超声心动图评估新生儿肺炎肺动脉压力的临床价值  

Clinical value of echocardiography in evaluating the pulmonary artery pressure in neonatal pneumonia

作　　者：王士锋[1] 郑华萍[1] 丁小莉[1] 王莉[1] 辛开荣 

机构地区：[1]湖北省钟祥市人民医院超声科,431900

出　　处：《临床超声医学杂志》2016年第7期470-473,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声心动图评估新生儿肺炎肺动脉压力的临床价值。方法选取新生儿肺炎患儿44例(轻症肺炎组28例,重症肺炎组16例),以及同期无心肺疾病的正常新生儿30例为健康对照组,应用超声心动图技术及肺动脉瓣M型运动曲线检测新生儿肺炎期间肺动脉压力水平,并与健康对照组及治疗后恢复期患儿情况进行比较。结果 1健康对照组、轻症肺炎组及重症肺炎组右房、右室及肺动脉内径两两比较差异均有统计学意义(均P<0.05);2健康对照组、轻症肺炎组及重症肺炎组肺动脉瓣口收缩期血流加速时间(AT)、右室射血时间(RVET)、a波深度及肺动脉压力测值两两比较,差异均有统计学意义(均P<0.05);3健康对照组与恢复期轻症肺炎组AT、RVET、a波深度及肺动脉压力测值比较,差异均无统计学意义(t=0.79、1.50、0.63、0.72);健康对照组与重症肺炎组、轻症肺炎组与重症肺炎组各测值比较,差异均有统计学意义(t=2.99、3.57、2.95、3.03和2.32、2.20、3.39、3.34,均P<0.05);4新生儿肺炎肺动脉高压程度与肺炎严重程度呈正相关(r=0.857,P<0.05)。结论超声心动图能实时监测新生儿肺炎肺动脉压力的变化,动态观察其恢复过程,对患儿病情及预后判断、临床诊疗有重要的指导作用。Objective To explore the clinical value of echocardiography in evaluating the pulmonary artery pressure in neonatal pneumonia.Methods Forty-four hospitalized newborns with neonatal pneumonia（28 cases with mild pneumonia and 16 cases with severe pneumonia） were included, and 30 normal newborns without heart and lung disease were used as healthy controls. Echocardiography and pulmonary valve M type motion curve were used to investigate the level of pulmonary artery pressure during neonatal pneumonia,the results was compared with those of healthy controls and newborns recovered after treatment.Results 1 Significant differences in the diameters of right atrium,right ventricle and pulmonary artery were found among health control group,mild pneumonia group and severe pneumonia group（all P〈0.05）. 2Among the mild pneumonia group, severe pneumonia group and healthy control group, there were significant differences for the comparison between the two of them in systolic acceleration time（AT）of pulmonary valve,ejection time（RVET）and a wave depth（all P〈0.05）. 3In recovery phase, the measured values of AT,RVET,a wave depth and pulmonary artery pressure between healthy controls and mild pneumonia group, there were no statistically significant difference（t = 0.79,1.50,0.63,0.72）.But the values between healthy controls and severe pneumonia group, also the mild pneumonia group and severe pneumonia group,there were both statistically significant differences（t= 2.99,3.57,2.95,3.03 and 2.32,2.20,3.39,3.34,all P〈0.05）. 4The degree of pulmonary arterial hypertension in newborns pneumonia was positively correlated with the severity of pneumonia（r = 0. 857,P〈0. 05）.Conclusion Echocardiography can monitor the pulmonary artery pressure change of newborns with pneumonia in real-time,dynamically observe the recovery process,it plays an important role in judging the children＇s condition and prognosis,as well as clinical diagnosis and treatment.

关 键 词：超声心动描记术 肺炎 新生儿 肺动脉压力 

分 类 号：R722.13[医药卫生—儿科] R540.45[医药卫生—临床医学]