\u6210\u529f\u6cbb\u7597\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24\u53ef\u80fd\u9700\u8981\u91c7\u53d6\u591a\u7ba1\u9f50\u4e0b\u7684\u65b9\u6cd5\uff0c\u65e8\u5728\u89e3\u51b3\u6c27\u7ea7\u8054\u6bcf\u4e2a\u6b65\u9aa4\u4e2d\u7684\u529f\u80fd\u969c\u788d\uff0c\u5305\u62ec\u5bf9\u6d41\u6c27\u8f93\u9001\u3001\u6c27\u6269\u6563\u548c\u6c27\u5229\u7528\u3002\u6b64\u5916\uff0c\u5728\u672a\u6765\u7684\u7814\u7a76\u4e2d\u5fc5\u987b\u8003\u8651\u5fc3\u810f\u9aa4\u505c\u590d\u82cf\u540e\u7684\u5e72\u9884\u65f6\u673a\u548c\u60a3\u8005\u7279\u5b9a\u7684\u75c5\u7406\u751f\u7406\u5b66\u60c5\u51b5\u3002<\/p>\n
PMID: 37507572<\/p>\n
DOI: 10.1007\/s00134-023-07165-x<\/p>\n
\u6458\u8981<\/p>\n
\u8111\u6c27\u7ea7\u8054\u5305\u62ec\u4e09\u4e2a\u5173\u952e\u9636\u6bb5\uff1a\uff08a\uff09\u5bf9\u6d41\u6c27\u6c14\u8f93\u9001\uff0c\u4ee3\u8868\u5927\u91cf\u6c27\u6c14\u6d41\u5411\u8111\u8840\u7ba1\u5e8a\uff1b(b) \u6c27\u6c14\u4ece\u8840\u6db2\u5411\u8111\u7ec4\u7ec7\u7684\u6269\u6563\uff1b(c)\u7ec6\u80de\u5229\u7528\u6c27\u6c14\u8fdb\u884c\u6709\u6c27\u4ee3\u8c22\u3002\u5fc3\u810f\u9aa4\u505c\u590d\u82cf\u540e\uff0c\u8fd9\u4e09\u4e2a\u9636\u6bb5\u90fd\u53ef\u80fd\u51fa\u73b0\u529f\u80fd\u969c\u788d\uff0c\u5bfc\u81f4\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24(HIBI)\u3002\u901a\u8fc7\u4f18\u5316\u8111\u8840\u6d41\u6765\u6539\u5584\u5bf9\u6d41\u6027\u8111\u6c27\u8f93\u9001\u5df2\u88ab\u5e7f\u6cdb\u7814\u7a76\u4f5c\u4e3a\u51cf\u8f7b HIBI \u7684\u7b56\u7565\u3002\u7136\u800c\uff0c\u65e8\u5728\u4f18\u5316\u5bf9\u6d41\u6c27\u6c14\u8f93\u9001\u7684\u4e34\u5e8a\u8bd5\u9a8c\u5374\u53d6\u5f97\u4e86\u4e2d\u6027\u7ed3\u679c\u3002\u5bf9HIBI\u75c5\u7406\u751f\u7406\u5b66\u7684\u8fdb\u4e00\u6b65\u8ba4\u8bc6\u8868\u660e\uff0c\u5728\u786e\u5b9a HIBI \u60a3\u8005\u4e34\u5e8a\u7ba1\u7406\u7684\u6cbb\u7597\u7b56\u7565\u65f6\uff0c\u8fd8\u5e94\u8003\u8651\u4e0e\u6c27\u6269\u6563\u548c\u7ec6\u80de\u5229\u7528\u6c27\u76f8\u5173\u7684\u6c27\u7ea7\u8054\u9636\u6bb5\u7684\u635f\u4f24\u3002\u5bfc\u81f4\u8fd9\u4e9b\u635f\u5bb3\u7684\u539f\u56e0\u53ef\u80fd\u5305\u62ec\u5468\u56f4\u8840\u7ba1\u6c34\u80bf\u5f15\u8d77\u6269\u6563\u5c4f\u969c\u6269\u5927\u548c\u7ebf\u7c92\u4f53\u529f\u80fd\u969c\u788d\u3002\u6db5\u76d6\u8111\u5b9e\u8d28\u5185\u548c\u975e\u4fb5\u5165\u6027\u795e\u7ecf\u76d1\u6d4b\u6280\u672f\u7684\u7efc\u5408\u65b9\u6cd5\u53ef\u80fd\u6709\u52a9\u4e8e\u68c0\u6d4b\u6c27\u7ea7\u8054\u7684\u75c5\u7406\u751f\u7406\u53d8\u5316\uff0c\u5e76\u5b9e\u73b0\u65e8\u5728\u964d\u4f4e HIBI \u4e25\u91cd\u7a0b\u5ea6\u7684\u4e2a\u4f53\u5316\u7ba1\u7406\u3002<\/p>\n
\u7efc\u8ff0<\/p>\n
\u5728\u5fc3\u810f\u9aa4\u505c\u590d\u82cf\u540e\u7684\u60a3\u8005\u4e2d\uff0c\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24(HIBI)\u662f\u6b7b\u4ea1\u7684\u4e3b\u8981\u539f\u56e0\uff0c\u5e76\u4e0e\u5e78\u5b58\u8005\u7684\u4e25\u91cd\u6b8b\u75be\u6709\u5173\u3002HIBI\u7684\u75c5\u7406\u751f\u7406\u5b66\u5305\u62ec\u4e09\u4e2a\u9636\u6bb5\uff1a(1) \u5168\u8111\u7f3a\u8840\uff08\u65e0\u8840\u6d41\uff09\u53d1\u751f\u5728\u5faa\u73af\u505c\u6b62\u548c\u5fc3\u80ba\u590d\u82cf(CPR)\u5f00\u59cb\u4e4b\u95f4\u7684\u65f6\u95f4\u95f4\u9694\u5185\uff1b(2) CPR\u8fc7\u7a0b\u4e2d\u53d1\u751f\u7684\u5168\u8111\u4f4e\u704c\u6ce8\uff08\u4f4e\u8840\u6d41\u91cf\uff09\uff1b(3)\u81ea\u4e3b\u5faa\u73af\uff08ROSC\uff09\u6062\u590d\u540e\u7684\u8111\u518d\u704c\u6ce8\u3002\u5728ROSC\u4e4b\u540e\uff0c\u6709\u76f8\u5f53\u7a0b\u5ea6\u7684HIBI\u4f5c\u4e3a\u7ee7\u53d1\u6027\u635f\u4f24\u53d1\u751f\uff0c\u5176\u4e2d\u4e00\u90e8\u5206\u4e0e\u8111\u7ec4\u7ec7\u7f3a\u6c27\u6709\u5173\u3002 \u89c2\u5bdf\u6027\u7814\u7a76\u8868\u660e\uff0c\u52a8\u8109\u4f4e\u8840\u538b\u3001\u8d2b\u8840\u548c\u4f4e\u78b3\u9178\u8840\u75c7\u5f15\u8d77\u7684\u8111\u6c27\u8f93\u9001(CDO2)\u51cf\u5c11\u4e0e\u590d\u82cf\u540e\u4e0d\u826f\u795e\u7ecf\u7cfb\u7edf\u7ed3\u5c40\u76f8\u5173\u3002\u56e0\u6b64\uff0c\u5c3d\u7ba1 ROSC \u540e\u8111\u7ec4\u7ec7\u7f3a\u6c27\u53ef\u80fd\u6301\u7eed\u5b58\u5728\u7684\u673a\u5236\u4f3c\u4e4e\u66f4\u4e3a\u590d\u6742\uff0cCDO2\u7684\u590d\u82cf\u540e\u4f18\u5316\u5df2\u6210\u4e3a\u4eba\u4eec\u5173\u6ce8\u7684\u7126\u70b9\u3002<\/p>\n
\u6c27\u6c14\u7ea7\u8054\u6db5\u76d6\u4e86\u4ece\u5927\u6c14\u4e2d\u5c06\u6c27\u6c14\u8fd0\u8f93\u5230\u7ebf\u7c92\u4f53\u7684\u8fc7\u7a0b\uff08\u56fe1\uff09\u3002\u5b83\u9700\u8981\u6574\u5408\u5fc3\u80ba\u3001\u5fae\u5faa\u73af\u548c\u7ec6\u80de\u7cfb\u7edf\uff0c\u5e76\u6d89\u53ca\u4e09\u4e2a\u5173\u952e\u9636\u6bb5\uff1a\uff081\uff09\u5bf9\u6d41\u6c27\u8f93\u9001\uff0c\uff082\uff09\u6c27\u6c14\u6269\u6563\uff0c\u548c\uff083\uff09\u7ec6\u80de\u5bf9\u6c27\u6c14\u7684\u5229\u7528\u3002\u5728\u8bd5\u56fe\u4f18\u5316\u590d\u82cf\u540eCDO2\u7684HIBI\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\uff0c\u795e\u7ecf\u7cfb\u7edf\u7684\u6539\u5584\u7ed3\u679c\u7f3a\u4e4f\u6539\u5584\uff08\u88681\uff09\uff0c\u8fd9\u53ef\u80fd\u662f\u56e0\u4e3a\u8fc7\u5206\u5173\u6ce8\u4ec5\u4ec5\u4f18\u5316\u5bf9\u6d41\u6027CDO2\uff0c\u800c\u6ca1\u6709\u8003\u8651\u6c27\u6269\u6563\u6216\u5229\u7528\u65b9\u9762\u7684\u5f02\u5e38\u3002\u6b64\u5916\uff0c\u5c06\u5065\u5eb7\u72b6\u6001\u4e0b\u8111\u8840\u7ba1\u751f\u7406\u5b66\u7684\u73b0\u4ee3\u8fdb\u5c55\u6574\u5408\u8d77\u6765\uff0c\u53ef\u80fd\u80fd\u591f\u66f4\u597d\u5730\u7406\u89e3HIBI\u75c5\u7406\u751f\u7406\u5b66\u5f02\u5e38\u7684\u80cc\u666f\uff0c\u5e76\u6709\u52a9\u4e8e\u672a\u6765\u7684\u4e34\u5e8a\u8bd5\u9a8c\u8bbe\u8ba1\u3002\u56e0\u6b64\uff0c\u672c\u7efc\u8ff0\u63d0\u4f9b\u4e86\u4e00\u4e2a\u56de\u987e\uff0c\u65e8\u5728\u5b9e\u73b0\u4e09\u4e2a\u76ee\u6807\uff1a\uff081\uff09\u5728\u6c27\u7ea7\u8054\u6bcf\u4e2a\u9636\u6bb5\u7684\u80cc\u666f\u4e0b\uff0c\u56de\u987e\u5fc3\u810f\u505c\u8df3\u540eHIBI\u60a3\u8005\u7684\u8111\u8840\u7ba1\u75c5\u7406\u751f\u7406\u5b66\uff1b\uff082\uff09\u56de\u987e\u8bc4\u4f30\u6c27\u6c14\u7ea7\u8054\u9636\u6bb5\u7684\u795e\u7ecf\u76d1\u6d4b\u6280\u672f\u7684\u6548\u7528\uff1b\uff083\uff09\u5f3a\u8c03\u6c27\u6c14\u7ea7\u8054\u529f\u80fd\u969c\u788d\u5bf9HIBI\u60a3\u8005\u7684\u4e34\u5e8a\u7ba1\u7406\u548c\u672a\u6765\u7814\u7a76\u7684\u4e34\u5e8a\u610f\u4e49\u3002<\/p>\n
\u56fe1 \u6c27\u7ea7\u8054\u548c\u8111\u90e8\u6c27\u8f93\u9001\u3002<\/p>\n
A \u6c27\u7ea7\u8054\u662f\u4e00\u4e2a\u591a\u6b65\u9aa4\u8fc7\u7a0b\uff0c\u6d89\u53ca\u6c27\u6c14\u4ece\u5927\u6c14\u4e2d\u5230\u8fbe\u7ebf\u7c92\u4f53\u7684\u79fb\u52a8\u3002\u6c27\u6c14\u8f93\u9001\u53d6\u51b3\u4e8e\u6c27\u7ea7\u8054\u4e2d\u7684\u5bf9\u6d41\u548c\u6269\u6563\u6c27\u8f93\u9001\uff0c\u4ee5\u53ca\u7ebf\u7c92\u4f53\u7684\u540e\u7eed\u5229\u7528\u3002<\/p>\n
