呼吸和重力的影响在正常和Fontan患者的红外膜静脉流
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
概括
呼吸的好处 促进血液循环的血液动力学,特别是在全腔肺连接 (TCPC) 患者中,通过增加肝静脉流. 重力对静脉回归有负面影响,尤其是在心房肺连接 (APC) 患者中.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 血管生理学 血管生理学
- 遗传性心脏病是一种先天性心脏病.
背景情况:
- 喷泉循环呈现出独特的连续性肺和全身血管阻力.
- 在Fontan患者的偏膜静脉生理学仍然不完全理解.
研究的目的:
- 为了研究呼吸和重力的影响在Fontan患者的内膜静脉流.
- 为了比较不同Fontan类型 (APC,TCPC) 和健康对照之间的这些影响.
主要方法:
- 用多普勒超声波测量肝静脉 (HV),下静脉 (IVC) 和门静脉 (PV) 流量.
- 在20名健康志愿者和48名Fontan患者 (15名APC,30名TCPC) 进行测量,测量时,他们处于仰卧和直立的位置,在吸气和呼气期间.
- 呼吸和重力效应的量化使用吸入到呼出和卧卧到直立的流量比率.
主要成果:
- 与对照组 (1.7) 和APC患者 (1.6) 相比,TCPC患者的肝静脉流显著更多地依赖于灵感 (比率3.4).
- 在APC和TCPC患者中,门静脉流的正常呼吸增强失去了 (对照组的比率为1.0和1.1与0.8).
- 在APC患者中,重力降低的肝静脉流量比TCPC患者 (3.2比率) 更多 (2.1).
结论:
- 呼吸和重力显著影响Fontan患者的红外膜静脉回归.
- 重力对身体下部静脉回归有不利影响,特别是在APC患者中.
- 呼吸在TCPC患者中提供有益的效果,主要是通过增强肝静脉流动,这对Fontan循环血液动力学有影响.
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