Tei指数评价缺氧新生儿左心室功能障碍的作用研究

Evaluation of left ventricular dysfunction by Tei index in neonates with hypoxemia

摘要:

目的：探讨Tei指数在评价缺氧新生儿左心室功能障碍中的作用。方法：52例低氧血症新生儿（轻度20例，中重度各16例）和40例正常新生儿作为研究对象，于生后1、3、7 d用多普勒超声心动图测定反映心脏收缩及舒张功能的指标：左心室射血分数（LVEF）、二尖瓣口E/A值；左心室Tei指数（LV-Tei）。结果：（1）中度低氧血症组生后1、3 d LVEF、左室E/A值明显低于对照组（P<0.01）；重度低氧血症组生后1、3、7 d LVEF、左室 E/A 值均明显低于对照组（P<0.01或0.05）。（2）轻度低氧血症组生后1 d、中度及重度低氧血症组生后1 d、3 d LV-Tei 值明显高于对照组（P<0.01）。（3）低氧血症组生后1 d、3 d PaO2与LV-Tei呈负相关(r=-0.50, P<0.05; r=-0.71, P<0.01)。结论：LV-Tei可敏感地发现低氧血症患儿左心室功能下降，对临床的诊治有重要的指导作用。

Abstract:

OBJECTIVE: To study the role of Tei index in the evaluation of left ventricular dysfunction in neonates with hypoxemia. METHODS: Fifty-two neonates with hypoxemia (20 mild, 16 moderate, 16 severe) and 40 normal neonates (control group) were enrolled. On postnatal days 1, 3 and 7, Doppler echocardiography was used to measure the indexes reflecting systolic and diastolic cardiac functions: ejection fraction of left ventricular (LVEF), E/A ratio of mitral value and Tei index of left ventricular (LV-Tei). RESULTS: LVEF and E/A ratio of left ventricular in the moderate hypoxemia group were significantly lower than those in the control group on postnatal days 1 and 3 (P<0.01). LVEF and E/A ratio of left ventricular in the severe hypoxemia group were significantly lower than those in the control group on postnatal days 1, 3 and 7 (P<0.01 or 0.05). Compared with the control group, LV-Tei increased significantly in the mild hypoxemia group on postnatal day 1 and increased significantly in the moderate and severe hypoxemia groups on postnatal days 1 and 3 (P<0.01). There was a negative correlation between PaO2 and LV-Tei in the hypoxemia group on postnatal days 1 and 3 (r=-0.50, P<0.05; r=-0.71, P<0.01 respectively). CONCLUSIONS: LV-Tei can be used as a sensitive indicator for the evaluation of left ventricular dysfunction in neonates with hypoxemia.