B \u7a7a\u6c14\u88ab\u5438\u5165\u80ba\u90e8\uff0c\u5438\u5165\u6c27\u7684\u5206\u538b\uff08PIO2\uff09\u7ea6\u4e3a150 mmHg\u3002\u968f\u540e\u4e0e\u6b8b\u4f59\u5bb9\u79ef\u6df7\u5408\uff0c\u4f7f\u80ba\u6ce1\u6c27\u7684\u5206\u538b\uff08PAO2\uff09\u7ea6\u4e3a103 mmHg\uff0c\u5728\u80ba\u6ce1-\u6bdb\u7ec6\u8840\u7ba1\u4ea4\u754c\u5904\uff0c\u6c27\u4ece\u80ba\u6ce1\u6269\u6563\u5230\u8840\u6db2\uff0c\u800c\u4e8c\u6c27\u5316\u78b3\u4ece\u8840\u6db2\u6269\u6563\u5230\u80ba\u6ce1\u3002\u8fd9\u4e2a\u6269\u6563\u8fc7\u7a0b\u4f1a\u5bfc\u81f4\u52a8\u8109\u6c27\u7684\u5206\u538b\uff08PaO2\uff09\u7565\u5fae\u964d\u4f4e\u5230\u7ea698 mmHg\u3002\u4e4b\u540e\uff0c\u8840\u6db2\u7531\u5fc3\u810f\u6cf5\u9001\u5230\u4f53\u5185\u3002\u91cd\u8981\u7684\u662f\uff0c\u5fc3\u8840\u7ba1\uff08\u5982\u5e73\u5747\u52a8\u8109\u538bMAP\uff09\u3001\u547c\u5438\uff08\u5982PaO2\/PaCO2\uff09\u3001\u4f53\u6db2\uff08\u5982\u8840\u7ea2\u86cb\u767d\u6d53\u5ea6\uff09\u548c\u5fae\u5faa\u73af\uff08\u5982\u8111\u8840\u7ba1\u963b\u529b\uff09\u56e0\u7d20\u5f71\u54cd\u8111\u8840\u6d41\uff08CBF\uff09\uff0cCBF\u7531\u8fd9\u4e9b\u751f\u7406\u56e0\u7d20\u548c\u66f4\u591a\u56e0\u7d20\u7684\u7efc\u5408\u51b3\u5b9a\u3002<\/p>\n
C \u63cf\u8ff0\u4e86\u795e\u7ecf\u8840\u7ba1\u5355\u5143\uff0c\u5b83\u662f\u8111\u5fae\u8840\u7ba1\u3001\u8840\u7ba1\u5468\u56f4\u80f6\u8d28\u7ec6\u80de\u548c\u795e\u7ecf\u5143\u7684\u89e3\u5256\u548c\u529f\u80fd\u6574\u5408\uff0c\u6700\u7ec8\u7ef4\u6301\u8111\u5b9e\u8d28\u7684\u7a33\u6001\u3002<\/p>\n
D \u5bf9\u6d41\u6027\u6c27\u8f93\u9001\uff0c\u8868\u793a\u4e3a\uff081\uff09\uff0c\u7531\u52a8\u8109\u6c27\u542b\u91cf\uff08CaO2\uff09\u548c\u8111\u8840\u6d41\uff08CBF\uff09\u51b3\u5b9a\u3002(2) \u6c27\u8f93\u9001\u5230\u8111\u6bdb\u7ec6\u8840\u7ba1\u7f51\u540e\uff08\u6bdb\u7ec6\u8840\u7ba1\u6c27\u5206\u538b[PCO2]\u7ea6\u4e3a45 mmHg\uff09\uff0c\u6c27\u4ece\u8111\u8840\u7ba1\u6269\u6563\u5230\u8111\u5b9e\u8d28\u3002\u8fd9\u4e2a\u6269\u6563\u8fc7\u7a0b\u7531\u8bb8\u591a\u56e0\u7d20\u51b3\u5b9a\uff0c\u5305\u62ec\u6269\u6563\u8868\u9762\u79ef\uff08A\uff09\u3001\u6269\u6563\u5c4f\u969c\u7684\u539a\u5ea6\uff08T\uff09\u548c\u6269\u6563\u538b\u529b\u68af\u5ea6\uff08\u0394PO2\uff09\uff0c\u5bfc\u81f4\u8111\u7ec4\u7ec7\u6c27\u5206\u538b\uff08PbtO2\uff09\u901a\u5e38\u5927\u4e8e20 mmHg\u3002\u7136\u540e\uff0c\u6c27\u5fc5\u987b\u7a7f\u8fc7\u7ec6\u80de\u8d28\u5230\u8fbe\u7ebf\u7c92\u4f53\uff0c\u5728\u90a3\u91cc\u7ebf\u7c92\u4f53\u6c27\u5206\u538b\uff08PMITOO2\uff09\u4e3a2-3 mmHg\uff08\u57fa\u4e8e\u808c\u7ea2\u86cb\u767d\u9971\u548c\u5ea6\u6d4b\u91cf\u4f30\u8ba1\uff09\u3002\u6700\u540e\uff0c\u80fd\u91cf\u7a33\u6001\u8981\u6c42\u901a\u8fc7\u7ebf\u7c92\u4f53\u6709\u6c27\u547c\u5438\u6210\u529f\u5229\u7528\u6c27\uff0c\u5e76\u4ea7\u751f\u4e09\u78f7\u9178\u817a\u82f7\uff08ATP\uff09\u3002<\/p>\n
\u7b2c\u4e00\u9636\u6bb5\uff1a\u5bf9\u6d41\u6c27\u8f93\u9001<\/p>\n
\u5bf9\u6d41\u6027CDO2\u6db5\u76d6\u4e86\u5faa\u73af\u7cfb\u7edf\u5c06\u6c27\u6c14\u4ece\u80ba\u8840\u7ba1\u8f93\u9001\u5230\u5927\u8111\u7684\u8fc7\u7a0b\uff08\u56fe1\uff09\u3002\u5bf9\u6d41\u6027CDO2\u662f\u8111\u8840\u6d41\u91cf\uff08CBF\uff09\u548c\u52a8\u8109\u6c27\u542b\u91cf\uff08CaO2\uff09\u7684\u4e58\u79ef\uff0c\u540e\u8005\u7531\u52a8\u8109\u6c27\u9971\u548c\u5ea6\uff08SaO2\uff09\u3001\u8840\u7ea2\u86cb\u767d\uff08Hb\uff09\u6d53\u5ea6\u4ee5\u53ca\u5728\u8f83\u5c0f\u7a0b\u5ea6\u4e0a\u52a8\u8109\u6c27\u5206\u538b\uff08PaO2\uff09\u786e\u5b9a\uff08\u56fe2\uff09\u3002\u5bf9\u6d41\u6027CDO2\u7684\u751f\u7406\u7ec4\u6210\u90e8\u5206\u53ef\u4ee5\u7531\u65b9\u7a0b\u5f0f1\u603b\u7ed3\u5982\u4e0b\uff1a<\/p>\n
CDO2=CBF\u22c5[(1.34\u22c5SaO2\u22c5[Hb])+0.003\u22c5PaO2]<\/p>\n
CBF\u4e0e\u8111\u8840\u7ba1\u963b\u529b\uff08CVR\uff09\u6210\u53cd\u6bd4\uff0c\u4e0e\u8111\u704c\u6ce8\u538b\uff08CPP\uff09\u6210\u6b63\u6bd4\uff0c\u5176\u4e2dCPP\u662f\u5e73\u5747\u52a8\u8109\u538b\uff08MAP\uff09\u4e0e\u9885\u5185\u538b\uff08ICP\uff09\u4e4b\u5dee\u3002<\/p>\n
\u56fe2 \u5927\u8111\u8840\u6d41\u548c\u5bf9\u6d41\u6027\u6c27\u8f93\u9001\u7684\u8c03\u8282\u3002<\/p>\n
A\u63cf\u8ff0\u4e86\u8111\u8840\u6d41\uff08CBF\uff09\u4e0e\u5e73\u5747\u52a8\u8109\u8840\u538b\uff08MAP\uff09\u3001\u52a8\u8109\u4e8c\u6c27\u5316\u78b3\u5206\u538b\uff08PaCO2\uff09\u548c\u52a8\u8109\u6c27\u5206\u538b\uff08PaO2\uff09\u4e4b\u95f4\u7684\u5173\u7cfb\u3002\u5728\u8840\u538b\u53d8\u5316\u65f6\uff0c\u76f8\u5bf9\u4e8eMAP\u7684\u4e0b\u964d\uff0c\u5927\u8111\u66f4\u6709\u6548\u5730\u80fd\u591f\u66f4\u6709\u6548\u5730\u5e94\u5bf9\u8840\u538b\u5347\u9ad8\u3002CBF\u4e0ePaCO2\u7684\u53d8\u5316\u5448\u7ebf\u6027\u548c\u6bd4\u4f8b\u5173\u7cfb\uff0c\u76f4\u5230\u51fa\u73b0\u4f4e\u78b3\u9178\u8840\u75c7\u6216\u9ad8\u78b3\u9178\u8840\u75c7\u7684\u6781\u7aef\u6c34\u5e73\u3002<\/p>\n
B\u63cf\u8ff0\u4e86PaO2\u548c\u8840\u7ea2\u86cb\u767d\u6d53\u5ea6[Hb]\u5bf9\u52a8\u8109\u6c27\u542b\u91cf\uff08CaO2\uff09\u7684\u5f71\u54cd\u3002\u5bf9\u4e8e15 g\/dL\u7684\u8840\u7ea2\u86cb\u767d\u6d53\u5ea6\u4ee5\u53ca\u5df2\u5728\u91cd\u75c7\u76d1\u62a4\u75c5\u623f\u4e2d\u7814\u7a76\u4f5c\u4e3a\u8f93\u8840\u9608\u503c\u7684\u4e24\u4e2a\u8840\u7ea2\u86cb\u767d\u9608\u503c\uff0c\u7ed8\u5236\u4e86\u4e0d\u540c[Hb]\u6d53\u5ea6\u7684\u5355\u72ec\u7ebf\u3002\u8fd8\u63cf\u7ed8\u4e86\u8865\u5145\u6c27\u5bfc\u81f4PaO2\u8fbe\u5230300 mmHg\u65f6CaO2\u7684\u6700\u5c0f\u589e\u52a0\u3002<\/p>\n
C\u63cf\u8ff0\u4e86\u9762\u677fA\u548cB\u4e2d\u6240\u63cf\u8ff0\u7684\u6bcf\u4e2a\u56e0\u7d20\u7684\u589e\u52a0\u548c\u51cf\u5c11\u5982\u4f55\u5f71\u54cd\u6574\u4f53\u5bf9\u6d41\u6027\u8111\u6c27\u8f93\u9001\uff08CDO2\uff09\u3002<\/p>\n
\u8111\u8840\u6d41\u91cf<\/p>\n
\u5728HIBI\u4e4b\u540e\uff0c\u8111\u8840\u7ba1\u963b\u529b\u589e\u52a0\uff0c\u53ef\u80fd\u662f\u7531\u4e8e\u8111\u5185\u76ae\u529f\u80fd\u969c\u788d\u3001\u8840\u7ba1\u5468\u7ec6\u80de\u6536\u7f29\u548c\u6b7b\u4ea1\u3001\u6c27\u5316\u5e94\u6fc0\u3001\u5f25\u6f2b\u6027\u8840\u7ba1\u5185\u51dd\u8840\u75c7\u548c\/\u6216\u5468\u56f4\u8840\u7ba1\u6c34\u80bf\u5bfc\u81f4\u5fae\u8840\u7ba1\u584c\u9677\u7b49\u673a\u5236\u3002\u52a8\u8109\u4f4e\u8840\u538b\u6216\u6301\u7eed\u6027\u4f4e\u78b3\u9178\u8840\u75c7\u5bfc\u81f4\u795e\u7ecf\u7cfb\u7edf\u72b6\u51b5\u6076\u5316\uff0c\u8868\u660e\u5728\u8fd9\u6bb5\u65f6\u95f4\u5185\u8111\u8840\u6d41\u51cf\u5c11\u662f\u6709\u5bb3\u7684\u3002\u5728\u751f\u7406\u7d0a\u4e71\u671f\u95f4\uff0c\u591a\u4e2a\u751f\u7406\u673a\u5236\u8c03\u8282\u8111\u8840\u6d41\u3002\u672c\u7efc\u8ff0\u4e2d\uff0c\u4e34\u5e8a\u76f8\u5173\u7684\u8111\u8840\u6d41\u8c03\u8282\u673a\u5236\u5305\u62ec\u8111\u81ea\u52a8\u8c03\u8282\u548c\u8111\u8840\u7ba1\u4e8c\u6c27\u5316\u78b3\u53cd\u5e94\u6027\uff08\u56fe2A\uff09\u3002<\/p>\n
