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目的 评价无创血液动力学监测系统(Bioz com)对急性心力衰竭(AHF)患者进行实时连续性血液动力学参数监测并指导AHF治疗的可行性。方法 对35 例AHF患者(治疗组)采用自身前后对照方法,在使用速尿或硝酸甘油前后采用Bioz com系统实时连续监测心衰患者的心率(HR)、平均动脉压(MAP)、心排血量(CO)、加速度指数(ACI)、胸腔体液指数(TFC)、左室做功指数(LCWI)、外周血管阻力(SVR)的变化并对参数的变化进行比较;同时与健康体检人员(健康组)进行比较;并与使用Bioz com系统进行监测前的AHF患者(对照组)4周死亡率进行比较。结果 35 例AHF患者,注入速尿或硝酸甘油后能快速增加CO、ACI、LCWI(P<0 01),明显降低TFC、SVR(P<0 01)。与健康组各血液动力学参数进行比较,HR、MAP、CO、ACI、LCWI、TFC、SVR 均有统计学差异(P< 0.05 ~ 0.01)。4 周死亡率治疗组与对照组分别为9/35(25.7%)、13/36(36.1%)(P<0.01)。结论 Bioz com系统在AHF患者中通过监测相关参数变化,为临床治疗和改善预后提供准确可靠依据,值得推广。
Objective To evaluate the feasibility of noninvasive hemodynamic monitoring system (Bioz com) monitoring real-time continuous hemodynamic parameters in patients with acute heart failure (AHF) and to guide the treatment of AHF. Methods Fifty-five patients with AHF (treatment group) were enrolled in this study. Before and after using furosemide or nitroglycerin, the heart rate (HR), mean arterial pressure (MAP), cardiac output (ACI), thoracic body fluid index (TFC), left ventricular function index (LCWI), and peripheral vascular resistance (SVR) were measured and compared. The changes of parameters were also compared with those of health checkups ); And compared with the 4-week mortality of AHF patients (control group) before monitoring with the Bioz com system. Results 35 patients with AHF could rapidly increase CO, ACI and LCWI (P <0.01) after injection of furosemide or nitroglycerin, and significantly reduce TFC and SVR (P <0.01). Compared with the hemodynamic parameters in healthy group, HR, MAP, CO, ACI, LCWI, TFC and SVR were all significantly different (P <0.05-0.01). The 4-week mortality rate was 9/35 (25.7%) in the treatment group and 13/36 (36.1%) in the control group (P <0.01). Conclusion The Bioz com system is worthy of promotion by monitoring the changes of related parameters in patients with AHF, providing accurate and reliable evidence for clinical treatment and improving the prognosis.