组织多普勒对呼吸窘迫综合征早产儿心功能的评价  

Evaluation of tissue doppler imaging on preterm newborns' cardiac function with infant respiratory distress syndrome

作　　者：张华[1] 梁伟翔[1] 袁文琳[1] 张费通[1] 

机构地区：[1]广州医科大学附属第三医院超声医学科,广东广州510150

出　　处：《医学影像学杂志》2014年第1期47-50,共4页Journal of Medical Imaging

摘　　要：目的利用组织多普勒(tissue doppler imaging,TDI)技术定量评价早产儿合并新生儿呼吸窘迫综合征(infant respiratory distress syndrome,IRDS)的心功能情况,为临床治疗提供依据。方法选取我院出生且诊断为新生儿呼吸窘迫综合征的早产儿30例,并选取健康足月儿30例为对照组,抽血检验血清CK-MB,并进行心脏组织多普勒超声检查。测定左室射血分数(LVEF),测量二、三尖瓣环收缩期峰值速度(Sm)、舒张早期峰值速度(Em)及舒张晚期峰值速度(Am),并计算Em/Am。测定等容收缩期(ICT)与等容舒张期(IRT)时间之和及射血期时间(ET),计算左右室Tei指数。结果 IRDS早产儿组中27例(90.0%)合并心肌损害,肺动脉收缩压、血清CK-MB及左、右室Tei指数均明显高于对照组(P<0.05),而且右室Tei指数偏高于左室。血清CK-MB值与肺动脉压力升高呈正相关关系(r=0.375,P=0.003)。左室Tei指数随着肺动脉压力升高而显著升高(r=0.254,P=0.050)。结论早产儿合并新生儿呼吸窘迫综合征易伴有心肌损害。组织多普勒Tei指数对心功能的评估相对传统射血分数具有更高的敏感性,为临床提供一种更快速准确的评价方法。Objective To quantitatively evaluate preterm newbornscardiac function with infant respiratory distress syn drome （IRDS） by tissue Doppler （tissue doppler imaging, TDI） technology. Methods The study groups consisted of 30 preterm newborns with IRDS, and 30 healthy fulbterm newborns in control. All of them were taken the serum CKMB blood tests and tissue doppler imaging echoeardiography. We measured left ventricular ejection fraction （LVEF）, mitral and tricuspid annulus peak systolic velocity （Sm）, peak early diastolic velocity （Em）, late diastolic peak velocity （Am）, and calculated the Em / Am. We also determined the isovolumie contraction time （ICT） and isovolumic relaxation time （IRT） , and ejection time （ET）, and calculation of left and right ventricular Tel index. Results There were 27（90.0%） myocardial injury in preterm newborns with IRDS group. Preterm newborns with IRDS group were significantly higher than the contrast group in pulmonary artery systolic pressure, serum CKMB values and double ventrieular Tel index by TDI（ P〈0.05）. The Tei index in right ventricular was higher than the left ventricular. There was a positive correlation between serum CKMB values and pulmonary artery pressure （ r =0. 375, P =0. 003）. Left ventricular Tei index with the elevated pulmonary artery pressure increased significantly （ r = 0. 254, P = 0. 050）. Conclusion Infant respiratory dis tress syndrome in preterm newborn oftern complicated with myocardial damage, Tei index by tissue doppler imaging for the assessment of cardiac function compared to conventional ejection fraction, has a higher sensitivity to provide a rapid and accurate clinical evaluation method.

关 键 词：新生儿呼吸窘迫综合征 组织多普勒 早产儿 心功能 

分 类 号：R722.12[医药卫生—儿科]