组织运动二尖瓣环位移技术评估早产儿左心室收缩功能的应用研究  

Evaluating Left Ventricular Systolic Function by Automated Motion Tracking of Mitral Annulus Displacement in Preterm Infants

作　　者：刘云[1] 周维维 栗河舟[1] 吴娟[1] 尚丽宏 LIU Yun;ZHOU Weiwei;LI Hezhou;WU Juan;SHANG Lihong(Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052 [2]郑州大学第三附属医院新生儿科,河南郑州450052

出　　处：《河南医学研究》2023年第13期2339-2346,共8页Henan Medical Research

基　　金：2020年度河南省医学科技攻关计划(联合共建)项目(LHGJ20200447)。

摘　　要：目的探讨组织运动二尖瓣环位移技术(TMAD)评估早产儿左心室收缩功能的应用价值。方法选取郑州大学第三附属医院住院早产儿55例(A组),A组患儿校正胎龄足月时获得随访的有36例(B组),另选取同期45例足月健康新生儿作为对照组。3组受检者均接受超声心动图检查。通过M型超声心动图获得左心室射血分数(LVEF)及左心室短轴缩短率(LVFS)等常规参数,同步连接心电图,存储心尖四腔心、心尖两腔心的二维动态图像,应用QLab13.0离线分析软件获得TMAD参数。比较3组M型超声心动图参数和TMAD参数。分析TMAD参数与胎龄、体表面积(BSA)及M型超声心动图参数的相关性。结果B组出生时与校正胎龄足月时、A组与对照组相比,左心室短轴缩短率(LVFS)、左心室射血分数(LVEF)差异无统计学意义(P>0.05),胎龄、BSA、室间隔舒张末期厚度(IVSd)、左心室后壁舒张末期厚度(LVPWd)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、每搏量(SV)差异有统计学意义(P<0.05)。B组校正胎龄足月时与对照组的性别、胎龄、BSA、IVSd、LVPWd、LVEDV、LVESV、SV、LVFS、LVEF的差异无统计学意义(P>0.05)。3组TMAD参数差异有统计学意义(P<0.05)。TMAD各参数与胎龄、BSA、LVPWd、LVEDV、SV呈正相关,与LVFS、LVEF无关。结论组织运动二尖瓣环位移技术可以早期定量评估早产儿左心室收缩功能,为临床敏感发现早产儿心功能异常并及早采取有效干预措施、评估预后提供有效依据。Objective To explore the value of echocardiographic tracking of mitral annular displacement(TMAD)for evaluating left ventricular(LV)systolic function in preterm infants.Methods There were 55 premature infants hospitalized in the Third Affiliated Hospital of Zhengzhou University(group A)were selected,36 children in group A received follow-up at full term corrected gestational age(group B),another 45 full-term healthy newborns from the same period were selected as the control group.The three groups participants underwent echocardiography.Conventional parameters such as left ventricular ejection fraction(LVEF)and left ventricular short axis shortening(LVFS)were calculated from M-mode echocardiography.Two-dimensional dynamic images of apical four-chamber and two-chamber synchronized with electrocardiogram(ECG)were stored.The parameters of TMAD were obtained by QLab13.0 offline analysis software.The differences of M-mode echocardiographic parameters and the TMAD parameters between group A and group B,group A and control group were compared.The correlation between the TMAD parameters and gestational age,body surface area(BSA)and M-mode echocardiographic parameters was analyzed.Results There was no statistically difference in gender,LVFS,and LVEF between birth and corrected gestational age at term of and group B,as well as between group A and the control group(P>0.05).However,there were statistically differences in gestational age,BSA,interventricular septal thickness at end-diastole(IVSd),left ventricular posterior wall thickness at end-diastole(LVPWd),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and stroke volume(SV)(P<0.05).There was no statistically difference in gender,gestational age,BSA,IVSd,LVPWd,LVEDV,LVESV,SV,LVFS,or LVEF between birth and corrected gestational age at term of group B and the control group(P>0.05).The differences in TMAD parameters among the three groups were statistically significant(P<0.05).The parameters of TMAD are positively correlated with gestat

关 键 词：超声心动描记术 二尖瓣环位移 早产儿 左心室功能 

分 类 号：R722.6[医药卫生—儿科]