二尖瓣狭窄患者弱脉的血流动力学、血液流变学机理探讨

本文报告运用心脉仪和血液流变仪,观察30例二尖瓣狭窄弱脉患者的脉图、血流动力学和血液流变学部分参数,其中24例进行了手术前后对比。结果表明:弱脉组主波幅和降中峡幅降低,主波宽度增加;心输出量减少,外周阻力增加,射血前期/左室射血时间比值增大.低切速全血粘度升高,红细胞电泳率增快(P<0.05～0.001),且血流动力学和血液流变学部分参数之间具有相关性。以上说明综合分析和观测能更全面地阐述弱脉机理。

英文摘要:

Exploration on the mechanism of pulse condition is a very important aspect in modern research of TCM sphygmology.The present study was undertaken to demonstrate the changes of the pulse picture and parameters of hemodynamics and hemorheology in 30 patients with weak pulse due to mitral stenosis.In 24 of them,their pulse conditions and hemodynamic and hemorheologic parame- ters before the operation were compared with that after the operation.The hemodynamic and hemorheologic mechanism of weak pulse was discussed.The results showed that in contrast with the non-weak pulse group,the weak pulse group was characterized by lowering the amplitude of main wave,the dicrotic notch flattened,and the width of main wave broadened.In addition,in weak pulse group,cardiac output reduced,TPR and PEP/LVET increased(P<0.001).The whole blood viscosity at low shear rate(1.92 S~-)became larger(P<0.05),the migration rate of RBC electrophoresis increased(P<0.001).Furthermore,the whole blood viscosity and TPR and PEP/LVET were signifi- cantly correlated(R=0.312 and r=0.274 respectively).The results suggest that the changes of hemodynamic and hemorheologic parameters play an important role in forming weak pulse,and their mechanisms are mutually influenced.So comprehensive observation and analysis of the hemodynamic and hemorheologic changes could be helpful for further explanation of the mechanism of weak pulse,and might provide the clinical experimental basis for noninvasive detection of the parameters of hemodynamics and hemorheology through pulse measurement.

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