多普勒组织成像法评价窒息新生儿左心收缩功能  

The ventricular velocity function of asphyxial newborn evaluated by Doppler Tissue Imaging

作　　者：韦翊[1] 徐婷[1] 樊静[1] 徐建新[1] 陶梢樱[1] 

机构地区：[1]浙江省金华市中心医院儿科,321000

出　　处：《中国新生儿科杂志》2006年第6期321-323,共3页Chinese Journal of Neonatology

摘　　要：目的 探讨多普勒组织成像法（DTI）评价窒息新生儿左心收缩功能。方法 足月窒息新生儿根据出生时Apgar评分分成重度窒息组（Apgar评分≤3分）共31例，轻度窒息组（Apgar评分4-7分）共31例，在出生后24、48、72h内分别通过超声心动图检测左室射血分数（LVEF），然后转入DTI模式测定二尖瓣前叶收缩期运动速度（s），并与正常新生儿组30例相对照，同时检测心肌肌钙蛋白（cTnI）。结果 重度组LVEF在24h明显低于48h和72h（P〈0．001），亦明显低于轻度组和对照组（P〈0．01），除此之外，3组之间及3组各时段之间LVEF差异无统计学意义（P〉0．05）。DTI重度组、轻度组的s在3个时段均明显低于对照组（P〈0．001），且重度组s在24h亦明显低于48h和72h（P〈0．001），除此之外3组之间及3组各时段之间（s），差异无统计学意义（P〉0．05）。重度组cTnI在3个时段明显高于轻度组及对照组（P〈0．01），而轻度组与对照组比较，差异无统计学意义（P〉0．05）。结论 新生儿窒息时左心收缩功能降低，DTIs较LVEF更能反映窒息新生儿左心收缩功能的变化。Objective To study the Doppler Tissue Imaging （DTI） evaluation of the left ventricular systolic function of asphyxial newborn . Methods Full term newborns with asphyxia were divided by Apgar score. The severe group （ Apgar≤ 3 ）, with 31 cases ; the mild group （ Apgar 4 - 7 ）, with 31 cases. The left ventricular ejection fraction （LVEF） was measured by Echocardiography, then the systolic velocity of anterior leaflet of mitral valve （s） with DTI mode ; 30 cases of normal newborns were set as control group and the cardiac troponin I （cTn I ）was examined. Results LVEF ①LVEF of the severe group in 24h was significantly lower than that in 48 h or 72 h （ P 〈 0. 01 ）, and also was significantly lower than that of the the mild group, and the control group （ P 〈 0. 01 ） ; while the others were no difference （P 〉 0. 05 ）. DTI s ② s of the severe group and the mild group were obviously lower than that of control group in the all three phase： （P 〈 0. 001 ）, and s of the severe group in 24h was significantly lower than that in 48h or 72h （P 〈 0. 001 ）, and also was significantly lower than that of the the mild group , while the others were no difference （P 〉 0. 05 ）. cTn I ③the values of cTn I of the severe group in all thee phase were obviously higher than those of the mild group and the control group （ P 〈0. 01 ）, while there was no difference between the mild group＇s and the control group＇s （P 〉 0. 05 ）. Conclusions The left ventricular systolic function of the newborn decreases in asphyxia. The s with DTI was a more sensitive index of newborn with asphyxia to show the systolic function, compared with the LVEF.

关 键 词：窒息 新生儿 心室功能 左 评价研究 

分 类 号：R722.1[医药卫生—儿科]