン患者における呼吸と重力のインフラジアフラグマ静脈流への影響を調査する.
- これらの効果を異なるフォンタン型 (APC,TCPC) と健康な対照群との間で比較する.
主な方法:
- ドップラー超音波検査は,肝静脈 (HV),下静脈 (IVC),門静脈 (PV) の流れ率を測定するために使用されました.
- 測定は,20人の健康なボランティアと48人のフォンタン患者 (15人のAPC,30人のTCPC) で,仰向けと直立の姿勢で,吸い込みと吐き出しの間に行われました.
- 呼吸と重力の効果は,吸入と吐出と横から直立の流れ率の比率を用いて定量化されました.
主要な成果:
- 肝臓静脈の流れは,対照群 (1.7) とAPC患者 (1.6) と比較して,TCPC患者 (3.4比) のインスピレーションに依存性が著しく高かった.
- ポータル静脈流の正常な呼吸増幅は,APCおよびTCPC患者では失われていました (対照群では1.0および1.1対0.8の比率).
- 重力により減少した肝静脈の流れは,TCPC患者 (2.1) よりも,APC患者 (3.2比) により減少した.
結論:
- 呼吸と重力は,フォンタンの患者の赤外線膜静脈回帰を著しく影響する.
- 重力は下部静脈リターンに悪影響を及ぼし,特にAPC患者には悪影響を及ぼします.
- 呼吸はTCPC患者において,主に肝臓静脈流の強化によって有益な効果をもたらし,Fontan循環の血液動力学にも影響を及ぼします.
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