\u8111\u81ea\u52a8\u8c03\u8282\u6307\u7684\u662f\u56fa\u6709\u7684\u8111\u8840\u7ba1\u8fd0\u52a8\u53cd\u5e94\uff0c\u5b83\u53ef\u4ee5’\u7f13\u51b2’MAP\u53d8\u5316\u5bf9\u8111\u8840\u6d41\u7684\u5f71\u54cd\u3002\u572820\u4e16\u7eaa30\u5e74\u4ee3\u65e9\u671f\uff0c\u4eba\u4eec\u5df2\u7ecf\u63cf\u8ff0\u4e86\u5728MAP\u589e\u52a0\u548c\u964d\u4f4e\u65f6\uff0c\u8f6f\u8111\u819c\u52a8\u8109\u72ed\u7a84\u548c\u6269\u5f20\u7684\u53cd\u5e94\u3002\u6b64\u540e\uff0c\u8111\u8840\u6d41\u5728MAP\u4e3a50-150 mmHg\u8303\u56f4\u5185\u4fdd\u6301\u6052\u5b9a\u7684\u89c2\u5ff5\uff08\u5373Lassen\u66f2\u7ebf\uff09\u53d8\u5f97\u975e\u5e38\u6d41\u884c\u3002\u7136\u800c\uff0c\u6700\u8fd1\u7684\u8bc1\u636e\u652f\u6301\u4e86\u5bf9Lassen\u66f2\u7ebf\u7684\u65e9\u671f\u6279\u8bc4\uff0c\u5e76\u91cd\u65b0\u786e\u8ba4\u81ea\u52a8\u8c03\u8282\u53ea\u5728\u4e00\u4e2a\u72ed\u7a84\u7684\u5065\u5eb7\u5e73\u53f0\u4e0a\u4fdd\u6301\u8111\u8840\u6d41\uff0c\u8fd9\u4e2a\u5e73\u53f0\u5e76\u4e0d\u5b8c\u5168\u5e73\u5766\uff0c\u800c\u662f\u7ecf\u5e38\u5448\u6e10\u8fdb\u6027\u4e0a\u5347\u8d8b\u52bf\u3002MAP\u7684\u6539\u53d8\u5e45\u5ea6\u5728\u6ca1\u6709\u4f34\u968f\u8111\u8840\u6d41\u6539\u53d8\u7684\u60c5\u51b5\u4e0b\u5927\u7ea6\u4e3a10\u523020 mmHg\uff08\u56fe2A\uff09\uff0c\u8fd9\u5728\u5f88\u5927\u7a0b\u5ea6\u4e0a\u53d6\u51b3\u4e8eMAP\u53d8\u5316\u7684\u5feb\u901f\u6027\u3002\u91cd\u8981\u7684\u662f\uff0c\u5728\u5065\u5eb7\u72b6\u6001\u4e0b\uff0c\u8111\u8840\u7ba1\u5bf9MAP\u7684\u589e\u52a0\u6bd4\u5bf9MAP\u7684\u964d\u4f4e\u66f4\u6709\u6548\uff0c\u56e0\u6b64\u5728\u4f4e\u8840\u538b\u65f6\u8111\u90e8\u66f4\u5bb9\u6613\u53d7\u5230\u7f3a\u8840\u7684\u5a01\u80c1\u3002\u5728\u5065\u5eb7\u72b6\u6001\u4e0b\uff0c\u81ea\u52a8\u8c03\u8282\u7684\u4e0b\u9650\u7ea6\u4e3a70 mmHg\uff0c\u5177\u6709\u5f88\u5927\u7684\u53d8\u5f02\u6027\uff1b\u7136\u800c\uff0c\u5728HIBI\u60a3\u8005\u4e2d\uff0c\u8fd9\u4e2a\u4e0b\u9650\u66f4\u9ad8\uff0c\u8868\u660e\u8111\u90e8\u5bf9\u8111\u4f9b\u8840\u4e0d\u8db3\u66f4\u52a0\u8106\u5f31\u3002\u4f7f\u7528\u4fb5\u5165\u6027\u795e\u7ecf\u76d1\u6d4b\uff0c\u5df2\u89c2\u5bdf\u5230HIBI\u60a3\u8005\u81ea\u52a8\u8c03\u8282\u7684\u5e73\u5747\u4e0b\u9650\u7ea6\u4e3a85 mmHg\uff0c\u4e2a\u4f53\u95f4\u53d8\u5f02\u6027\u663e\u8457\uff08\u8303\u56f4\u4e3a60-100 mmHg\uff09\u3002\u4e34\u5e8a\u4e0a\uff0c\u8fd9\u610f\u5473\u7740HIBI\u60a3\u8005\u53ef\u80fd\u5728\u6807\u51c6MAP\u76ee\u6807\uff08\u537365 mmHg\u4ee5\u4e0a\uff09\u4e0b\u51fa\u73b0\u8111\u4f9b\u8840\u4e0d\u8db3\u3002<\/p>\n
\u4f5c\u8005\u4e4b\u524d\u66fe\u63d0\u51fa\uff0cMAP \uff08\u5e73\u5747\u52a8\u8109\u538b\uff09\u589e\u52a0\u53ef\u80fd\u662f\u4e00\u79cd\u6709\u6548\u7684\u5fc3\u8df3\u9aa4\u505c\u540e\u590d\u82cf\u6cbb\u7597\u7b56\u7565\u3002\u7136\u800c\uff0c\u5bf9MAP\u589e\u52a0\u8fdb\u884c\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u4e2d\u6027\u7ed3\u679c\uff0c\u4ee5\u53ca\u6700\u8fd1\u7684\u4e00\u9879\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0cMAP\u589e\u52a0\u5bf9\u795e\u7ecf\u7cfb\u7edf\u7ed3\u679c\u6ca1\u6709\u5f71\u54cd\uff0c\u8fd9\u4f7f\u5f97\u7814\u7a76\u8005\u5bf9\u8fd9\u79cd\u65b9\u6cd5\u7684\u6709\u6548\u6027\u4ea7\u751f\u4e86\u7591\u95ee\u3002\u5728\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\uff0c\u589e\u52a0MAP\u7684\u8ba4\u77e5\u91cd\u8981\u6027\u4e0e\u795e\u7ecf\u7cfb\u7edf\u7ed3\u679c\u7f3a\u4e4f\u6548\u76ca\u4e4b\u95f4\u7684\u4e0d\u4e00\u81f4\uff0c\u53ef\u80fd\u53ef\u4ee5\u901a\u8fc7\u6c27\u7ea7\u8054\u7684\u540e\u671f\u529f\u80fd\u969c\u788d\uff08\u89c1\u7b2c2\u9636\u6bb5\uff1a\u6c27\u6269\u6563\u548c\u7b2c3\u9636\u6bb5\uff1a\u6c27\u5229\u7528\uff09\u4ee5\u53ca\u53ef\u80fd\u53cd\u6620\u60a3\u8005\u7279\u5b9a\u8111\u8840\u7ba1\u751f\u7406\u7684\u4e2a\u4f53\u5316\u704c\u6ce8\u9608\u503c\u6765\u89e3\u91ca\u3002\u9664\u4e86MAP\u589e\u52a0\u5bf9CDO2\u7684\u6f5c\u5728\u5f71\u54cd\u5916\uff0cMAP\u589e\u52a0\u8fd8\u4e0e\u6539\u5584\u80be\u529f\u80fd\u548c\u51cf\u5c11\u5fc3\u808c\u635f\u4f24\u6709\u5173\u3002\u6b63\u5728\u8fdb\u884c\u7684\u591a\u4e2d\u5fc3\u56fd\u9645\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08STEPCARE\uff1aNCT05564754\uff09\u5c06\u8fdb\u4e00\u6b65\u63ed\u793a\u9ad8MAP\u76ee\u6807\u5bf9HIBI\u60a3\u8005\u795e\u7ecf\u6062\u590d\u7684\u5f71\u54cd\u3002<\/p>\n
CBF\u7684\u53e6\u4e00\u4e2a\u91cd\u8981\u8c03\u8282\u56e0\u7d20\u662fPaCO2\u3002\u5728\u5065\u5eb7\u60c5\u51b5\u4e0b\uff0cPaCO2\u7684\u53d8\u5316\u4f1a\u5bfc\u81f4CBF\u65b9\u5411\u4e0a\u4e00\u81f4\u7684\u53d8\u5316\u3002\u6bcf1 mmHg\u7684PaCO2\u53d8\u5316\uff0cCBF\u7ea6\u589e\u52a04-8%\u6216\u51cf\u5c111-4%\uff08\u56fe2A\uff09\u3002\u8111\u8840\u6d41\u52a8\u529b\u5b66CO2\u53cd\u5e94\u8c03\u8282\u6574\u4e2a\u8111\u8840\u7ba1\u7684CBF\uff0c\u800c\u7070\u8d28\u7684\u8111\u8840\u7ba1CO2\u53cd\u5e94\u6bd4\u767d\u8d28\u9ad8\u4e24\u5230\u4e09\u500d\u3002\u5728\u5065\u5eb7\u4eba\u4e2d\uff0c\u901a\u8fc7\u7ecf\u9885\u591a\u666e\u52d2\u8d85\u58f0\u6d4b\u91cf\u7684\u6b63\u5e38\u8111\u8840\u7ba1CO2\u53cd\u5e94\uff08\u5373\u0394\u4e2d\u8111\u52a8\u8109\u8840\u6d41\u901f\u5ea6\uff08cm\/s\uff09\/\u0394PaCO2\uff08mmHg\uff09\uff09\u7ea6\u4e3a2.5-3.6 cm\/s\/mmHg\u3002\u7136\u800c\uff0c\u5728\u5fc3\u8df3\u9aa4\u505c\u540e\u590d\u82cf\u7684\u60a3\u8005\u4e2d\uff0cBuunk\u7b49\u4eba\u548cBisschops\u7b49\u4eba\u7684\u7814\u7a76\u5206\u522b\u62a5\u544a\u4e861.85\u548c1.34 cm\/s\/mmHg\u7684PaCO2\u503c\u3002<\/p>\n
\u8fd9\u4e9b\u6570\u636e\u8868\u660e\uff0cHIBI\u60a3\u8005\u53ef\u80fd\u5b58\u5728\u8111\u8840\u7ba1CO2\u53cd\u5e94\u529f\u80fd\u969c\u788d\u3002\u4e34\u5e8a\u4e0a\uff0cCO2\u53cd\u5e94\u53d7\u635f\u53ef\u80fd\u9650\u5236\u9ad8\u78b3\u9178\u8840\u75c7\u6539\u5584\u5bf9\u6d41\u6027CDO2\u7684\u80fd\u529b\u3002\u8fd9\u53ef\u80fd\u6709\u52a9\u4e8e\u89e3\u91ca\u4e3a\u4ec0\u4e48\u6700\u521d\u7684\u5c0f\u578b\u4e34\u5e8a\u8bd5\u9a8c\u548c\u6700\u8fd1\u53d1\u8868\u7684TAME\u8bd5\u9a8c\u6ca1\u6709\u663e\u793a\u51fa\u8f7b\u5ea6\u9ad8\u78b3\u9178\u8840\u75c7\u4e0e\u6b63\u5e38\u78b3\u9178\u8840\u75c7\u7684HIBI\u60a3\u8005\u5728\u795e\u7ecf\u7cfb\u7edf\u7ed3\u679c\u4e0a\u7684\u5dee\u5f02\u3002TAME\u8bd5\u9a8c\u5c061700\u540d\u9662\u5916\u5fc3\u810f\u9aa4\u505c\u60a3\u8005\u968f\u673a\u5206\u4e3a\u8f7b\u5ea6\u9ad8\u78b3\u9178\u8840\u75c7\u7ec4\uff08PaCO2 50-55 mmHg\uff09\u548c\u6b63\u5e38\u78b3\u9178\u8840\u75c7\u7ec4\uff08PaCO2 35-45 mmHg\uff09\uff0c\u6301\u7eed24\u5c0f\u65f6\u3002\u4e3b\u8981\u7ed3\u5c40\u662f\u6709\u5229\u7684\u795e\u7ecf\u7cfb\u7edf\u7ed3\u679c\uff0c\u5b9a\u4e49\u4e3a\u683c\u62c9\u65af\u54e5\u6269\u5c55\u8bc4\u5206\u22655\u3002\u8be5\u8bd5\u9a8c\u5e76\u672a\u8bc1\u660e\u8f7b\u5ea6\u9ad8\u78b3\u9178\u8840\u75c7\u60a3\u8005\u4e0e\u6b63\u5e38\u78b3\u9178\u8840\u75c7\u60a3\u8005\u7684\u826f\u597d\u7ed3\u5c40\u7387\u5b58\u5728\u5dee\u5f02\u3002\uff0843.5% vs 44.6%\uff0c\u76f8\u5bf9\u98ce\u9669 (RR)\uff09 0.98\uff1b95% \u7f6e\u4fe1\u533a\u95f4 (CI) 0.87\u20131.11\uff1bP \u2009= 0.76\uff09\u3002<\/p>\n
\u52a8\u8109\u8840\u6c27\u542b\u91cf<\/p>\n
\u7ef4\u6301\u548c\u589e\u52a0\u52a8\u8109\u8840\u6c27\u542b\u91cf\u5728\u5371\u91cd\u75c5\u60a3\u8005\u4e2d\u5f97\u5230\u4e86\u5e7f\u6cdb\u7814\u7a76\uff0c\u4f46\u5728\u7f3a\u8840\u7f3a\u6c27\u6027\u8111\u635f\u4f24\uff08HIBI\uff09\u65b9\u9762\u7684\u7814\u7a76\u76f8\u5bf9\u8f83\u5c11\u3002\u7531\u4e8e\u8d2b\u8840\u6216\u4f4e\u6c27\u8840\u75c7\uff08PaO2\u2009<\u200960 mmHg\uff09\uff08\u56fe2B\uff09\uff0cCaO2\u7684\u964d\u4f4e\u4f1a\u589e\u52a0\u5065\u5eb7\u4eba\u7684\u8111\u8840\u6d41\uff08CBF\uff09\u3002\u5177\u4f53\u6765\u8bf4\uff0cCaO2\u964d\u4f4e1%\uff0c\u4f1a\u5bfc\u81f4CBF\u589e\u52a02% \u3002\u8fd9\u79cdCBF\u53cd\u5e94\u7684\u5e45\u5ea6\u8db3\u4ee5\u5728\u5065\u5eb7\u4eba\u4e2d\u7ef4\u6301\u5bf9\u6d41\u5f0f\u52a8\u8109\u6c27\u8f93\u9001\uff08CDO2\uff09\u3002\u76ee\u524d\u5c1a\u4e0d\u6e05\u695aHIBI\u662f\u5426\u4f1a\u6539\u53d8\u8fd9\u79cd\u5173\u7cfb\u3002\u4f4e\u6c27\u8840\u75c7\u4e0eHIBI\u60a3\u8005\u7684\u6b7b\u4ea1\u7387\u589e\u52a0\u6709\u5173\u3002\u7136\u800c\uff0c\u6700\u8fd1\u4e00\u9879\u540d\u4e3aBOX\u7684\u8bd5\u9a8c\u6bd4\u8f83\u4e86\u6b63\u5e38\u52a8\u8109\u6c27\u5f20\u529b\uff08\u4f8b\u5982\uff0cPaO2\u2009=\u200998\u2013105 mmHg\uff09\u4e0e\u9650\u5236\u6027\u52a8\u8109\u6c27\u5f20\u529b\uff08\u4f8b\u5982\uff0cPaO2\u2009=\u200968\u201375 mmHg\uff09\uff0c\u5e76\u672a\u663e\u793a\u795e\u7ecf\u5b66\u7ed3\u679c\u4e0a\u7684\u5dee\u5f02\uff0c\u8fd9\u53ef\u80fd\u8868\u660e\u5728PaO2\u4fdd\u6301\u572860 mmHg\u4ee5\u4e0a\u7684\u9002\u5ea6\u964d\u4f4e\u65f6\uff0cHIBI\u4e2d\u7684CDO2\u4ecd\u7136\u5f97\u4ee5\u7ef4\u6301\u3002<\/p>\n
