肺静脉血流频谱及Tei指数评估小儿左向右分流型先心病左心功能改变的研究  

Evaluation of left ventricular diastolic function in children with left to right congenital heart disease by Doppler pulmonary venous flow and Tei index

作　　者：郑虹[1] 仇烨[1] 吴杰[1] 黄晓玲[1] 郑雪燕[1] 潘英[1] 蔡若吟[1] 

机构地区：[1]汕头大学医学院第一附属医院儿科,515041

出　　处：《实用医学杂志》2006年第1期21-23,共3页The Journal of Practical Medicine

基　　金：汕头市卫生局立项课题(汕府科[2003]119号)

摘　　要：目的:应用二尖瓣血流(MVF)频谱、肺静脉血流(PVF)频谱及Tei指数评价左向右分流型先天性心脏病(CHD)患儿左心室舒张功能的改变。方法:患病组55例患儿根据心室负荷分为左心型和右心型,用HP-SONOS5500彩色超声诊断仪,经胸MVF、PVF相关参数以及Tei指数3种方法测量患儿左室舒张功能并与55例正常对照组儿童进行对比研究。结果:与对照组比较,左心型CHD组MVF频谱A/E比值增加,TVI-E、TVI-E/TVI-A、EFF降低,Tei值增大;右心型CHD组MVF频谱A/E比值增加,TVI-E/TVI-A、EFF降低,Tei值增大;上述各指标CHD左心型组及右心型组分别与对照组比较,差别具有显著性(P<0.05,P<0.01),CHD左心型组与右心型组各指标差异无显著性(P>0.05);S峰和EF值各组间差异无显著性(P>0.05)。结论:S/D比值、Tei指数可能是评价CHD左室舒张功能的可靠指标,可鉴别二尖瓣血流E/A比值假性正常;Tei指数可能更全面反映心脏整体功能。三者结合有参照意义,有助于更好地评价左室舒张功能。Objective To study the characteristics of left ventricular （LV） diastolic function in children with left to right congenital heart disease （CHD）. Methods 55 children with CHD and 55 age-matched healthy children were studied respectively by using spectra of transmitral flow and pulmonary venous flow. LV Tei index was also estimated by Doppler echocardiography. The patients were divided into two groups according to their ventricular volume load. Results In group I （left ventricular overload）： A/E and Tei index were increased （P 〈 0.05, P 〈 0. 01） . And TVI-E/TVI-A, TVI-E, EFF were significantly lower than those of the normal controls （P 〈 0.01, P 〈 0.05, P 〈 0.01）. In group Ⅱ （right ventricular overload）： A/E and Tei index were all increased （P 〈 0.05, P 〈 0. 01）. And TVI-E/TVI-A,EFF were significantly lower than those of the normal controls （P 〈 0. 05, P 〈 0.05）. No significant difference of S wave and EF among the groups （P 〉 0. 05） . Conclusions Tei index with flow Doppler spectrum can help to assess left ventficular diastolic function of patients with left to right CHD. They can be used to exclude the false normal E/A rate. Tei index may be more valuable to signal the whole function of the heart.

关 键 词：心脏缺损 先天性 超声心动描记术 心室功能 左 

分 类 号：R725.4[医药卫生—儿科]