心肌活动指数评价新生儿窒息后右室功能应用价值研究  

Application value of cardiac activity index on evaluation right ventricular function after neonatal asphyxia

作　　者：连文喜 钟秋红 余连芝 黄桂兰 

机构地区：[1]广东省河源市人民医院儿科,广东河源517000

出　　处：《中国医师进修杂志》2013年第24期4-6,共3页Chinese Journal of Postgraduates of Medicine

基　　金：广东省青年自然基金（B2011347）

摘　　要：目的探讨心肌活动指数（Tei指数）在评价新生儿窒息后右室功能中的作用。方法选择60例窒息新生儿，其中轻度窒息（轻度窒息组）35例，重度窒息（重度窒息组）25例，另选择30例正常足月新生儿作为对照组，于出生后24.48h以超声心动图测定肺动脉收缩压（PASP）、右室射血分数（RVEF）、三尖瓣口心室舒张早期峰值（E峰）、心室舒张晚期峰值（A峰），计算E／A，并从血流频谱测得右室心肌活动指数（RV.Tei指数）。结果轻度窒息组、重度窒息组RVEF、E／A与对照组比较差异无统计学意义（P〉0.05）。轻度窒息组和重度窒息组RV-Tei指数均较对照组升高（0.4894-0.090、0.6254-0.100比0.3454-0.120），差异有统计学意义（P〈0.05或〈0.01）。轻度窒息组和重度窒息组RV.Tei指数比较差异亦有统计学意义（P〈0.05）。窒息新生儿RV-Tei指数与PASP呈正相关（r=0.950，P〈0.05），与胎龄、体重、心率无相关性（r=-0.068、-0.280、-0.360，P〉0.05）。结论新生儿窒息后引起新生儿右室功能减低，Tei指数是评价窒息新生儿右室功能早期变化的简便而敏感的多普勒超声新指标。Objective To investigate the roles of cardiac activity index（Tei index） on evaluation the right ventrieular function after neonatal asphyxia. Methods Sixty neonatal asphyxia who included 35 eases of mild asphyxia（ mild asphyxia group） and 25 cases of severe asphyxia（severe asphyxia group ） and 30 eases of normal full-term newborns（control group） were selected. Echocardiographic examinations were performed on 24 - 48 h after birth, which included pulmonary artery systolic pressure （PASP）, right ventricular ejection fraction （RVEF）, tricuspid early diastolic peak （peak E ） and late diastolic peak （peak A）, and E/A ratio was acquired. The right ventricular cardiac activity index （RV-Tei index） was measured by Doppler spectrum. Results There was no significant difference in RVEF, E/A ratio among mild asphyxia group, severe asphyxia group and control group （P 〉 0.05）. RV-Tei index in mild asphyxia group and severe asphyxia group was increased compared with that in control group （0.489 ＋ 0.090 , 0.625 ＋ 0.100 vs. 0.345 ~ 0.120）, and there was significant difference （P 〈 0.05 or 〈 0.01 ）. There was significant difference in RV-Tei index between mild asphyxia group and severe asphyxia group （P 〈 0.05）. RV-Tei index in neonatal asphyxia was positively correlated with PASP （r = 0.950,P 〈 0.05 ）, and there was no relationship between RV-Tei index and gestational age, weight, heart rate （r =-0.068,-0.280,-0.360,P 〉0.05）. Conclusions Neonatal asphyxia can lead to disorders of the right ventricular function. Tei index can evaluate early overall changes of the right ventricular function and is better than conventional ultrasound technology in neonatal asphyxia.

关 键 词：窒息 新生儿 心室功能 右 TEI指数 

分 类 号：R722.1[医药卫生—儿科]