\u89c2\u5bdf\u6027\u8bc1\u636e\u8868\u660e\uff0c\u4e25\u91cd\u9ad8\u6c27\u8840\u75c7\uff08\u4f8b\u5982\uff0cPaO2\u2009>\u2009300 mmHg\uff09\u4e0e\u5fc3\u810f\u9aa4\u505c\u540e\u7684\u4e0d\u826f\u7ed3\u679c\u6709\u5173\uff0c\u5c3d\u7ba1\u5177\u4f53\u7684\u6709\u5bb3PaO2\u9608\u503c\u5c1a\u672a\u786e\u5b9a\u3002\u6700\u8fd1\u4e00\u9879TTM2\u8bd5\u9a8c\u7684\u4e8b\u540e\u5206\u6790\u53d1\u73b0\uff0c\u4e0e\u9ad8\u6c27\u8840\u75c7\u76f8\u5173\u76846\u4e2a\u6708\u6b7b\u4ea1\u7387\u7684\u6700\u4f73\u622a\u65ad\u70b9\u4e3a195 mmHg\uff08RR 1.006, 95% CI 0.95\u20131.06\uff09\u3002\u6709\u4eba\u8ba4\u4e3a\u9ad8\u6c27\u8840\u75c7\u53ef\u80fd\u4f1a\u589e\u52a0\u4ea7\u751f\u6d3b\u6027\u6c27\u81ea\u7531\u57fa\uff0c\u52a0\u91cdHIBI\u7684\u635f\u4f24 \u3002\u7136\u800c\uff0cCOMACARE\u7684\u4e8b\u540e\u5206\u6790\u663e\u793a\uff0c\u76ee\u6807PaO2\u4e3a75\u2013112 mmHg\u548c150\u2013187 mmHg\u7684HIBI\u60a3\u8005\u76f8\u6bd4\uff0c\u5728\u8111\u8102\u8fc7\u6c27\u5316\u6807\u5fd7\u7269\u4e0a\u6ca1\u6709\u5dee\u5f02\u3002\u9700\u8981\u8fdb\u4e00\u6b65\u7814\u7a76\u6765\u9610\u660e\u9002\u5ea6\u6c34\u5e73\u7684\u6c27\u4f9b\u5bf9HIBI\u4e2dCDO2\u7684\u5f71\u54cd\uff0c\u4ee5\u53ca\u662f\u5426\u9700\u8981\u4e2a\u4f53\u5316\u7684PaO2\u76ee\u6807\u3002<\/p>\n
\u9664\u4e86ICU\u4e2d\u9ad8\u6c27\u8840\u75c7\u7684\u5f71\u54cd\u5916\uff0c\u6025\u6027\u590d\u82cf\u540e\u8840\u6c27\u6c34\u5e73\u5bf9\u5bf9\u6d41CDO2\u7684\u5f71\u54cd\u4e5f\u9700\u8003\u8651\u3002\u6700\u8fd1\u7684EXACT\u8bd5\u9a8c\u8868\u660e\uff0c\u4e0e\u6807\u51c6\u62a4\u7406\u7ec4\uff08SpO2 99%\uff09\u76f8\u6bd4\uff0c\u8840\u6c27\u6c34\u5e73\u7565\u5fae\u964d\u4f4e\uff08SpO2 97%\uff09\u5e76\u4e0d\u4f1a\u663e\u8457\u5f71\u54cd\u4f4f\u9662\u51fa\u9662\u751f\u5b58\u7387\uff08\u6bd4\u503c\u6bd4[OR] 0.68 [95% CI 0.46-1.00]; P\u2009=\u20090.05\uff09\u3002\u6b64\u5916\uff0c\u5b58\u6d3b\u81f3\u51fa\u9662 \u60a3\u8005\u768412 \u4e2a\u6708\u795e\u7ecf\u7cfb\u7edf\u7ed3\u679c\u6216\u6240\u6709\u60a3\u8005\u7684 12 \u4e2a\u6708\u751f\u5b58\u7387\u4e5f\u6ca1\u6709\u660e\u663e\u5dee\u5f02\u3002\u9700\u8981\u8003\u8651\u7684\u4e00\u4e2a\u91cd\u8981\u95ee\u9898\u662fPaO2\u80fd\u591f\u63d0\u9ad8\u8111\u7ec4\u7ec7\u6c27\u5206\u538b\uff08PbtO2\uff09\u7684\u7a0b\u5ea6\uff08\u89c1\u201c\u5b9e\u8d28\u6027\u8111\u7ec4\u7ec7\u6c27\u5408\u201d\uff09\u3002\u5c3d\u7ba1\u5982\u6b64\uff0cEXACT\u8bd5\u9a8c\u7684\u7ed3\u679c\u5e76\u4e0d\u652f\u6301\u5728ROSC\u540e\u7684\u9662\u524d\u9636\u6bb5\u91c7\u7528\u66f4\u4f4e\u7684\u6c27\u6c14\u76ee\u6807\u3002<\/p>\n
\u867d\u7136\u5728PaO2\u4f9d\u8d56\u7684CaO2\u964d\u4f4e\uff08\u5373\u4f4e\u6c27\u8840\u75c7\uff09\u671f\u95f4CBF\u53cd\u5e94\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u8db3\u4ee5\u7ef4\u6301CDO2\uff0c\u4f46\u6025\u6027\u8d2b\u8840\uff08\u4f8b\u5982\u7531\u6025\u6027\u51fa\u8840\u5f15\u8d77\u7684CaO2\u964d\u4f4e\uff09\u7684CBF\u53cd\u5e94\u4e0d\u8db3\u4ee5\u7ef4\u6301CDO2\uff08\u56fe2C\uff09\u3002\u56e0\u6b64\uff0c\u6025\u6027\u8d2b\u8840\u53ef\u80fd\u4f1a\u5bfc\u81f4HIBI\u60a3\u8005\u7684\u8111\u7ec4\u7ec7\u7f3a\u6c27\uff0c\u5e76\u52a0\u91cd\u5fc3\u810f\u9aa4\u505c\u540e\u7684\u795e\u7ecf\u5b66\u7ed3\u5c40\u4e0d\u826f\u3002\u5728\u5bf9118\u4f8bHIBI\u60a3\u8005\u8fdb\u884c\u7684\u4e00\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u4e2d\uff0c\u5fc3\u810f\u9aa4\u505c\u540e48\u5c0f\u65f6\u548c7\u5929\u5185\u5e73\u5747\u8840\u7ea2\u86cb\u767d\u6d53\u5ea6\u8f83\u9ad8\u4e0e\u5728\u51fa\u9662\u65f6\u8c03\u6574\u540e\u795e\u7ecf\u5b66\u7ed3\u5c40\u4e0d\u826f\u7684\u60a3\u8005\u6bd4\u4f8b\u4e0b\u964d\u6709\u5173\uff08OR 0.69\/\u6bcf10\u4e2a\u5355\u4f4d\u7684Hb\u964d\u4f4e\uff0c95% CI 0.54-0.88\uff0cP\u2009<\u20090.01\uff09\u3002<\/p>\n
\u5728HIBI\u4e2d\u9488\u5bf9\u4f18\u5316\u5bf9\u6d41CDO2\u7684\u4e34\u5e8a\u5e72\u9884\u4ecd\u7136\u662f\u79ef\u6781\u7814\u7a76\u7684\u7126\u70b9\uff08\u56fe3\uff09\u3002\u4ece\u6982\u5ff5\u4e0a\u8bb2\uff0c\u7814\u7a76MAP\u589e\u52a0\u3001\u8f7b\u5ea6\u9ad8\u78b3\u9178\u8840\u75c7\u3001\u9ad8\u6c27\u8840\u75c7\u548c\u7ea2\u7ec6\u80de\u8f93\u6ce8\u7684\u6f5c\u5728\u6548\u7528\u662f\u5408\u7406\u7684\uff08\u56fe3A\uff09\u3002\u7136\u800c\uff0c\u5b83\u4eec\u7684\u4e34\u5e8a\u7597\u6548\u5c1a\u672a\u786e\u5b9a\uff08\u88681\uff09\uff0c\u8fd9\u8868\u660eHIBI\u7684\u75c5\u7406\u751f\u7406\u5b66\u6bd4\u4ec5\u4ec5\u662f\u5bf9\u6d41CDO2\u7684\u5931\u8c03\u66f4\u4e3a\u590d\u6742\u3002\u91cd\u8981\u7684\u662f\uff0c\u5728\u9009\u62e9\u589e\u52a0\u5bf9\u6d41CDO2\u7684\u6b63\u786e\u4e34\u5e8a\u5e72\u9884\u65f6\uff0c\u8003\u8651\u4e2a\u4f53\u60a3\u8005\u7684\u9885\u5185\u538b\u548c\u9885\u5185\u5bb9\u79ef\u5f39\u6027\u662f\u81f3\u5173\u91cd\u8981\u7684\u3002\u4f8b\u5982\uff0c\u5728\u9885\u5185\u538b\u5347\u9ad8\u7684HIBI\u60a3\u8005\u4e2d\uff0c\u8f7b\u5ea6\u9ad8\u78b3\u9178\u8840\u75c7\u53ef\u80fd\u5bfc\u81f4\u8111\u8840\u7ba1\u6269\u5f20\u3001\u8111\u8840\u5bb9\u91cf\u589e\u52a0\u548c\u9885\u9ad8\u538b\u3002\u540c\u6837\uff0c\u5728\u4e25\u91cd\u4f4e\u6c27\u8840\u75c7\u6216CPP\u964d\u4f4e\u7684\u60c5\u51b5\u4e0b\uff0c\u8fd9\u4e9b\u60a3\u8005\u4e5f\u53ef\u80fd\u51fa\u73b0\u4ee3\u507f\u6027\u8840\u7ba1\u6269\u5f20\u53cd\u5e94\u800c\u5f15\u8d77\u5371\u9669\u7684\u9885\u5185\u538b\u5347\u9ad8\u3002\u56e0\u6b64\uff0c\u5728ROSC\u540e\u4f18\u5316\u5bf9\u6d41CDO2\u7b56\u7565\u65f6\uff0c\u8bc4\u4f30\u9885\u5185\u538b\uff08\u89c1\u4e0b\u6587\u7684\u201c\u795e\u7ecf\u76d1\u6d4b\uff1a\u9885\u5185\u538b\u201d\uff09\u662f\u5fc5\u987b\u8003\u8651\u7684\u5173\u952e\u751f\u7406\u53d8\u91cf\u3002<\/p>\n
\u56fe3 \u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24\uff08HIBI\uff09\u7684\u6cbb\u7597\u65b9\u6cd5\u4e0e\u6c27\u7ea7\u8054\u6709\u5173\u3002\u8be5\u56fe\u63cf\u8ff0\u4e86\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24\u4e2d\u6c27\u7ea7\u8054\u529f\u80fd\u969c\u788d\u4ee5\u53ca\u65e8\u5728\u6539\u5584\u6c27\u6c14\u8f93\u9001\u5230\u5927\u8111\u3001\u5927\u8111\u6c27\u5408\u4ee5\u53ca\/\u6216\u6c27\u6c14\u5229\u7528\uff08\u7ebf\u7c92\u4f53\u529f\u80fd\uff09\u7684\u9776\u5411\u6cbb\u7597\u65b9\u6cd5\u3002<\/p>\n
A \u4ee5\u5bf9\u6d41\u6c27\u8f93\u9001\u4e3a\u6cbb\u7597\u76ee\u6807\uff0c\u589e\u52a0\u5e73\u5747\u52a8\u8109\u8840\u538b\uff08MAP\uff09\u548c\u9ad8\u78b3\u9178\u8840\u75c7\u65e8\u5728\u901a\u8fc7\u589e\u52a0\u6d41\u91cf\u7684\u6db2\u538b\u538b\u5934\u548c\u901a\u8fc7CO2\u4ecb\u5bfc\u7684\u8111\u8840\u7ba1\u8212\u5f20\u964d\u4f4e\u5927\u8111\u8840\u7ba1\u963b\u529b\uff0c\u4ece\u800c\u589e\u52a0\u8111\u704c\u6ce8\u3002\u76f8\u53cd\uff0c\u9ad8\u6c27\u548c\u8f93\u8840\u65e8\u5728\u5206\u522b\u901a\u8fc7\u589e\u52a0\u6eb6\u89e3\u6c27\u538b\u529b\u548c\u8840\u7ea2\u86cb\u767d\u6d53\u5ea6\u6765\u589e\u52a0\u6c27\u542b\u91cf\u3002<\/p>\n
