基于超声心动图不同胎龄早产新生儿心脏结构及腔径和室壁厚度差异分析  

Analysis on the differences of cardiac structure,lumen diameter and thickness of ventricular wall of preterm neonates with different gestational ages based on echocardiography

作　　者：刘志宝[1] 李光 李静[1] 王志勇 张海燕[1] LIU Zhi-bao;LI Guang;LI Jing

机构地区：[1]唐山市妇幼保健院超声医学科,河北唐山063000 [2]邯郸市中心医院超声医学科,河北邯郸056002

出　　处：《中国医学装备》2022年第8期80-84,共5页China Medical Equipment

基　　金：河北省医学科学技术课题(20200464)“应用超声心动图评价早产新生儿心脏结构及心功能变化的研究”。

摘　　要：目的:探讨基于超声心动图不同胎龄早产新生儿心脏结构及腔径及室壁厚度的差异。方法:选取在医院出生的112例早产新生儿,根据不同胎龄将其分为≤29+6 d周组(37例)、30~33+6 d周组(37例)和34~36+6 d周组(38例)。3组早产儿均在出生后48 h内行超声心动图检查左心室舒张末期内径(LVDd)、左心室后壁舒张末期厚度(LVPWd)、右心室舒张末期内径(RVDd)、室间隔舒张末期厚度(IVSd)和主动脉根部内径(AOD),在收缩末期测量左心房收缩末期内径(LAD)、左心室收缩末期内径(LVDs)、胸骨旁大动脉短轴切片在舒张末期测量右心室前壁厚度(RVAW),在收缩期测量主肺动脉内径(MAP)。采用M型超声心动图检测二尖瓣环运动位移(MAPSE)、三尖瓣环运动位移(TAPSE)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)指标,并采用Pearson分析心室内径、血管腔径及室壁厚度与胎龄、出生体重的相关性。结果:3组早产儿在出生体重和心率方面比较差异有统计学意义(F=125.65,F=16.95;P<0.05)。随着胎龄的增加,早产儿超声心动图RVDd、IVSd、RVAW和MAP逐渐增加,3组比较差异具有统计学意义(F=12.94,F=36.83,F=143.32,F=21.08;P<0.05);且LVDd、LVPWd、AOD、LAD和LVDs逐渐增加,3组比较差异有统计学意义(F=61.30,F=87.66,F=48.83,F=51.89,F=116.45;P<0.05)。Peason相关性分析结果显示,RVDd、IVSd、RVAW、MAP、LVDd、LVPWd、AOD、LAD及LVDs与胎龄及出生体重呈明显正相关(r_(胎龄)=0.727,r=0.639,r=0.860,r=0.511,r=0.762,r=0.725,r=0.686,r=0.725,r=0.754;r_(出生体重)=0.714,r=0.618,r=0.763,r=0.423,r=0.679,r=0.684,r=0.650,r=0.713,r=0.662;P<0.05)。随着胎龄的增加,早产儿的TAPSE、MAPSE、LVEF及LVSF逐渐增加,3组比较差异具有统计学意义(F=620.67,F=32.17,F=30.18,F=28.02;P<0.05)。结论:早产新生儿心室内径、血管腔径及室壁厚度与胎龄、出生体重呈明显正相关,且随着胎龄的增长左右心室收缩功能逐渐改善,超声心动图可记Objective:To investigate the differences of cardiac structure,lumen diameter and thickness of ventricular wall in preterm neonates with different gestational ages based on echocardiography.Methods:112 preterm neonates born in hospital were selected as the research objects,and they were divided into group ≤ 29 + 6 weeks(37 cases),group 30-33 + 6 weeks(37 cases) and group 34-36+6 weeks(38 cases) according to different gestational ages of them.All preterm neonates underwent echocardiography examination within 48 hours after birth,which included left ventricular end diastolic diameter(LVDd),left ventricular posterior wall-end diastolic(LVPWd) thickness,right ventricular end diastolic diameter(RVDd),interventricular septal-end diastolic(IVSd) thickness and aortic root diameter(AOD).In addition,the left atrial end systolic diameter(LAD),the left ventricular end systolic diameter(LVDs) and the section of short axis of parasternal main artery of them were measured at end-systole,and the thickness of right ventricular anterior wall(RVAW) of them were measured at the end of diastole,and the diameter of main pulmonary artery(MAP) of them was measured at systolic phase.M-mode echocardiography was used to detect mitral annular plan systolic excursion(MAPSE),tricuspid annular plan systolic excursion(TAPSE),left ventricular ejection fraction(LVEF) and left ventricular shortening fraction(LVFS).And Pearson was adopted to analyze the correlations of ventricular diameter,vascular lumen diameter and the thickness of ventricular wall with gestational age and birth weight,respectively.Results:The differences of birth weight and heart rate among three groups were significant(F=125.65,F=16.95,P<0.05).The RVDd,IVSD,RVAW and MAP increased gradually with the increasing of gestational age,and the differences of them among three groups were significant(F=12.94,F=36.83,F=143.32,F=21.08,P<0.05),and the LVDd,LVPWd,AOD,LAD and LVDs also increased gradually with the increasing of gestational age,and the differences of them among three groups w

关 键 词：超声心动图 胎龄 早产新生儿 心脏结构 腔径 室壁厚度 

分 类 号：R445.1[医药卫生—影像医学与核医学]