中国实用儿科杂志

中国实用儿科杂志

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右室Tei指数评价缺氧性肺动脉高压新生儿右室功能应用价值研究

李明霞a ， 朱艳萍a ， 唐　琪b   

  1. 新疆医科大学第一附属医院 a新生儿科 b 超声诊断科， 乌鲁木齐　830054
  • 收稿日期:2008-04-17 修回日期:2008-12-17 出版日期:2009-05-06 发布日期:2010-03-01

Research on right ventricular function in neonates with hypoxia-induced pulmonary artery hypertension by the Tei index of right ventricle.

LI Ming-xia*， ZHU Yan-ping，TANG Qi.   

  1. *Department of Neonate， the First Affiliated Hospital of Xinjiang Medical University， Urumqi 830054， China.
  • Received:2008-04-17 Revised:2008-12-17 Online:2009-05-06 Published:2010-03-01

摘要： 目的　探讨右室Tei指数（RV-Tei）在评价缺氧性肺动脉高压（HPH）新生儿右室功能中的作用。方法　对2006年6月至2008年1月在新疆医科大学第一附属医院新生儿病房住院的75例HPH新生儿（HPH组，其中轻度29例、中度21例、重度25例）及22名对照组新生儿，于生后3 d以超声心动图测定肺动脉收缩压（PASP）、右室射血分数（RVEF）、三尖瓣口舒张早期峰值（E峰）、舒张晚期峰值（A峰），计算E/A值，并从血流频谱测得右室RV-Tei。 结果　（1）轻、中度HPH组RVEF、E/A值与对照组比较，差异无统计学意义。重度HPH组RVEF、E/A值较对照组减小 （ P < 0.01）。（2）HPH轻、中、重3组RV-Tei均较对照组升高 （ P < 0.01）。3组间RV-Tei差异亦有统计学意义（ P < 0.05） 。（3） HPH组RV-Tei与PASP呈正相关（ r = 0.75， P < 0.05），与胎龄、体重、心率无相关。结论　肺动脉高压引起新生儿右室功能减低，RV-Tei是评价HPH新生儿右室功能早期变化的简便而敏感的多普勒超声新指标。

关键词: 缺氧性肺动脉高压, 新生儿, 右室功能, Tei指数

Abstract: Objective　To investigate the roles of the Tei index of right ventricle （RV-Tei） in assessing right ventricular function in neonates with HPH. Methods　Echocardiographic examinations were performed on day 3 on 75 cases （HPH group）， which included 29 cases of mild HPH， 21 cases of moderate HPH and 25 cases of severe HPH , and 22 cases of neonates as control group， and pulmonary artery systolic pressure （PASP）， right ventricular ejection fraction （RVEF）， tricuspid early diastolic peak （peak E）and the late diastolic peak （peak A） were estimated， and E/A ratio was acquired. The Tei index of right ventricle （RV-Tei） was measured by Doppler spectrum. Results　（1） Comparing the neonates of HPH groups with the control group， the RVEF and E/A ratio of right ventricle was decreased significantly in severe HPH group （ P < 0.01）， while in the other two groups there was no statistical difference. （2） The RV-Tei in three HPH groups was higher than the control group （ P < 0.01）. The RV-Tei in the three HPH groups had statistical difference （P < 0.05）.（3） RV-Tei and PASP in HPH group were positively correlated （ r = 0.75， P < 0.05）， but had no correlation with their gestational age， birth weight and heart rate. Conclusion　Neonatal pulmonary artery hypertension can lead to disorders of the right ventricular function. RV-Tei index can evaluate early overall changes of the right ventricular function and is better than conventional ultrasound technology in newborns with HPH.

Key words: Tei index , newborn, right ventricular function