B \u4e3a\u4e86\u6cbb\u7597\u6269\u6563\u9650\u5236\uff0c\u9ad8\u6e17\u76d0\u6c34\u5df2\u88ab\u8bc1\u660e\u80fd\u51cf\u5c11\u8111\u6c34\u80bf\u4ee5\u53ca\u8111\u9759\u8109\u8840\u548c\u5b9e\u8d28\u4e4b\u95f4\u7684\u6c27\u68af\u5ea6\uff0c\u8868\u660e\u6539\u5584\u4e86\u6c27\u6269\u6563\u3002<\/p>\n
C \u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24\u548c\u5168\u8111\u7f3a\u8840\u6027\u75be\u75c5\u6a21\u578b\u4e2d\u5df2\u7ecf\u6709\u4e86\u5145\u5206\u7684\u8bc1\u636e\u8bc1\u660e\u6c27\u5229\u7528\u548c\u7ebf\u7c92\u4f53\u529f\u80fd\u969c\u788d\u3002\u590d\u5408\u72691\u4ea7\u751f\u8fc7\u91cf\u7684\u6d3b\u6027\u6c27\u7269\u8d28\uff08ROS\uff09\uff0c\u5bfc\u81f4TCA \u5faa\u73af\u4e2d\u5173\u952e\u9176\u548c\u4ee3\u8c22\u8fc7\u7a0b\u7684\u529f\u80fd\u969c\u788d\u3002\u6b64\u5916\uff0c\u9499\u589e\u52a0\u5bfc\u81f4\u7ec6\u80de\u8272\u7d20C\u7684\u7ebf\u7c92\u4f53\u6d41\u51fa\u548c\u4fc3\u51cb\u4ea1\u4fe1\u53f7\u4f20\u5bfc\u3002\u5b9e\u9a8c\u6a21\u578b\u4f7f\u7528\u4e19\u4e8c\u9178\u4e8c\u7532\u916f\u6765\u963b\u65ad\u7425\u73c0\u9178\u7684\u8fc7\u5ea6\u7f3a\u8840\u540e\u6c27\u5316\uff0c\u800cMitoSNO\u548cRotenone\u5219\u7528\u4e8e\u9009\u62e9\u6027\u963b\u65ad\u590d\u5408\u72691\u901a\u8fc7\u9006\u7535\u5b50\u4f20\u9012\u4ea7\u751f\u7684\u4e0b\u6e38ROS\u7684\u4ea7\u751f\u3002\u73af\u5b62\u9709\u7d20A\u88ab\u7528\u6765\u6291\u5236\u7ebf\u7c92\u4f53\u6e17\u900f\u8f6c\u6362\u5b54\uff0c\u5e76\u51cf\u5c11\u7ec6\u80de\u8272\u7d20C\u7684\u5916\u6d41\u548c\u968f\u4e4b\u800c\u6765\u7684\u51cb\u4ea1\u4fe1\u53f7\u4f20\u5bfc\u3002\u6700\u540e\uff0c\u8f85\u56e0\u5b50\u786b\u80fa\u7d20\u548c\u8f85\u9176Q10\uff08Co-Q10\uff09\u5df2\u88ab\u7528\u4e8e\u6062\u590d\u7f3a\u8840\u518d\u704c\u6ce8\u635f\u4f24\u540e\u7684\u4ee3\u8c22\u529f\u80fd\u3002<\/p>\n
\u7b2c\u4e8c\u9636\u6bb5\uff1a\u6c27\u6c14\u6269\u6563<\/p>\n
\u5728\u6b63\u5e38\u7684\u9759\u606f\u72b6\u6001\u4e0b\uff0c\u8f93\u9001\u5230\u5927\u8111\u7684\u6c27\u6c14\u5927\u7ea6\u670925%\u4f1a\u6269\u6563\u5230\u8111\u7ec4\u7ec7\u4e2d\u3002\u56e0\u6b64\uff0c\u6b63\u5e38\u7684\u8111\u9759\u8109\u8840\u7ea2\u86cb\u767d\u6c27\u9971\u548c\u5ea6\u7ea6\u4e3a70-75%\u3002\u5f53\u9700\u8981\u4ece\u8840\u7ea2\u86cb\u767d\u4e2d\u989d\u5916\u63d0\u53d6\u6c27\u6c14\u4ee5\u7ef4\u6301\u6052\u5b9a\u7684\u8111\u4ee3\u8c22\u65f6\uff0c\u8fd9\u79cd\u5173\u7cfb\u53ef\u4ee5\u901a\u8fc7CBF\uff08\u8111\u8840\u6d41\u91cf\uff09\u7684\u51cf\u5c11\u800c\u6539\u53d8\u3002\u6c27\u6c14\u4ece\u8111\u8840\u7ba1\u8fdb\u5165\u8111\u7ec4\u7ec7\u7684\u6269\u6563\u53d7\u5230Fick\u6269\u6563\u5b9a\u5f8b\u7684\u751f\u7269\u7269\u7406\u539f\u7406\u7684\u63a7\u5236\uff0c\u8be5\u5b9a\u5f8b\u5728\u65b9\u7a0b\uff082\uff09\u4e2d\u6982\u8ff0\u3002<\/p>\n
Diffusion\u221dAT\u22c5D\u22c5\u0394PO2<\/p>\n
\u5177\u4f53\u800c\u8a00\uff0c\u6c27\u6c14\u7684\u6269\u6563\u4e0e\u6269\u6563\u8868\u9762\u79ef\uff08A\uff09\u3001\u6269\u6563\u7cfb\u6570\uff08D\uff09\u4ee5\u53ca\u4ece\u8840\u7ba1\u5230\u7ec4\u7ec7\u7684\u538b\u529b\u68af\u5ea6\uff08\u0394PO2\uff09\u6210\u6b63\u6bd4\u3002\u5728\u8003HIBI\u80cc\u666f\u4e0b\uff0c\u6700\u91cd\u8981\u7684\u662f\u8981\u8003\u8651\u5230\u6c27\u6c14\u8fdb\u5165\u5927\u8111\u7684\u6269\u6563\u4e0e\u6269\u6563\u5c4f\u969c\u7684\u539a\u5ea6\uff08T\uff09\u6210\u53cd\u6bd4\u3002\u7136\u800c\uff0c\u5728\u6982\u5ff5\u4e0a\uff0c\u66f4\u5408\u9002\u7684\u65b9\u5f0f\u662f\u5c06\u5176\u89c6\u4e3a\u6c27\u6c14\u6210\u529f\u8fdb\u5165\u8111\u7ec4\u7ec7\u6240\u5fc5\u987b\u7ecf\u8fc7\u7684\u6269\u6563\u8def\u5f84\u7684\u957f\u5ea6\u3002\u8be5\u5c4f\u969c\u5305\u62ec\u8111\u8840\u7ba1\u5185\u76ae\u3001\u8840\u7ba1\u58c1\u548c\u95f4\u8d28\u7ec4\u7ec7\uff0c\u7531\u4e8e\u591a\u79cd\u56e0\u7d20\uff08\u5305\u62ec\u8111\u6c34\u80bf\uff09\uff0c\u6269\u6563\u7684\u8def\u5f84\u957f\u5ea6\u53ef\u80fd\u4f1a\u589e\u52a0\u3002\u6b64\u5916\uff0c\u7531\u4e8e\u5fae\u8840\u6813\u5f62\u6210\u6216\u5185\u76ae\u6c34\u80bf\u5bfc\u81f4\u7684\u5c40\u90e8\u5fae\u8840\u7ba1\u5173\u95ed\u53ef\u80fd\u4f7f\u8111\u90e8\u4f9d\u8d56\u4e8e\u9700\u8981\u4ece\u4fdd\u6301\u901a\u7545\u7684\u8fdc\u5904\u6bdb\u7ec6\u8840\u7ba1\u6269\u6563\u7684\u6c27\u6c14\uff0c\u5bfc\u81f4\u6c27\u6c14\u6269\u6563\u7684\u8def\u5f84\u957f\u5ea6\u663e\u8457\u589e\u52a0\u3002<\/p>\n
Menon \u7b49\u4eba\u5728\u521b\u4f24\u6027\u8111\u635f\u4f24\u7684\u4eba\u4f53\u7814\u7a76\u4e2d\u9996\u6b21\u8bc1\u660e\u4e86\u8840\u6db2\u5230\u8111\u7ec4\u7ec7\u7684\u6c27\u6c14\u6269\u6563\u53d7\u9650\uff08\u5373\u6269\u6563\u9650\u5236\uff09\u4f5c\u4e3a\u6025\u6027\u8111\u635f\u4f24\u4e2d\u8111\u7ec4\u7ec7\u7f3a\u6c27\u7684\u75c5\u7406\u751f\u7406\u5b66\u7ec4\u6210\u90e8\u5206\u3002\u8be5\u7814\u7a76\u8868\u660e\uff0c\u8111\u9759\u8109\u6c27\u5206\u538b\uff08PvO2\uff09\u4e0e\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\uff08PbtO2\uff09\u4e4b\u95f4\u7684\u5dee\u5f02\uff0c\u5373PvO2-PbtO2\u68af\u5ea6\uff0c\u5728\u8111\u7ec4\u7ec7\u7f3a\u6c27\u60a3\u8005\u4e2d\u66f4\u5927\u3002\u901a\u8fc7\u77ed\u6682\u7684\u4f4e\u78b3\u9178\u8840\u75c7\u8fc5\u901f\u964d\u4f4eCBF\uff0c\u7814\u7a76\u8005\u89c2\u5bdf\u5230\u4e0e\u8111\u7ec4\u7ec7\u6b63\u5e38\u6c27\u5408\u7684\u60a3\u8005\u76f8\u6bd4\uff0c\u8111\u7ec4\u7ec7\u7f3a\u6c27\u60a3\u8005\u4e2d\u8111\u6c27\u63d0\u53d6\u5206\u6570\u7684\u589e\u52a0\u8f83\u5c0f\uff0c\u8868\u660e\u5b58\u5728\u6c27\u6c14\u6269\u6563\u53d7\u9650\uff087\u00b15% vs 16\u00b16%\uff0cP<0.05\uff09\u3002\u7c7b\u4f3c\u7684\u89c2\u5bdf\u7ed3\u679c\u4e5f\u5728\u60a3\u6709HIBI\u7684\u4eba\u7fa4\u4e2d\u5f97\u5230\u8bc1\u5b9e\u3002\u5177\u4f53\u800c\u8a00\uff0c\u590d\u82cf\u540e\u8111\u7ec4\u7ec7\u7f3a\u6c27\u7684\u60a3\u8005\u8868\u73b0\u51fa\u6bd4\u8111\u7ec4\u7ec7\u6b63\u5e38\u6c27\u5408\u7684\u60a3\u8005\u66f4\u5927\u7684\u8111\u9759\u8109\u6c27\u5206\u538b-\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\u68af\u5ea6\uff0839 mmHg [SD11] vs 16 mmHg [SD6]\uff0cP<0.001\uff09\u3002\u6b64\u5916\uff0cCPP\u7684\u589e\u52a0\u4e0e\u8111\u7ec4\u7ec7\u6b63\u5e38\u6c27\u5408\u7684\u60a3\u8005\u4e2dPvO2-PbtO2\u68af\u5ea6\u7684\u51cf\u5c0f\u76f8\u5173\uff0c\u5373\u6bcf\u589e\u52a01 mmHg\u7684CPP\uff0cPvO2-PbtO2\u68af\u5ea6\u51cf\u5c0f0.36 mmHg\uff0895% CI 0.18-0.54\uff0cP<0.001\uff09\uff0c\u8868\u660e\u6c27\u6c14\u6269\u6563\u6b63\u5e38\u3002\u76f8\u53cd\uff0c\u5728\u8111\u7ec4\u7ec7\u7f3a\u6c27\u7684\u60a3\u8005\u4e2d\uff0cCPP\u7684\u53d8\u5316\u4e0ePvO2-PbtO2\u68af\u5ea6\u4e4b\u95f4\u6ca1\u6709\u5173\u7cfb\uff08\u7cfb\u6570\u4e3a-0.29\uff0c95% CI -0.17\u81f30.11\uff0cP=0.73\uff09\uff0c\u8868\u660e\u5b58\u5728\u6269\u6563\u9650\u5236\u3002<\/p>\n
