Objective: To investigate the relationship between ultrasound derived ratio of femoral vein to femoral artery diameter and hemodynamics in patients with heart failure. Methods: This was a case-control study. A total of 61 patients with heart failure and 49 patients with non-heart failure hospitalized in the Department of Critical Care Medicine from September 2017 to September 2018 were included in this study. Doppler ultrasound was used to measure the femoral artery and vein diameter. After deep inhalation, the femoral vein diameter was measured again, and the ratio of femoral vein and artery diameter was calculated. The central venous pressure (CVP) and mean pulmonary wedge pressure (mPAWP) were also measured. Pearson correlation analysis was used to explore the correlation between the ratio of femoral vein diameter to femoral artery diameter and CVP and mPAWP, and linear regression equation was established. Results: The overall CVP and mPAWP levels were significantly higher, and the femoral vein diameter after deep inhalation was bigger in heart failure patients than in non-heart failure patients(all P<0.001). The femoral vein diameter/femoral artery diameter ratio was positively correlated with CVP (r=0.76, P<0.001), and positively correlated with mPAWP (r=0.40, P<0.001) in heart failure group. The linear regression equation established by the femoral vein/femoral artery diameter ratio and CVP in the heart failure group showed that the inner diameter of the femoral vein/the inner diameter of the femoral artery ratio≥1.3 corresponded CVP≥15.518 cmH2O(1 cmH2O=0.098 kPa) in heart failure patients. Conclusions: In patients with heart failure, the inner diameter of the femoral vein/femoral artery ratio is positively correlated with CVP and mPAWP. The ratio of inner diameter of the femoral vein/femoral artery can be used to assess the volumetric load of patients with heart failure and to guide the clinical treatment of heart failure patients.
目的： 探讨超声测量的股静脉与股动脉内径比值（简称为股静动脉内径比值）与心力衰竭（心衰）患者血流动力学的关系。 方法： 该研究为病例对照研究，选取2017年9月至2018年9月于哈尔滨医科大学附属第四医院重症医学科住院治疗的心衰患者61例作为心衰组，另选取同期在本院重症医学科住院的非心衰患者49例作为对照组。采用多普勒超声测量患者的股静、动脉内径，深吸气后再次测量股静脉内径，并分别计算平静呼吸及深吸气后的股静动脉内径比值；同时测量患者的中心静脉压（CVP）以及平均肺动脉楔压（mPAWP）。比较两组患者血流动力学指标间的差异，采用Pearson相关分析探索两组患者的股静动脉内径比值与CVP、mPAWP的相关性，并建立线性回归方程。 结果： 与对照组比较，心衰组患者的CVP和mPAWP水平较高，吸气后股静脉内径较大（P均<0.001）。心衰组患者的股静动脉内径比值与CVP相关性较强（r=0.76，P<0.001），与mPAWP呈正相关（r=0.40，P<0.001）。心衰组患者的股静动脉内径比值与CVP所建立起的线性回归方程显示，当股静动脉内径比值≥1.3时，患者的CVP水平较高（CVP≥15.518 cmH2O，1 cmH2O=0.098 kPa）。 结论： 心衰患者的股静动脉内径比值与CVP和mPAWP具有一定相关性，超声测量的股静动脉内径比值可用于评估心衰患者容量负荷，指导临床治疗。.
Keywords: Femoral artery; Femoral vein; Heart failure; Hemodynamic; Ultrasound, Doppler.