二维斑点追踪技术评估呼吸窘迫综合征早产儿左室心肌功能  

Evaluation of the left ventricular myocardial function in preterm infants with neonatal respiratory distresssyndrome by two-dimensional speckle tracking imaging

作　　者：庞虹 江岚[1] 廖剑艺 陈智毅[1] PANG Hong;JIANG Lan;LIAO Jianyi;CHEN Zhiyi(Department of Ultrasound Medicine,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院超声医学科,广州市510150

出　　处：《临床超声医学杂志》2021年第2期96-100,共5页Journal of Clinical Ultrasound in Medicine

基　　金：2019年广州医科大学开放实验室项目(C195015026);广东省教育厅普通高校人工智能重点领域专项(2019KZDZX1032);广州市卫生健康科技项目(2019A011086)。

摘　　要：目的应用二维斑点追踪(2D-STI)技术评估呼吸窘迫综合征(NRDS)早产儿左室心肌功能。方法选取在我院出生的新生儿41例,其中NRDS早产儿20例(NRDS早产组),非NRDS早产儿10例(非NRDS早产组),足月正常新生儿11例(足月对照组)。应用2D-STI技术获取各组不同切面左室整体纵向峰值应变(LV-GLPS)及各室壁应变测值;并收集左室常规超声参数,包括左室射血分数(LVEF)、二尖瓣舒张早期和晚期血流速度峰值(MV-E和MV-A)、二尖瓣环收缩期组织运动速度(MV-S’)、二尖瓣环收缩期位移(MAPSE)和左室Tei指数,并对各组上述参数进行比较分析。结果各组MV-S’、MAPSE、左室Tei指数比较差异均有统计学意义(均P<0.05)。NRDS早产组MV-S’减低、MAPSE减低,左室Tei指数增高,与非NRDS早产组和足月对照组比较差异均有统计学意义(均P<0.05)。各组左室纵向峰值应变(除心尖四腔心切面LV-GLPS和后壁应变外)及组间比较差异均有统计学意义(均P<0.05);NRDS早产组除四腔心切面LV-GLPS、下壁、后壁应变外,左室纵向峰值应变均较非NRDS早产组和足月对照组减低,差异均有统计学意义(均P<0.05);非NRDS早产组与足月对照组除下壁应变比较差异有统计学意义外,余应变参数比较差异均无统计学意义。结论2D-STI技术可早期发现NRDS早产儿左室心肌受损情况;NRDS早产儿左室心肌功能较非NRDS早产儿及正常新生儿减低。Objective To evaluate left ventricular myocardial function in neonatal respiratory distress syndrome(NRDS)by two-dimensional speckle tracking imaging(2 D-STI).Methods Forty-one newborns were selected in our hospital,including 20 NRDS premature infants(NRDS premature group),10 cases of non-NRDS premature infants(non-NRDS premature group),and 11 cases of full-term normal newborns(full-term control group).2 D-STI were used to obtain the global longitudinal peak strain(LV-GLPS)and wall strain measurements of the left ventricle in the three groups.Left ventricular ejection fraction(LVEF),peak values of early and late diastolic blood flow velocity of mitral valve(MV-E,MV-A)and tissue velocity of mitral annulus during systole(MV-S’),mitral annular plane systolic excusion(M APSE)and left ventricular Tei index of the three group were collected and compared.Results MV-S’,MAPSE and left ventricular Tei index were significant difference among three groups(all P<0.05).Compared with non-NRDS premature group and full-term control group,MV-S’and MAPSE were decreased and left ventricular Tei index was increased in NRDS premature group,the differences were statistically significant(all P<0.05).Except LV-GLPS-A4 C and posterior wall,the longitudinal peak strain of left ventricle in each group were significant difference,the differences were statistically significant(all P<0.05).Except LV-GLPS-A4 C,inferior wall and posterior wall strain,the longitudinal peak strain of left ventricle in NRDS premature group were lower than that in non-NRDS premature group and full-term control group,the differences were statistically significant(all P<0.05).Except inferior wall strain in non-NRDS premature group and full-term control group,there was no significant difference of rest strain parameters between the two groups.Conclusion 2.D-STI technology can early detect the left ventricular myocardial damage of premature infants with ARDS.The left ventricular myocardial function of premature infants with NRDS is lower than that of non-NRDS and

关 键 词：超声心动描记术 斑点追踪 新生儿呼吸窘迫综合征 早产儿 心功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]