HIBI\u53ef\u80fd\u5b58\u5728\u4e0d\u540c\u7684\u75c5\u7406\u751f\u7406\u5b66\u8868\u578b\uff0c\u5176\u4e2d\u4e00\u4e9b\u60a3\u8005\u8868\u73b0\u51fa\u201c\u704c\u6ce8\u4f9d\u8d56\u578b\u201d\u751f\u7406\u72b6\u6001\uff08\u5373\uff0cPbtO2\u968f\u7740\u704c\u6ce8\u589e\u52a0\u800c\u589e\u52a0\uff09\u3002\u76f8\u53cd\uff0c\u5176\u4ed6\u60a3\u8005\u8868\u73b0\u51fa\u201c\u6269\u6563\u9650\u5236\u578b\u201d\u751f\u7406\u72b6\u6001\uff08\u5373\uff0c\u7531\u4e8e\u6c27\u6c14\u6269\u6563\u53d7\u9650\uff0cPbtO2\u5bf9\u589e\u52a0\u7684\u704c\u6ce8\u4e0d\u654f\u611f\uff09\u3002\u4e34\u5e8a\u4e0a\uff0c\u5728\u8868\u73b0\u51fa\u6269\u6563\u9650\u5236\u7684HIBI\u60a3\u8005\u4e2d\uff0c\u6cbb\u7597\u65b9\u6cd5\u65e8\u5728\u4f18\u5316\u5bf9\u6d41\u6027CDO2\uff08\u4f8b\u5982\uff0cMAP\u589e\u52a0\uff09\u7684\u60a3\u8005\u8111\u7ec4\u7ec7\u6c27\u5408\u4e0d\u4f1a\u589e\u52a0\uff0c\u4f7f\u5f97\u6b64\u7c7b\u5e72\u9884\u63aa\u65bd\u65e0\u6548\u3002\u76f8\u53cd\uff0c\u6c27\u6269\u6563\u6b63\u5e38\u7684\u60a3\u8005\u5f88\u53ef\u80fd\u56e0\u4e3a\u5bf9\u6d41\u6027CDO2\u589e\u52a0\u800c\u8868\u73b0\u51fa\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\u7684\u6539\u5584\u3002\u5b9e\u65f6\u8bc6\u522b\u8fd9\u4e9b\u8868\u578b\u5bf9\u4e8e\u5e8a\u8fb9\u4e34\u5e8a\u533b\u751f\u6765\u8bf4\u662f\u4e00\u4e2a\u660e\u786e\u7684\u63aa\u65bd\uff0c\u4ee5\u4fc3\u8fdb\u590d\u82cf\u540e\u4e2a\u4f53\u5316\u7ba1\u7406\u8303\u5f0f\u7684\u5b9e\u65bd\u3002<\/p>\n
\u65e8\u5728\u4f18\u5316\u6c27\u6269\u6563\u7684\u5e72\u9884\u63aa\u65bd\u7684\u7814\u7a76\u4ecd\u5904\u4e8e\u521d\u6b65\u9636\u6bb5\u3002\u5728\u4eba\u4f53\u4e2d\uff0c\u6269\u6563\u9650\u5236\u4e0e\u7535\u955c\u4e0b\u7684\u8840\u7ba1\u5468\u56f4\u6c34\u80bf\u6709\u5173\uff0c\u8fd9\u53ef\u80fd\u5bf9\u6e17\u900f\u7597\u6cd5\u4ea7\u751f\u53cd\u5e94\u3002\u9ad8\u6e17\u76d0\u6c34\u53ef\u4ee5\u51cf\u5c11\u8111\u9759\u8109\u6c27\u5206\u538b-\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\u68af\u5ea6\uff0c\u5e76\u6539\u5584\u8111\u7ec4\u7ec7\u7f3a\u6c27\u7684HIBI\u60a3\u8005\u7684\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\uff0c\u800c\u5bf9\u9885\u5185\u538b\uff08ICP\uff09\u3001\u8111\u704c\u6ce8\u538b\uff08CPP\uff09\u548c\u5e73\u5747\u52a8\u8109\u538b\uff08MAP\uff09\u7b49\u5176\u4ed6\u5173\u952e\u751f\u7406\u53d8\u91cf\u6ca1\u6709\u663e\u8457\u5f71\u54cd\uff08\u56fe3B\uff09\u3002\u8111\u9759\u8109\u6c27\u5206\u538b-\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\u68af\u5ea6\u7684\u964d\u4f4e\u548c\u540c\u65f6\u6539\u5584\u7684\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\u4e3a\u901a\u8fc7\u51cf\u5c11\u6269\u6563\u5c4f\u969c\u7684\u539a\u5ea6\u7684\u6e17\u900f\u7597\u6cd5\uff08\u516c\u5f0f2\uff09\u63d0\u4f9b\u4e86\u521d\u6b65\u8bc1\u636e\uff0c\u8868\u660e\u6e17\u900f\u7597\u6cd5\u53ef\u80fd\u589e\u5f3a\u6c27\u6c14\u8fdb\u5165\u8111\u7ec4\u7ec7\u7684\u6269\u6563\u3002\u5c3d\u7ba1\u524d\u666f\u5e7f\u9614\uff0c\u4f46\u4ecd\u9700\u5f00\u5c55\u5927\u91cf\u5de5\u4f5c\u6765\u8fdb\u4e00\u6b65\u63cf\u8ff0\u8fd9\u79cd\u751f\u7406\u5b66\u7279\u5f81\u5e76\u8bc4\u4f30\u5176\u6f5c\u5728\u7684\u4e34\u5e8a\u7597\u6548\u3002<\/p>\n
\u7b2c\u4e09\u9636\u6bb5\uff1a\u6c27\u6c14\u5229\u7528<\/p>\n
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CMRO2=CBF(CaO2\u2212 CvO2)<\/p>\n
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\u4e3a\u4e86\u6539\u5584CDO2\u548c\u6c27\u5229\u7528\u4e4b\u95f4\u7684\u5e73\u8861\uff0c\u5728\u590d\u82cf\u540e\u7684\u62a4\u7406\u4e2d\u5e7f\u6cdb\u91c7\u7528\u4e86\u4e2d\u5ea6\u6cbb\u7597\u6027\u4f4e\u6e29\u3002\u7136\u800c\uff0c\u652f\u6301\u6027\u7684\u8bc1\u636e\u5b58\u5728\u51b2\u7a81\uff0c\u6700\u8fd1\u7684\u7efc\u5408TTM2\u8bd5\u9a8c\u663e\u793a\u4f4e\u6e29\u7597\u6cd5\u5728HIBI\u4e2d\u6ca1\u6709\u76ca\u5904\u3002\u5c3d\u7ba1\u6cbb\u7597\u6027\u4f4e\u6e29\u5728\u975e\u53ef\u7535\u51fb\u5fc3\u5f8b\u5931\u5e38\u60a3\u8005\u4e2d\u663e\u793a\u4e86\u4e00\u4e9b\u6f5c\u5728\u7684\u76ca\u5904\uff0c\u4f46\u5c1a\u672a\u786e\u5b9a\u54ea\u4e9b\u60a3\u8005\u4eba\u7fa4\u53ef\u80fd\u4ece\u6cbb\u7597\u6027\u4f4e\u6e29\u4e2d\u53d7\u76ca\u3002\u9274\u4e8e\u6301\u7eed\u4f4e\u6e29\u7684\u660e\u663e\u5168\u8eab\u526f\u4f5c\u7528\uff0c\u6b63\u5728\u7814\u7a76\u66ff\u4ee3\u6cbb\u7597\u65b9\u6cd5\u4ee5\u4f18\u5316\u6c27\u5229\u7528\u548c\u7ebf\u7c92\u4f53\u529f\u80fd\u3002<\/p>\n
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\u901a\u8fc7\u795e\u7ecf\u76d1\u6d4b\u8bc4\u4f30O2\u7ea7\u8054<\/p>\n
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\u9885\u5185\u538b<\/p>\n
\u901a\u8fc7\u6d4b\u91cf\u52a8\u8109\u8840\u538b\uff0c\u9885\u5185\u538b\uff08ICP\uff09\u76d1\u6d4b\u80fd\u591f\u6301\u7eed\u91cf\u5316\u8111\u704c\u6ce8\u538b\uff08CPP\uff09\uff0c\u8fd9\u662f\u8111\u8840\u6d41\u548c\u5bf9\u6d41\u6c27\u8f93\u9001\u7684\u5173\u952e\u51b3\u5b9a\u56e0\u7d20\u3002ICP\u76d1\u6d4b\u4f20\u7edf\u4e0a\u7528\u4e8e\u521b\u4f24\u6027\u8111\u635f\u4f24\u6cbb\u7597\uff0c\u4f46\u7814\u7a76\u4eba\u5458\u4e5f\u5f00\u59cb\u5728\u7f3a\u8840\u6027\u8111\u635f\u4f24\u540e\u8111\u7f3a\u8840\u7f3a\u6c27\uff08HIBI\uff09\u60a3\u8005\u4e2d\u76d1\u6d4bICP\u3002\u5728HIBI\u60a3\u8005\u4e2d\uff0c\u9885\u5185\u9ad8\u538b\u7684\u8d1f\u62c5\u5b58\u5728\u660e\u663e\u7684\u60a3\u8005\u5f02\u8d28\u6027\uff0c\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u7684\u8303\u56f4\u4ece\u6b63\u5e38ICP\u5230\u66b4\u53d1\u6027\u8111\u6c34\u80bf\u548c\u8111\u6b7b\u4ea1\u3002\u6700\u8fd1\u4e00\u9879\u5173\u4e8eHIBI\u60a3\u8005\u8fde\u7eed\u6837\u672c\u7684\u524d\u77bb\u6027\u5e72\u9884\u7814\u7a76\u663e\u793a\uff0c\u5e73\u5747ICP\u4e3a14 mmHg\uff08SD11\uff09\u3002\u5728\u8fd9\u4e2a\u961f\u5217\u4e2d\uff0c\u76d1\u6d4b\u671f\u95f4ICP > 20 mmHg\u7684\u65f6\u95f4\u767e\u5206\u6bd4\u4e3a22\uff05\uff08\u8303\u56f40-100\uff09\u3002\u91cd\u8981\u7684\u662f\uff0c\u8fd9\u4e9bHIBI\u60a3\u8005\u8fd8\u8868\u73b0\u51fa\u9885\u5185\u987a\u5e94\u6027\u6709\u9650\uff0c\u8fd9\u53ef\u80fd\u662f\u7531\u4e8e\u8f7b\u5ea6\u8111\u6c34\u80bf\u6240\u81f4\u3002\u56e0\u6b64\uff0c\u5982\u679c\u4e0d\u91c7\u53d6\u964d\u4f4e ICP \u7684\u5e72\u9884\u63aa\u65bd\uff0c\u5373\u4f7fHIBI\u60a3\u8005\u7684ICP\u201c\u6b63\u5e38\u201d\uff0c\u4ecd\u53ef\u80fd\u53d1\u5c55\u4e3a\u9885\u5185\u9ad8\u538b\u3002\u4e8b\u5b9e\u4e0a\uff0c\u4e34\u5e8a\u524d\u7814\u7a76\u8868\u660e\uff0c\u6e17\u900f\u7597\u6cd5\u7684\u5e94\u7528\u53ef\u4ee5\u51cf\u8f7bHIBI\u4e2d\u7684\u8111\u6c34\u80bf\uff0c\u5e76\u51cf\u5c11\u8111\u635f\u4f24\u751f\u7269\u6807\u5fd7\u7269\u7684\u91ca\u653e\u3002\u76d1\u6d4bICP\u53ef\u4ee5\u6d4b\u91cf\u81ea\u52a8\u8c03\u8282\u6307\u6570\uff0c\u7279\u522b\u662f\u538b\u529b\u53cd\u5e94\u6307\u6570\uff0c\u53ef\u7528\u4e8e\u4f30\u8ba1\u4e2a\u4f53\u5316\u7684\u6700\u4f73\u704c\u6ce8\u538b\u3002\u7136\u800c\uff0c\u8fd9\u4e9b\u6307\u6807\u5728\u60a3\u8005\u7ba1\u7406\u4e2d\u7684\u4e34\u5e8a\u6548\u7528\u5c1a\u5f85\u786e\u5b9a\u3002\u5c3d\u7ba1ICP\u76d1\u6d4b\u662fHIBI\u4e2d\u4e00\u4e2a\u6709\u8da3\u7684\u8bca\u65ad\u65b9\u6cd5\uff0c\u4f46\u5176\u4fb5\u5165\u6027\u7684\u7279\u70b9\u9650\u5236\u4e86\u5176\u5728\u6307\u5bfcHIBI\u7ba1\u7406\u65b9\u9762\u7684\u5e7f\u6cdb\u5e94\u7528\u3002\u73b0\u6709\u6587\u732e\u4e2d\u63cf\u8ff0\u7684HIBI\u4e2dICP\u76d1\u6d4b\u7684\u4e00\u4e2a\u91cd\u8981\u5c40\u9650\u6027\u662f\u5b83\u4e3b\u8981\u662f\u5728\u975e\u5fc3\u6e90\u6027\u505c\u640f\u7684\u60a3\u8005\u4e2d\u8fdb\u884c\u7684\uff08\u4f8b\u5982\uff0c\u4e0d\u53ef\u7535\u51fb\u8282\u5f8b\uff09\u3002\u5728\u51fa\u73b0\u53ef\u7535\u51fb\u8282\u5f8b\u7684\u60a3\u8005\u4e2d\uff0c\u5176\u505c\u640f\u5f80\u5f80\u662f\u7531\u4e8e\u6025\u6027\u51a0\u72b6\u52a8\u8109\u95ed\u585e\u5f15\u8d77\u7684\uff0c\u968f\u540e\u9700\u8981\u6297\u8840\u5c0f\u677f\u6216\u6297\u51dd\u6cbb\u7597\u53ef\u80fd\u4f1a\u59a8\u788d\u4fb5\u5165\u6027\u795e\u7ecf\u76d1\u6d4b\u7684\u5b9e\u65bd\u3002\u4f5c\u4e3a\u81ea\u4e3b\u5faa\u73af\u6062\u590d\u540e\u91cd\u75c7\u76d1\u62a4\u7ba1\u7406\u7684\u4e00\u90e8\u5206\uff0c\u4ecd\u9700\u8fdb\u884c\u5927\u91cf\u7684\u5de5\u4f5c\u4ee5\u9610\u660eICP\u76d1\u6d4b\u5728HIBI\u60a3\u8005\u4e2d\u7684\u4f5c\u7528\u53ca\u5176\u9002\u5e94\u75c7\u548c\u7597\u6548\u3002<\/p>\n
