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目的:比较间歇热稀释法与间接Fick法测定肺动脉高压患者心排出量结果的一致性。方法:79例患者,男性18例,女性61例,平均年龄(36±10)岁。其中特发性肺动脉高压41例,先天性心脏病相关性肺动脉高压12例,结缔组织病相关性肺动脉高压12例,慢性血栓栓塞性肺动脉高压5例,其他肺动脉高压9例。上述患者同时采用间歇热稀释法与间接Fick法测定心排出量,对两种方法的测定结果进行了相关分析及Bland-Altman一致性分析。然后根据间接Fick法测定结果将患者分为低心排出量组和正常心排出量组,并重新进行上述相关分析及一致性分析。结果:间歇热稀释法心排出量3.60±1.16(1.88～7.05)L/min,间接Fick法心排出量3.56±1.12(1.90～6.88)L/min,差值(间歇热稀释法-间接Fick法)为(0.04±0.70)L/min;两种方法心排出量相关分析得r=0.81(P<0.01)。低心排出量组(n=23,心排出量≤3 L/min):间歇热稀释法心排出量2.76±0.65(1.9～4.5)L/min,间接Fick法心排出量2.46±0.26(1.9～3.0)L/min,差值为(0.3±0.59)L/min;两种方法心排出量相关分析得r=0.45(P<0.01)。正常心排出量组(n=56,心排出量>3 L/min):间歇热稀释法心排出量3.95±1.15(2.23～7.05)L/min,间接Fick法心排出量4.01±1.01(3.01～6.88)L/min;差值为(-0.07±0.73)L/min;两种方法心排出量相关分析得r=0.78(P<0.01)。结论:间歇热稀释法与间接Fick法测定肺动脉高压患者的心排出量一致性欠佳。两种方法测定结果不能互换。
OBJECTIVE: To compare the concordance between intermittent thermodilution and indirect Fick determination of cardiac output in patients with pulmonary hypertension. Methods: 79 patients, 18 males and 61 females, mean age (36 ± 10) years. Among them, 41 cases were idiopathic pulmonary hypertension, congenital heart disease-related pulmonary hypertension in 12 cases, connective tissue disease-related pulmonary hypertension in 12 cases, chronic thromboembolic pulmonary hypertension in 5 cases, and other pulmonary hypertension in 9 cases. The above-mentioned patients also used intermittent thermodilution and indirect Fick to determine cardiac output. The correlation analysis and Bland-Altman agreement analysis of the two methods were carried out. Then according to the indirect Fick method, the patients were divided into low cardiac output group and normal cardiac output group, and the above correlation analysis and consistency analysis were reformed. Results: The cardiac output of intermittent thermodilution was 3.60 ± 1.16 (1.88 ~ 7.05) L / min, indirect Fick cardiac output was 3.56 ± 1.12 (1.90 ~ 6.88) L / min, ) Was (0.04 ± 0.70) L / min. Correlation analysis of cardiac output between the two methods showed r = 0.81 (P <0.01). (N = 23, cardiac output ≤ 3 L / min): 2.76 ± 0.65 (1.9-4.5) L / min in intermittent thermodilution and 2.46 ± 0.26 (1.9 ~ 3.0) L / min, and the difference was (0.3 ± 0.59) L / min. Correlation analysis of cardiac output between the two methods showed r = 0.45 (P <0.01). The normal cardiac output (n = 56, cardiac output> 3 L / min) was 3.95 ± 1.15 (2.23 ~ 7.05) L / min for intermittent thermodilution and 4.01 ± 1.01 ~ 6.88) L / min, and the difference was (-0.07 ± 0.73) L / min; r = 0.78 (P <0.01). Conclusion: Intermittent thermal dilution method and indirect Fick method to determine the consistency of cardiac output in patients with pulmonary hypertension. The results of two methods are not interchangeable.