心肌收縮能力变异性的研究.docVIP

心肌收缩能力变异性的研究 北京生物医学工程 2000年第3期第19卷 论　　著 作者：刘国传　肖守中 单位：重庆大学生物工程学院国家教委生物力学及生物流变学开放研究实验室 重庆400044 关键词：心肌收缩能力；变异性；心音 　　摘　要　为了揭示心肌收缩能力变异的规律性和评估其临床应用价值，把第一心音幅值的变化作为心肌收缩力变异性的一个指标，并测试和分析呼吸、运动、心理应激对心肌收缩能力变异性的影响。结果表明：第一心音幅值对呼吸和运动非常敏感。特别是，运动对心肌收缩能力产生强烈的影响。心肌收缩能力的变异存在一定的规律性：(1)在深呼吸和运动试验过程的每一个呼吸周期中，第一心音幅值呈现规律性波动；(2)在屏气试验过程中，第一心音幅值也呈现规律性波动，但这显然与呼吸无关。健康人与心血管疾病病人的心肌收缩能力的变异性存在着显著性差异。此外，少数人在心理应激试验中第一心音幅值和心率明显增加。研究和分析第一心音幅值和心肌收缩能力的变异性可能有重要的临床应用价值，值得进一步研究。 A Study on Cardiac Contractility Variability Liu Guochuan 　　(College of Bioengineering,Chongqing University,Chonqing 400044) 　　Xiao Shouzhong 　　(College of Bioengineering,Chongqing University,Chonqing 400044) 　　Abstract 　　To find the rules of cardiac contractility variability(CCV),and to evaluate its clinical application,the influence of three factors(respiration,exercise,and psychological activity)on the cardiac contractility was measured and analyzed.The change of the amplitude of the first heart sound(S1)was used as an index for evaluating the change of the cardiac contractility.The results show that the amplitude of the first heart sound has a very sensitive response to the respiration and exercise.Especially,the exercise has a very strong influence to the cardiac contractility.The S1s are of continuously varying amplitude.Cardiac contractility variability has obvious rules:(1)During test of deep breath of exercise,there was a cyclic rise and fall(crescendo-decrescendo) of S1 amplitude in each respiratory cycle;(2)During breath holding,there was also a cyclic rise and fall (crescendo-decrescendo) of S1 amplitude,but obviously,it was not related to respiratory cycle.CCV of healthy subjects was significantly different from that of patients with heart or lung disease.In addition,a few subjects exhibited changes after psychological stress test:an increase of both S1 amplitude and heart rate.Analyzing the rules of S1 variability and cardiac contractility variability may have practical linical value.It is worth to study further. 　　Key