\u9888\u9759\u8109\u7403\u8840\u6c27\u9971\u548c\u5ea6\u6d4b\u5b9a<\/p>\n
\u9888\u9759\u8109\u7403\u56ca\u6c27\u5408\u672f\uff08SjvO2\uff09\u901a\u8fc7\u9006\u884c\u653e\u7f6e\u5728\u9888\u9759\u8109\u4f18\u52bf\u9759\u8109\u4e2d\u7684\u8840\u7ba1\u5185\u5bfc\u7ba1\u6d4b\u91cf\u4e59\u72b6\u7aa6\u8fdc\u7aef\u8840\u7ea2\u86cb\u767d\u7684\u6c27\u9971\u548c\u5ea6\u3002\u5728\u6b63\u5e38\u6c27\u6269\u6563\u72b6\u6001\u4e0b\uff0cSjvO2\u53ef\u4ee5\u901a\u8fc7\u53cd\u6620\u5bf9\u6d41\u6027CDO2\u548c\u6c27\u5229\u7528\u4e4b\u95f4\u7684\u6574\u4f53\u5e73\u8861\u6765\u4ee3\u8868\u5168\u8111\u8840\u6db2\u52a8\u529b\u5b66\u3002\u7136\u800c\uff0c\u5728HIBI\u4e2d\uff0c\u5982\u679c\u6c27\u6269\u6563\u5f02\u5e38\uff0c\u589e\u52a0\u7684SjvO2\u53ef\u80fd\u8868\u660e\u6f5c\u5728\u7684\u75c5\u7406\u751f\u7406\u8fc7\u7a0b\uff0c\u5982\u5267\u70c8\u8111\u6c34\u80bf\u3001\u7ebf\u7c92\u4f53\u529f\u80fd\u969c\u788d\uff0c\u6216\u5e7f\u6cdb\u7684\u8111\u7ec4\u7ec7\u6b7b\u4ea1\u3002<\/p>\n
\u589e\u52a0\u7684SjvO2\u4e0e\u4e0d\u826f\u795e\u7ecf\u529f\u80fd\u7ed3\u5c40\u548c\u795e\u7ecf\u5143\u7279\u5f02\u6027\u70ef\u9187\u9176\uff08NSE\uff09\u7684\u8840\u6e05\u6c34\u5e73\u5347\u9ad8\u76f8\u5173\uff0cNSE\u662f\u795e\u7ecf\u5143\u7ec6\u80de\u4f53\u635f\u4f24\u7684\u751f\u7269\u6807\u5fd7\u7269\u3002Richter\u7b49\u8fdb\u884c\u4e86\u4e00\u9879\u56de\u987e\u6027\u7814\u7a76\uff0c\u7814\u7a76\u5bf9\u8c61\u4e3a40\u4f8b\u9662\u5916\u5fc3\u810f\u505c\u8df3\u60a3\u8005\uff0c\u4ed6\u4eec\u5728\u5165\u9662\u540e\u768472\u5c0f\u65f6\u5185\u95f4\u6b47\u6027\u91c7\u6837SjvO2\u3002\u4ed6\u4eec\u5c06\u53c2\u4e0e\u8005\u5206\u4e3a\u4e09\u4e2a\u7814\u7a76\u7ec4\uff0c\u6839\u636e\u5e73\u5747SjvO2\u5206\u5c42\uff08\u7b2c1\u7ec4\uff1a\u4f4eSjvO2<55%\uff1b\u7b2c2\u7ec4\uff1aSjvO2 55-75%\uff1b\u7b2c3\u7ec4\uff1aSjvO2>75%\uff09\u3002\u4f5c\u8005\u53d1\u73b0\uff0c27\/40\uff0868%\uff09\u60a3\u8005\u7684\u5e73\u5747SjvO2>75%\uff0c\u5176\u4f59\u7684\u60a3\u8005\u7684SjvO2\u572855-75%\u4e4b\u95f4\uff0c\u6ca1\u6709\u4f4e\u4e8e55%\u7684\u3002\u6b64\u5916\uff0c\u4ed6\u4eec\u53d1\u73b0\uff0c\u4e0eSjvO2>75%\u7684\u60a3\u8005\u76f8\u6bd4\uff0c\u572872\u5c0f\u65f6\u5185\u8868\u73b0\u51faSjvO2\u572855-75%\u4e4b\u95f4\u7684HIBI\u60a3\u8005NSE\u6c34\u5e73\u8f83\u4f4e\uff089 [IQR 7-13] vs 46 [IQR 14-65] ng\/mL\uff1bP<0.01\uff09\u3002\u5176\u4ed6\u5c06SjvO2\u76d1\u6d4b\u4f5c\u4e3a\u7efc\u5408\u795e\u7ecf\u76d1\u6d4b\u5e73\u53f0\u7684\u4e00\u90e8\u5206\u7684\u7814\u7a76\u53d1\u73b0\uff0c\u5728ROSC\u540eSjvO2\u5347\u9ad8\u7684\u60a3\u8005\u795e\u7ecf\u529f\u80fd\u7ed3\u5c40\u8f83\u5dee\u3002<\/p>\n
\u76ee\u524d\uff0c\u5e38\u89c4\u76d1\u6d4bSjvO2\u5728HIBI\u4e2d\u7684\u4e34\u5e8a\u6548\u7528\u5c1a\u4e0d\u6e05\u695a\u3002SjvO2\u53ef\u80fd\u4e3a\u4f53\u5185\u75c5\u7406\u751f\u7406\u63d0\u4f9b\u89c1\u89e3\uff0c\u5e76\u5e2e\u52a9\u533a\u5206HIBI\u60a3\u8005\u4e2d\u5177\u6709\u5b8c\u597d\uff08\u4f4e\u6b63\u5e38SjvO2\uff09\u6216\u5f02\u5e38\u6c27\u6269\u6563\uff08\u9ad8SjvO2\uff09\u7684\u60c5\u51b5\u3002\u589e\u52a0\u7684SjvO2\u5728HIBI\u4e2d\u662f\u5426\u8868\u793a\u75be\u75c5\u4e25\u91cd\u7a0b\u5ea6\u6216\u53ef\u80fd\u6210\u4e3a\u6cbb\u7597\u76ee\u6807\uff0c\u4ecd\u6709\u5f85\u89c2\u5bdf\u5e76\u9700\u8981\u8fdb\u4e00\u6b65\u7814\u7a76\u3002<\/p>\n
\u8111\u5b9e\u8d28\u7ec4\u7ec7\u6c27\u5408<\/p>\n
\u5b9e\u8d28\u8111\u7ec4\u7ec7\u6c27\u5408\u63a2\u5934\u7684\u653e\u7f6e\u80fd\u591f\u8fde\u7eed\u8bc4\u4f30\u989d\u53f6\u76ae\u8d28\u4e0b\u767d\u8d28\u5185\u7684\u8111\u7ec4\u7ec7\u6c27\u5f20\u529b\uff08\u5373PbtO2\uff09\u3002Sekhon\u7b49\u4eba\u6700\u8fd1\u7684\u7814\u7a76\u65e8\u5728\u91cf\u5316HIBI\uff08\u7f3a\u6c27\u7f3a\u8840\u6027\u8111\u635f\u4f24\uff09\u4e2d\u8111\u7ec4\u7ec7\u7f3a\u6c27\u7684\u8d1f\u62c5\u3002\u8fd9\u9879\u524d\u77bb\u6027\u5e72\u9884\u6027\u4fb5\u5165\u6027\u795e\u7ecf\u76d1\u6d4b\u7814\u7a76\u53d1\u73b0\uff0c\u60a3\u8005\u5728\u76d1\u6d4b\u671f\u95f4\u7ea6\u670940%\u7684\u65f6\u95f4\uff08\u8303\u56f4\u4e3a6-100%\uff09\u5904\u4e8e\u8111\u7ec4\u7ec7\u7f3a\u6c27\u72b6\u6001\uff08PbtO2\u4f4e\u4e8e20 mmHg\uff09\u3002Balu\u7b49\u4eba\u8bc1\u660e\uff0cPbtO2\uff1c18 mmHg\u4e0eHIBI\u7684\u4e0d\u826f\u795e\u7ecf\u5b66\u7ed3\u679c\u76f8\u5173\u3002\u5728\u4e00\u9879\u914d\u5bf9\u961f\u5217\u7814\u7a76\u4e2d\uff0cFergusson\u7b49\u4eba\u6839\u636e\u63a5\u53d7PbtO2\u5f15\u5bfc\u6cbb\u7597\uff08n=21\uff09\u548c\u6807\u51c6\u62a4\u7406\uff08\u65e0PbtO2\uff0cn=44\uff09\u7684HIBI\u60a3\u8005\u8fdb\u884c\u5206\u5c42\u3002\u4ed6\u4eec\u89c2\u5bdf\u5230\u63a5\u53d7PbtO2\u76d1\u6d4b\u7684\u60a3\u8005\u6bd4\u672a\u63a5\u53d7PbtO2\u76d1\u6d4b\u7684\u60a3\u8005\u5177\u6709\u66f4\u9ad8\u7684\u6709\u5229\u795e\u7ecf\u5b66\u7ed3\u5c40\u7387\uff08\u8111\u529f\u80fd\u7c7b\u522b1\u62162\uff09\uff0844% vs 18%\uff0cP=0.03\uff09\u3002\u7136\u800c\uff0c\u8fd9\u9879\u7814\u7a76\u7684\u6837\u672c\u91cf\u8f83\u5c0f\u4e14\u540e\u7eed\u8bbe\u8ba1\u9650\u5236\u4e86\u5176\u4f18\u52bf\u3002<\/p>\n
\u4ece\u751f\u7406\u5b66\u4e0a\u8bb2\uff0cPbtO2\u53cd\u6620\u4e86\u5bf9\u6d41\u6027\u8111\u6c27\u8f93\u9001\uff08CDO2\uff09\u548c\u6c27\u6269\u6563\u8fdb\u5165\u8111\u7ec4\u7ec7\u4ee5\u53ca\u8111\u4ee3\u8c22\u4e4b\u95f4\u7684\u5e73\u8861\u3002\u4e00\u9879\u9488\u5bf9\u63a5\u53d7PbtO2\u76d1\u6d4b\u7684HIBI\u60a3\u8005\u7684\u524d\u77bb\u6027\u7814\u7a76\u663e\u793a\uff0c\u5e73\u5747\u52a8\u8109\u538b\uff08MAP\uff09\u589e\u52a0\u4e0ePbtO2\u589e\u52a0\u5448\u76f8\u5173\u5173\u7cfb\uff08R2=0.71\uff0cP<0.001\uff09\u3002\u7136\u800c\uff0c\u6bcf\u4f4d\u60a3\u8005\u7684MAP\u4e0ePbtO2\u4e4b\u95f4\u7684\u5173\u7cfb\u659c\u7387\u5b58\u5728\u5f02\u8d28\u6027\u3002\u8fd9\u8868\u660eHIBI\u5b58\u5728\u4e0d\u540c\u7684\u75c5\u7406\u751f\u7406\u8868\u578b\uff0c\u6d89\u53ca\u5bf9\u6d41\u6027CDO2\u548c\u6c27\u6269\u6563\u8fdb\u5165\u8111\u7ec4\u7ec7\u7684\u8026\u5408\u6216\u89e3\u8026\uff08\u53e6\u89c1\u201c\u7b2c2\u9636\u6bb5\uff1a\u6c27\u6269\u6563\u201d\u90e8\u5206\uff09\u3002\u56e0\u6b64\uff0cPbtO2\u4e0e\u5176\u4ed6\u751f\u7406\u53d8\u91cf\uff08\u5982MAP\uff09\u4e4b\u95f4\u7684\u5173\u7cfb\u53ef\u63ed\u793a\u6c27\u6269\u6563\u5230\u8111\u7ec4\u7ec7\u7684\u529f\u80fd\u6027\u4fe1\u606f\u3002<\/p>\n
