超声心动图评价健康足月早期新生儿的右心室功能  

Evaluation of early right ventricular function in normal term neonates by echocardiography

作　　者：韦馨[1] 郑红[1] 郑研[1] 蒋艳[2] 徐志红[3] 闫珊玲[1] 李成[1] 康彧[4] 

机构地区：[1]德阳市人民医院超声科,四川德阳618000 [2]德阳市人民医院儿科,四川德阳618000 [3]德阳市人民医院产科,四川德阳618000 [4]成都中医药大学附属医院超声科,四川成都610072

出　　处：《西部医学》2017年第11期1571-1576,共6页Medical Journal of West China

基　　金：四川省卫生厅科研基金(120417);成都中医药大学校基金(YYZX201303)

摘　　要：目的应用超声心动图评价健康足月早期新生儿的右心室功能,进一步探讨其与出生天数、未闭卵圆孔(FO)及动脉导管(DA)的相关性。方法选取2013年4月~2015年4月出生的健康足月新生儿320例,按出生后1~4d及FO、DA开闭状态分为1d(FO+DA+)、1d(FO-DA-)、1d(FO+DA-)、1d(FO-DA+)、2d(FO+DA+)、2d(FODA-)、2d(FO+DA-)、2d(FO-DA+)、3d(FO+DA+)、3d(FO-DA-)、3d(FO+DA-)、3d(FO-DA+)、4d(FO+DA+)、4d(FO-DA-)、4d(FO+DA-)、4d(FO-DA+)共计16组(+代表开放,-代表闭合)。采集各组的一般情况、FO及DA开闭状态;二维测量FO及DA直径,Simpson,s法测量右心室收缩功能指标,如右心室舒张末容积(RVEDV)、右心室收缩末容积(RVESV)、右心室射血分数(RVEF);获取三尖瓣环收缩期前向位移(TAPSE)及TEI指数。比较各组上述各项指标测值的差异性,分析其与出生时间、FO及DA的相关性。结果相同出生日龄各组基础情况测值差异无统计学意义(均P>0.05);对于各右心室功能指标测值(RVEDV、RVESV、RVSV、RVEF),FO+DA+组与FO-DA-组差异均有统计学意义(均P<0.05);各组Tei指数、TAPSE分别与RVEF具有良好的相关性(均P<0.05),且Tei指数与RVEF的相关系数r绝对值均大于TAPSE与RVEF的相关系数r绝对值,RVEDV与DA直径成负相关(r=-0.78,P<0.05),与FO直径呈正相关(r=0.80,P<0.05);相同FO及DA开闭状态下不同出生日龄各指标测值差异均无统计学意义,且各项指标测值与出生天数也无明显相关性(均P>0.05)。结论新生儿早期右心室功能与出生日龄无关,与FO、DA的开闭及直径有关;TEI指数与RVEF的相关性较TAPSE高,因此TEI指数较TAPSE更能简单、有效地评价新生儿右心室功能。Objective To evaluate early right ventricular function of normal term neonates by echocardiography and further discuss the correlation of right ventricular function and day-ages or PFO or PDA.Methods 320 normal term neonates born from April 2013 to April 2015 were divided into 16 groups according to day-ages（1 to 4 d）and the opening and closing state of FO and DA.Basic data,the opening and closing state of FO and DA of all groups were acquired.The diameter of FO and DA,RVEDV,RVESV,RVSV,RVEF were measured by 2D echocardiography,TAPSE and Tei index were measured by M-mode color doppler and color tissue doppler imaging.The difference comparison of measurement data in all groups were studyed and the correlation between right ventricular function and day-ages or PFO or PDA were analyzed.Results There were no significant differences of basic clinical data among all groups（P〈0.05）,while the RVEDV,RVESV,RVSV and RVEF value between groupFO＋DA＋ and groupFO-DA-had significant differences（P〈0.05）.The correlation coefficient absolute value r between TEI index and RVEF was higher than TAPSE（P〈0.05）.RVEDV and DA diameter had a negative correlation（r=-0.78,P〈0.05）,while RVEDV and FO diameter had a positively correlation（r=0.80,P〈0.05）.ALL measurement data were not associated with day-ages（P〈0.05）.ConclusionEarly right ventricular function of normal term neonates is not correlated with day-ages,but is associated with the opening and closing state and diameter of FO and DA.TEI index can be more simply and effectively to evaluate right ventricular function of neonates than TAPSE due to it,s higher correllation with RVEF.

关 键 词：超声心动图 足月 新生儿 右心室功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R722.1[医药卫生—诊断学]