Study On The Monitoring Value Of Non-invasive Hemodynamics For Hypertension And Diabetes

Objective:Hypertension and diabetes have the characteristics of high incidence,high disability and wide complications.They are closely related to the damage to the target organs and the instability of the hemodynamic state.The aim of this study is to compare the hemodynamic indexes of different patients and to explore the application value of noninvasive hemodynamic test in hypertension and diabetes,and to improve the control rate of hypertension,diabetes and its complications.Method:From June 2017 to December 2017,223 patients who were hospitalized at the affiliated cardio cerebrovascular disease hospital of Yan'an University and(or)non invasive hemodynamic examination in the outpatient department were selected.According to the disease,they were divided into health group(A),hypertension group(B),diabetes group(C),hypertension and diabetes group(D).All the basic data of all the subjects were collected and sorted out.All the subjects were included in the CSM-3000 noninvasive hemodynamic monitoring system,which were used to record cardiac output(CO),cardiac index(CI),stroke index(SI),pre ejection(PEP),thoracic fluid conductivity(TFC),inotropic state index(ISI),left stroke work index(LSWI),systemic vascular resistance(SSVR),volume,etc.Compare the general basic data of the patients in each group;The correlation between the age and the hemodynamic parameters of each group was compared,and the correlation between BMI and the hemodynamic parameters of each group was compared.The hemodynamic parameters of each group were compared with each other,and the difference of parameters between the groups was observed.All data were statistically processed with SPSS 20 statistical software.Counting data were represented as percentage,and chi square test was used.The measurement data were expressed with mean standard deviation,and LSD-t test was used.P<0.05,which was statistically significant.Results:1.The total of 223 subjects were included in the study,of which 36 were in the health group,101 in the hypertension group,62 in the diabetic group and 22 in the diabetes group.There was no statistical difference in the basic data between the 4 groups.2.There was no significant correlation between the age of the healthy control group and the hemodynamic indexes,but the age of the hypertension group was negatively correlated with the inotropy,the systolic time ratio(STR)and the pre-ejection period(PEP).In the diabetic group,the patients' age and cardiac output(CO),stroke volume(SV),volemia,left ventricular stroke work(LSW),and left ventricular stroke work index(LSWI)was negatively correlated,and in the hypertensive patients with diabetes,the patient's age was negatively correlated with cardiac output(CO),chronotropy,left stroke work(LSW)and left stroke work index(LSWI).In the healthy control group,the BMI was positively correlated with the cardiac output(CO),stroke volume(SV)and volemia.In hypertensive patients,BMI was positively correlated with inotropy and inotropic state index(ISI)and negative correlation to stroke volumet(SV)and systemic vascular resistance(SVR);In diabetic group,the patients' BMI was positively correlated with cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke index(SI),volemia,left stroke work(LSW),left stroke work index(LSWI)and negative correlation with pre-ejection period(PEP);and in the hypertensive and diabetic group,the BMI was positively correlated with the cardiac output(CO),stroke volume(SV),volemia,left stroke work(LSW)and systemic vascular resistance(SVR),but negatively correlated with the systolic time ratio(STR),inotropic state index(ISI)and the inotropy.3.There were statistical differences between the 4 groups in volemia,stroke systemic vascular resistance(SSVR),stroke systemic vascular resistance index(SSVRI),systemic vascular resistance(SVR),vasoactivity,inotropic state index(ISI),inotropy,the pre-ejection period(PEP)and the systolic time ratio(STR).In the volemia,the healthy control group was compared with the 3 groups of hypertension group,diabetes group,hypertension combined with diabetes group,and the back three groups increased the preload,but there was no difference between the 3 groups.Among the stroke systemic vascular resistance(SSVR),stroke systemic vascular resistance index(SSVRI),systemic vascular resistance(SVR)and vasoactivity,the healthy control group was compared with the hypertension group,the hypertension combined with diabetes group,and the post load of the hypertension group and the hypertension combined diabetes group increased.And there were differences between hypertension group and the hypertension combined with diabetes group also.In the four indexes of cardiac inotropic state index(ISI),inotropy,the pre-ejection period(PEP)and the systolic time ratio(STR),there was a statistical difference between the healthy control group and the diabetic group and there was a statistical difference between the hypertension group and the hypertension combined with diabetes group also.The other indexes such as: the left stroke work(LSW)and left stroke work index(LSWI),the left ventricular ejection time(LVET),ejection phase contractility index(EPCI),stroke volume(SV),stroke index(SI),cardiac output(CO),cardiac index(CI),chronotropy;No significant statistical difference was found between each group.Conclusion:1.the increase of age and BMI can cause hemodynamic changes.2.Age and BMI are risk factors for hypertension and diabetes,which can aggravate vascular remodeling and cause hemodynamic changes.3.The heart and arterial blood vessels of the patients with hypertension,diabetes and hypertension combined with diabetes have varying degrees of damage,and the hyperglycemia may have additional damage to the heart and heart function,and noninvasive hemodynamic monitoring system has certain value for disease monitoring.