双多普勒Tei指数评估肺动脉高压新生儿肺动脉压力及右心功能的价值  

Assessment of pulmonary artery pressure and right heart function in neonates with pulmonary hypertension by dual Doppler Tei index

作　　者：戴泽艺 李玉娟 陈泽坤 陈晓康 吕国荣 DAI Ze-yi;LI Yu-juan;CHEN Ze-kun;CHEN Xiao-kang;LYU Guo-rong(Department of Ultrasound,Xiamen Children's Hospital,Xiamen,Fujian 361006,China;不详)

机构地区：[1]厦门市儿童医院超声医学科,福建厦门361006 [2]厦门市思明区妇幼保健院超声科 [3]泉州医学高等专科学校

出　　处：《中国妇幼保健》2024年第20期4100-4103,共4页Maternal and Child Health Care of China

基　　金：福建省厦门市自然科学基金项目(3502Z202374066);厦门市儿童医院“1125人才工程”培养计划(厦儿[2016]39号)。

摘　　要：目的探讨双多普勒Tei指数(DD-Tei指数)评估肺动脉高压新生儿肺动脉压力及右心功能的应用价值。方法选取2020年7月—2021年6月在厦门市儿童医院住院的矫正胎龄28~40周肺动脉高压新生儿90例(肺动脉高压组),按肺动脉压力分为轻度(40~50 mm Hg)、中度(51~70 mm Hg)、重度(>70 mm Hg)3组,其中轻度组35例,中度组30例,重度组25例。另选择同期同孕龄、无肺动脉高压新生儿30例为对照组。测量右心室面积变化分数(RVFAC)、三尖瓣环收缩期峰值位移(TAPSE)、三尖瓣环峰值速度(TAPSV)、DD-Tei指数。绘制受试者工作特征(ROC)曲线,评价右心功能参数对肺动脉高压的诊断效能。结果对照组、轻度组、中度组、重度组RVFAC分别为40.80%(37.33%,43.66%)、38.20%(36.80%,38.90%)、36.00%(33.93%,37.55%)、33.60%(31.80%,34.30%)。对照组、轻度组、中度组、重度组TAPSE分别为9.60(8.86,10.82)mm、8.56(8.34,8.76)mm、7.49(6.88,7.92)mm、6.43(6.18,7.05)mm。对照组、轻度组、中度组、重度组TAPSV分别为8.47(7.33,9.20)cm/s、7.78(7.30,8.00)cm/s、6.35(5.84,6.96)cm/s、5.75(5.25,6.42)cm/s。对照组、轻度组、中度组、重度组DD-Tei指数分别为0.44(0.42,0.49)、0.56(0.52,0.58)、0.66(0.63,0.69)、0.76(0.74,0.80)。RVFAC、TAPSE及TAPSV随着肺动脉压力升高而降低(H=67.840,89.510,82.980,均P<0.05),DD-Tei指数随着肺动脉压力升高而增高(H=103.340,P<0.05)。RVFAC、TAPSE、TAPSV与肺动脉压力均呈负相关(r=-0.789,-0.879,-0.841,均P<0.05),DD-Tei指数与肺动脉压力呈正相关(r=0.938,P<0.05)。RVFAC、TAPSE、TAPSV及DD-Tei指数对肺动脉高压均具有较好的诊断效能,曲线下面积分别为0.834,0.923,0.861,0.969,其中DD-Tei指数诊断效能最好。结论DD-Tei指数可以较好地评价肺动脉高压新生儿的右心功能,而且可以反映肺动脉压力变化。Objective To explore the application value of double Doppler Tei index in assessing pulmonary artery pressure and right heart function in neonates with pulmonary hypertension.Methods Ninety neonates with pulmonary hypertension(pulmonary hypertension group)with corrected gestational age 28-40 weeks in Xiamen Children's Hospital from July 2020 to June 2021 were selected and divided into mild group(40-50 mm Hg,35 cases),moderate group(51-70 mm Hg,30 cases),and severe group(more than 70 mm Hg,25 cases)according to pulmonary artery pressure.Thirty neonates of the same gestational age without pulmonary hypertension were selected as control group.The right ventricular area change fraction(RVFAC),tricuspid annular plane systolic displacement(TAPSE),peak tricuspid annulus displacement velocity(TAPSV),and DD-Tei index were measured.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of right ventricular function parameters in diagnosis of pulmonary hypertension.Results The levels of RVFAC in control group,mild group,moderate group,and severe group were 40.80%(37.33%,43.66%),38.20%(36.80%,38.90%),36.00%(33.93%,37.55%),and 33.6%(31.80%,34.30%),respectively.The levels of TAPSE in control group,mild group,moderate group,and severe group were 9.60(8.86,10.82)mm,8.56(8.34,8.76)mm,7.49(6.88,7.92)mm,and 6.43(6.18,7.05)mm,respectively.The levels of TAPSV in control group,mild group,moderate group,and severe group were 8.47(7.33,9.20)cm/s,7.78(7.30,8.00)cm/s,6.35(5.84,6.96)cm/s,and 5.75(5.25,6.42)cm/s,respectively.The levels of DD-Tei index in control group,mild group,moderate group,and severe group were 0.44(0.42,0.49),0.56(0.52,0.58),0.66(0.63,0.69),and 0.76(0.74,0.80),respectively.RVFAC,TAPSE,and TAPSV decreased with the increase of pulmonary artery pressure(H=67.840,89.510,82.980,P<0.05),DD-Tei index increased with the increase of pulmonary artery pressure(H=103.340,P<0.05).RVFAC,TAPSE,and TAPSV were negatively correlated with pulmonary artery pressure(r=-0.789,-0.879,-0.841,P<0.05),DD-Tei in

关 键 词：新生儿 肺动脉高压 双多普勒Tei指数 右心功能 

分 类 号：R725.6[医药卫生—儿科]