Tei指数联合QT离散度评估新生儿窒息后心脏受损的应用价值  

The application value of Tei index and QT dispersion to assess cardiac damage in neonatal asphyxia

作　　者：郑惟 马晓棠[2] 汪文杰[2] ZHENG Wei1, MA Xiaotang2, FANG Wenjie2(1. Department of Ultrasonography, Deqing people＇s Hospital, Huzhou 313200, P. R. China; 2. Department of Ultrasonography, Hangzhou Traditional Chinese Medical Hospital, Hangzhou 310006, P. R. China)

机构地区：[1]浙江省德清县人民医院超声科,浙江湖州313200 [2]浙江省杭州市中医院超声科,浙江杭州310006

出　　处：《医学影像学杂志》2018年第9期1514-1517,共4页Journal of Medical Imaging

摘　　要：目的运用Tei指数和QT离散度探讨新生儿窒息的心脏受损特征及其临床应用价值。方法选取经临床确诊的71例窒息足月新生儿作为观察对象,根据窒息程度的不同分为:轻度窒息组(A组,39例)和重度窒息组(B组,32例),同期选择35例正常足月新生儿作为对照组。运用ELISA方法测定所有观察对象的血清肌钙蛋白I(cardiac troponinI,c Tn I)水平,运用心电图及超声心动图分别测定其QT离散度及左心Tei指数,并对数据结果进行比较分析。结果 A、B组的血清c Tn I水平、QT离散度及Tei指数均明显高于对照组,差异均有统计学意义(P均<0. 05); B组的血清c Tn I水平、QT离散度及Tei指数均明显高于A组,差异均有统计学意义(P均<0. 05); A、B组经治疗后的血清c Tn I水平、QT离散度及Tei指数均明显低于治疗前,差异均有统计学意义(P均<0. 05);窒息患儿的QT离散度与血清c Tn I水平呈正相关,r=0. 718,(P <0. 05),而Tei指数与血清c Tn I水平也呈正相关,r=0. 757,(P <0. 05)。结论 Tei指数联合QT离散度能早期有效评估新生儿窒息的心脏受损情况及临床疗效,为全面评估病情,制定治疗方案提供参考依据。Objective To explore the characteristics of cardiac damage in neonatal asphyxia by Tel index and QT dispersion and its clinical value. Methods We selected 71 cases of full-term newborns with asphyxia as the subjects. According to the degree of asphyxia, those were divided into mild asphyxia group （group A, 39 cases） and severe asphyxia group （group B, 32 cases）. At the same time, we selected 35 cases of normal full-term newborns as control group. We measured serum cardiac troponin I （cTnI） by the method of ELISA, QT dispersion by ECG and left ventricular Tel index by echocardiography. The data were compared and analyzed. Results The cTnI, QT dispersion and Tel index in group A, B were significantly higher than those in control group, the differences were statistically significant （ all P 〈 0.05 ） ; The cTnI, QT dispersion and Tel index in group B were significantly higher than those in group A, the differences were statistically significant （ all P 〈 0.05 ） ; The cTnI, QT dispersion and Tel index in group A, B after treatment were significantly lower than those before treatment , the differences were statistically significant （all P 〈 0. 05 ） ; QT dispersion was positively correlated with cTnI in newborns with asphyxia, r = 0.718, （ P 〈 0.05 ）, Tel index was positively correlated with cTnI in newborns with asphyxia, r = 0. 757, （ P 〈 0. 05）. Conclusion Tel index combined with QT dispersion can effectively assess the cardiac damage and clinical efficacy in neonatal asphyxia, and provide a reference for the overall assessment, making treatment plan.

关 键 词：新生儿窒息 心肌损伤 QT离散度 TEI指数 超声检查 

分 类 号：R722.1[医药卫生—儿科] R445.1[医药卫生—临床医学]