\u901a\u8fc7PbtO2\u8bc6\u522b\u60a3\u8005\u7279\u5f02\u6027\u8868\u578b\u5728\u4e34\u5e8a\u4e0a\u975e\u5e38\u91cd\u8981\uff0c\u56e0\u4e3a\u5bf9\u6d41\u6027CDO2\u548cPbtO2\u4e4b\u95f4\u8868\u73b0\u51fa\u89e3\u8026\u8054\u7684\u60a3\u8005\u4e0d\u592a\u53ef\u80fd\u4ece\u589e\u52a0MAP\u6216\u5176\u4ed6\u9488\u5bf9\u5bf9\u6d41\u6027CDO2\u7684\u5e72\u9884\u63aa\u65bd\u4e2d\u83b7\u76ca\u3002\u76f8\u53cd\uff0c\u5177\u6709\u5b8c\u6574\u6c27\u6269\u6563\u7684\u60a3\u8005\u53ef\u80fd\u4f1a\u53d7\u76ca\u3002\u56e0\u6b64\uff0c\u6839\u636e\u751f\u7406\u8868\u578b\u8fdb\u884c\u60a3\u8005\u8bc6\u522b\u548c\u9009\u62e9\u662f\u4f7f\u7528PbtO2\u76d1\u6d4b\u8fdb\u884cHIBI\u7814\u7a76\u7684\u5173\u952e\u8003\u8651\u56e0\u7d20\u3002\u672a\u6765\u7684\u7814\u7a76\u9700\u8981\u8fdb\u4e00\u6b65\u4e86\u89e3\u590d\u82cf\u540e\u8111\u7ec4\u7ec7\u7f3a\u6c27\u5bf9HIBI\u795e\u7ecf\u7ed3\u679c\u7684\u5f71\u54cd\uff0c\u5e2e\u52a9\u786e\u5b9a\u65e0\u521b\u8bc6\u522b\u8111\u7ec4\u7ec7\u7f3a\u6c27\u7684\u65b9\u6cd5\uff0c\u5e76\u786e\u5b9a\u89e3\u51b3\u8111\u7ec4\u7ec7\u7f3a\u6c27\u7684\u5e72\u9884\u63aa\u65bd\u662f\u5426\u5177\u6709\u4e34\u5e8a\u7597\u6548\u3002<\/p>\n
\u5fc5\u987b\u8003\u8651\u7684PbtO2\u76d1\u6d4b\u7684\u4e00\u4e2a\u91cd\u8981\u9650\u5236\u662f\u8111\u8840\u7ba1\u5185\u6eb6\u89e3\u6c27\u53ef\u80fd\u5bf9PbtO2\u8bb0\u5f55\u9020\u6210\u6df7\u6dc6\u3002\u5c3d\u7ba1\u8ba4\u4e3a\u5bfc\u7ba1\u4ec5\u53cd\u6620\u7ec4\u7ec7\u6c27\u5f20\u529b\uff0c\u4f46\u53ef\u80fd\u65e0\u6cd5\u533a\u5206\u8111\u5b9e\u8d28\u5185\u548c\u5fae\u8840\u7ba1\u5185\u6eb6\u89e3\u6c27\u5f20\u529b\u4e4b\u95f4\u7684\u5dee\u5f02\u3002Rosenthal\u7b49\u4eba\u5728\u521b\u4f24\u6027\u8111\u635f\u4f24\u540e\u8fdb\u884c\u591a\u6a21\u5f0f\u795e\u7ecf\u76d1\u6d4b\u7684\u60a3\u8005\u4e2d\u8fdb\u884c\u4e86\u6b63\u5e38\u538b\u6c27\u5b9e\u9a8c\u3002\u52a8\u8109\u8840\u6c27\u5206\u538b\uff08PaO2\uff09\u4ece127\uff08103-150\uff09\u5347\u9ad8\u5230441 mmHg\uff08363-518\uff09\uff0cPbtO2\u4ece22.9\uff0817.2-28.6\uff09\u5347\u9ad8\u523077 mmHg\uff0858.1-96\uff09\u3002\u5c3d\u7ba1\u8111\u8840\u6d41\u91cf\uff08CBF\uff09\u4ece23.9\uff0816.5-31.2\uff09\u964d\u4f4e\u523018.5 mL\/100 g\/min\uff0812.2-24.8\uff09\uff0cPbtO2\u4ecd\u7136\u4e0a\u5347\u3002\u8fd9\u8868\u660ePbtO2\u5728\u6b63\u5e38\u538b\u6c27\u60c5\u51b5\u4e0b\u589e\u52a0\uff0c\u5c3d\u7ba1CBF\u548cCDO2\u51cf\u5c11\uff0c\u53ef\u80fd\u8868\u660ePaO2\u5bf9PbtO2\u7684\u8bb0\u5f55\u503c\u6709\u72ec\u7acb\u5f71\u54cd\u3002\u5176\u4ed6\u7814\u7a76\u4e5f\u652f\u6301\u4e86\u8fd9\u4e00\u89c2\u70b9\u3002<\/p>\n
\u7ecf\u9885\u591a\u666e\u52d2\u8d85\u58f0<\/p>\n
\u7ecf\u9885\u591a\u666e\u52d2\u8d85\u58f0\uff08Transcranial Doppler ultrasound\uff0cTCD\uff09\u5728HIBI\uff08\u8111\u7f3a\u8840\u7f3a\u6c27\u6027\u8111\u635f\u4f24\uff09\u7684\u7ba1\u7406\u548c\u7814\u7a76\u4e2d\u53ef\u80fd\u6709\u53cc\u91cd\u4f5c\u7528\uff1a\uff081\uff09\u6d4b\u91cf\u5927\u8111\u4e2d\u8840\u6d41\u901f\u5ea6\u4ee5\u4f30\u8ba1\u8111\u8840\u6d41\u91cf\uff08CBF\uff09\uff0c\uff082\uff09\u65e0\u521b\u4f30\u8ba1\u9885\u5185\u538b\uff08ICP\uff09\u3002\u56e0\u6b64\uff0cTCD\u63d0\u4f9b\u4e86\u786e\u5b9a\u5bf9\u6d41\u6027CDO2\uff08CBF\u548cICP\uff09\u7684\u751f\u7406\u53d8\u91cf\u7684\u4f30\u8ba1\u503c\u3002\u5982\u679c\u8840\u7ba1\u76f4\u5f84\u4fdd\u6301\u6052\u5b9a\uff0c\u5728\u4f7f\u7528TCD\u8fdb\u884c\u8d85\u58f0\u68c0\u6d4b\u7684\u8840\u7ba1\uff08\u4f8b\u5982\u5927\u8111\u4e2d\u52a8\u8109\uff09\u5185\uff0cCBF\u4e0e\u6d41\u901f\u4e4b\u95f4\u5b58\u5728\u7ebf\u6027\u5173\u7cfb\u3002\u56e0\u6b64\uff0cTCD\u5df2\u88ab\u7528\u4f5cHIBI\u4e2dCBF\u7684\u95f4\u63a5\u975e\u4fb5\u5165\u6027\u4ee3\u7528\u54c1\u3002Hoedemaekers\u7b49\u4eba\u5bf920\u4f8bHIBI\u60a3\u8005\u4e2d\u8fdb\u884c\u4e86\u4e00\u9879\u524d\u77bb\u6027\u89c2\u5bdf\u6027\u7814\u7a76\uff0c\u4f7f\u7528TCD\u4f30\u8ba1\u8111\u704c\u6ce8\u3002\u4f5c\u8005\u89c2\u5bdf\u5230\uff0cHIBI\u60a3\u8005\uff0866 [59.5\u201373]\u5c81\uff09\u7684\u5927\u8111\u4e2d\u52a8\u8109\u8840\u6d41\u901f\u5ea6\u572824\u5c0f\u65f6\u65f6\u4f4e\u4e8e\u5065\u5eb7\u5bf9\u7167\u7ec4\uff0828\u00b14.5\u5c81\uff09\uff0826 [18.6\u201340.4] vs. 59.1 cm\/s [52.8\u201369]\uff0cP<0.001\uff09\uff0c\u4f46\u572872\u5c0f\u65f6\u65f6\u663e\u8457\u589e\u52a0\uff0863.9 cm\/s [48.3\u201373.1]\uff09\u3002\u5c3d\u7ba1\u6b64\u7814\u7a76\u89c2\u5bdf\u5230\u7684CBF\u964d\u4f4e\u53ef\u80fd\u53d7\u5e74\u9f84\u5f71\u54cd\uff0c\u4f46\u8fd9\u4e9b\u6570\u636e\u8868\u660eHIBI\u7684\u8111\u8840\u6db2\u52a8\u529b\u5b66\u5728\u65f6\u95f4\u4e0a\u5177\u6709\u52a8\u6001\u6027\u3002\u4e00\u9879\u6b63\u5728\u8fdb\u884c\u7684\u4e34\u5e8a\u8bd5\u9a8c\uff08NCT04000334\uff09\u6b63\u5728\u8bc4\u4f30\u4f7f\u7528TCD\u8fdb\u884c\u76ee\u6807\u5bfc\u5411\u8840\u6d41\u52a8\u529b\u5b66\u7ba1\u7406\u5728HIBI\u4e2d\u7684\u53ef\u884c\u6027\u3002<\/p>\n
TCD\u5728HIBI\u795e\u7ecf\u76d1\u6d4b\u4e2d\u7684\u7b2c\u4e8c\u4e2a\u5173\u952e\u4f5c\u7528\u662fICP\u7684\u65e0\u521b\u4f30\u8ba1\u3002TCD \u884d\u751f\u7684\u4e00\u4e2a\u91cd\u8981\u53d8\u91cf\u662f\u640f\u52a8\u6307\u6570 (PI)\u3002PI\u8ba1\u7b97\u4e3a\u5cf0\u503c\u6536\u7f29\u671f\u548c\u8212\u5f20\u671f\u6d41\u901f\u4e4b\u95f4\u7684\u5dee\u503c\u9664\u4ee5\u5e73\u5747\u6d41\u901f\uff0cPI\u5927\u4e8e1.2\u8868\u793a\u9885\u5185\u9ad8\u538b\u3002\u6700\u8fd1\u7684\u4e00\u9879\u9488\u5bf9\u795e\u7ecf\u91cd\u75c7\u60a3\u8005\u7684\u591a\u4e2d\u5fc3\u7814\u7a76\u8bc4\u4f30\u4e86\u57fa\u4e8e\u8212\u5f20\u671f\u6d41\u901f\u548c\u5e73\u5747\u52a8\u8109\u538b\u7684ICP\u9884\u6d4b\u7684\u51c6\u786e\u6027\uff0c\u5728\u6392\u9664\u9885\u5185\u9ad8\u538b\u65b9\u9762\u5177\u6709\u826f\u597d\u7684\u9634\u6027\u9884\u6d4b\u503c\u3002HIBI\u60a3\u8005\u4e2d\u7684\u9ad8PI\u548c\u4f4e\u8212\u5f20\u671f\u8840\u6d41\u901f\u5ea6\u4e0e\u4e0d\u826f\u795e\u7ecf\u7cfb\u7edf\u9884\u540e\u76f8\u5173\u3002Cardim\u7b49\u4eba\u5728HIBI\u60a3\u8005\u4e2d\u8fdb\u884c\u4e86\u4e00\u9879\u5bf9\u6bd4\u7814\u7a76\uff0c\u6bd4\u8f83\u4e86\u4fb5\u5165\u6027\u76d1\u6d4b\u7684ICP\u4e0e\u5305\u62ecTCD\u5728\u5185\u7684\u975e\u4fb5\u5165\u6027\u66ff\u4ee3\u7269\u4e4b\u95f4\u7684\u4e00\u81f4\u6027\u3002\u4f5c\u8005\u53d1\u73b0\uff0c\u901a\u8fc7TCD\u6d4b\u91cf\u7684\u975e\u4fb5\u5165\u6027ICP\u4e0e\u7ecf\u8111\u5b9e\u8d28\u76d1\u6d4b\u7684ICP\u4e4b\u95f4\u5b58\u5728\u7ebf\u6027\u5173\u7cfb\uff08R=0.3\uff0cP=0.01\uff09\u3002\u7528\u4e8e\u9884\u6d4b\u9885\u5185\u9ad8\u538b\uff08ICP>20 mmHg\uff09\u7684TCD\u7684\u53d7\u8bd5\u8005\u5de5\u4f5c\u7279\u5f81\uff08ROC\uff09\u66f2\u7ebf\u4e0b\u9762\u79ef\u4e3a0.91\uff0895% CI 0.83\u20131.00\uff09\u3002\u5c3d\u7ba1TCD\u6709\u7528\u4e14\u65e0\u98ce\u9669\uff0c\u4f46\u6280\u672f\u4e13\u4e1a\u77e5\u8bc6\u7684\u9700\u6c42\u3001\u6f5c\u5728\u7684\u89c2\u5bdf\u8005\u8bef\u5dee\u4ee5\u53ca\u83b7\u5f97\u9ad8\u4fdd\u771f\u8fde\u7eed\u8bb0\u5f55\u7684\u56f0\u96be\u53ef\u80fd\u9650\u5236\u4e86TCD\u5728HIBI\u7ba1\u7406\u4e2d\u7684\u5e7f\u6cdb\u5e94\u7528\u3002\u9700\u8981\u8fdb\u4e00\u6b65\u7684\u7814\u7a76\u6765\u66f4\u597d\u5730\u786e\u5b9aTCD\u5728HIBI\u60a3\u8005\u7ba1\u7406\u4e2d\u7684\u6548\u7528\u3002<\/p>\n
\u8fd1\u7ea2\u5916\u5149\u8c31<\/p>\n
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\u4e34\u5e8a\u610f\u4e49<\/p>\n
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