新版左室舒张功能不全指南在ICU的应用现状

doi:10.3969/j.issn.1002-1949.2019.09.020

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摘要越来越多的证据表明，重症监护病房(ICU)患者左室舒张功能不全(LVDD)与预后恶化有关。2016年美国超声心动图学会和欧洲心血管成像协会推出新版指南，试图简化LVDD的诊断和分级。然而，左室舒张功能在发病前常常是未知的，并且存在一些混杂因素。血管活性药物的使用、正压通气、容量负荷使所提出的监测参数难以解释，尤其是在ICU。在LVDD的诊断和分级标准中，多普勒成像衍生参数e′和E/e′似乎是最可靠的，但也具有局限性。本综述基于新版指南和既往文献进行总结，讨论LVDD不同分级的临床意义和超声心动图表现，描述LVDD对患者预后的影响，并为LVDD患者的管理提供依据。

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	李佳
	王金荣

关键词 ：舒张功能, 收缩功能, 脱机失败, 脓毒症, 危重症, 左室舒张功能不全

基金资助:河北省科技厅支持项目（162777279）

通讯作者: 王金荣（1982-），男，博士，副主任医师，科副主任，E-mail：iamwjr306@163.com。

作者简介: 李佳（1987-），女，护师，E-mail:1096244662@qq.com。

引用本文:

李佳，王金荣. 新版左室舒张功能不全指南在ICU的应用现状[J]. 中国急救医学, 2019, 39(9): 902-907.
Li Jia, Wang Jin-rong. Clinical applications of diastolic dysfunction in light of the new guidelines in the intensive care unit. Chinese Journal of Critical Care Medicine, 2019, 39(9): 902-907.

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http://www.cnemergency.org.cn/CN/10.3969/j.issn.1002-1949.2019.09.020 或 http://www.cnemergency.org.cn/CN/Y2019/V39/I9/902

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