多普勒超声心动图在评价窒息新生儿左心室功能动态变化中的作用

Doppler echocardiography in evaluation of dynamic changes of left ventricular function in asphyxial newborns

摘要:

目的  探讨多普勒超声心动图在评价窒息新生儿左心室功能变化中的作用。方法  生后1、3和7 d分别用多普勒超声心动图测定窒息组（54例）和正常对照组新生儿（40例）左心室射血分数（LVEF）、心输出量（CO）、短轴缩短率（FS）、二尖瓣口舒张早期峰值（E峰）、舒张晚期峰值（A峰），计算E/A值，从二尖瓣口和左室流出道的多普勒血流频谱测左心室Tei指数（LV-Tei），并进行比较。结果  ①与对照组比较，轻、重度窒息组生后第1天LV-Tei及二尖瓣A峰峰值升高，LVEF、左室E/A值、CO值、FS减小，差异有统计学意义（P <0.01），E峰峰值变化比较差异无统计学意义（P >0.05）；②重度窒息组LV-Tei、A峰峰值、EF、FS值在生后第1天与第3天、第3天与第7天分别比较，差异有统计学意义（P <0.01）；③窒息组PaO2与左心室E/A值、EF值、CO呈正相关，与Tei指数呈负相关。结论  多普勒超声心动图可以发现窒息新生儿左心功能的早期变化，对临床诊治有重要的指导作用。

Abstract:

Objective To study the effect of Doppler echocardiography in the evaluation of left ventricular function changes in neonatal asphyxia. Methods There were 54 cases in neonatal asphyxia group and 40 cases in normal newborn group. Doppler echocardiography was used to determine left ventricular ejection fraction (LVEF), cardiac output (CO), fraction shortening (FS), early diastolic peak (E peak) and late diastolic peak (A peak) within 1, 3 and 7 days after birth; then E/A was calculated and left ventricular Tei index (LV-Tei) was measured. The indexes were compared between both groups. Results Compared with the control group, LV-Tei and mitral A peak both went up (P < 0.01), while LVEF, left ventricular E/A value, CO value and FS decreased (P < 0.01) in the two groups of asphxia on the 1st postnatal day; but E peak had no significant change (P > 0.05). In the severe asphyxial group, LV-Tei, A peak, FS and EF of on the 3rd day were all significantly different from those on the 1st and 7th day (P < 0.01). In the asphyxial group, PaO2 was positively correlated with left ventricular E/A value, EF value and CO, but negatively correlated with Tei index. Conclusions Doppler echocardiography can reveal the early changes of left ventricular function in asphyxial newborns. It has significant effect on guiding clinical treatment.