摘要
目的应用组织多普勒显像（DTI）评价窒息后新生儿心功能。方法足月窒息新生儿62例，根据Apgar评分分为重度窒息组（Apgar评分≤3分）31例，轻度窒息组（Apgar评分〉3分且≤7分）31例。在出生后24、48、72h应用DTI测定各组的二尖瓣前叶收缩期运动速度（DTIs），舒张早期峰值运动速度（DTIe），舒张晚期峰值运动速度（DTIa），（DTIe／a）比值，对比M型超声的左心室射血分数（LVEF）及脉冲多普勒超声心动图的二尖瓣E峰、A峰值及比值（FJA），并与正常新生儿（对照组）30例对照。结果LVEF仅在重度窒息组24h内[（62±4）cm／s]明显低于对照组（P〈0．05），而DTIs在3个时段均明显低于对照组，重度窒息组内24h明显低于48h[（3．9±0．4）cm／s比（5．3±0．8）cm／s]、72h[（5．0±0．9）cm／s]（均P〈0．01）。E、E／A在72h时重度窒息组（55±12，0．94±0．25）与轻度窒息组（51±10，0．89±0．20）均明显低于对照组（均P〈0．01），A峰值（60±7）明显高于对照组（P〈0．01），而DTIe（5．6±1．2、5．7±0．9、5．6±0．9）、e／a（0．64±0．14、0．69±0．11、0．61±0．12）在3个时段均明显低于对照组，DTIa3个时段（8．5±0．7、8．9±1．5、8．9±1．4）均明显高于对照组（均P〈0．01）。结论新生儿窒息后左心收缩功能、舒张功能均降低，DTI指标较M型超声与脉冲多普勒超声心动图指标更能灵敏的反映心功能的改变。
Objective To investigate the value of Doppler tissue imaging （DTI） in evaluation the changes of cardiac function after neonatal asphyxia. Methods Sixty-two full-term neonates suffering from asphyxia at birth were divided into 2 groups according to Apgar scores： severe asphyxia group with the Apgar scores ≤ 3 （ n = 31 ） and mild asphyxia group with the Apgar scores 〉 3 and ≤ 7 （ n = 31 ）. Thirty normal neonates were used as control group. DTI was conducted 24, 48, and 72 hours after birth to measure the values of systolic peak myocardial motion velocity （ DTIs）, early diastolic peak myocardial motion velocity （TDIe）, late diastolic peak myocardial motion velocity （DTIa） and DTI e/a of anterior leaflet of mitral valve, and the values were compared with the left ventricular ejection fraction （LVEF） measured by M-mode ultrasound and the values of E, A, and E/A of mitral valve shown in pulsed Doppler echoeardiography. Results The LVEF of the severe asphyxia group measured 24 h after birth was （62 ± 4）era/s, significantly lower than that of the control group （P 〈 0.05 ） , while the values of DTIs 24, 48, and 72 hours of the severe asphyxia group were all significantly lower than those of the control group （ all P 〈 0.05 ）. In the severe asphyxia group the DTIs value 24 hours [ （ 3.9 ± 0.4 ） cm/s ] after the birth was significantly lower than those 48 and 72 hours after birth[ （5.3±0.8） cm/s, （5.0 ± 0.9） cm/s, both P 〈 0.01 ]. The values of E and E/A of the severe asphyxia group（55± 12,0.94±0.25）72 h after birth of the mild asphyxia group （51 ± 10,0.89±0.20） were both significantly lower than those of the control group （ both P 〈 0.01 ）, the value of A 72 h after birth of the mild asphyxia group （ 60 ± 7 ） was significantly higher than that of the control group （P 〈0.01 ）. The values of DTIe and DTIe/a 24, 48, and 72 h after birth of the mild asphyxia group were all significantly lower than those of the control group, and
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第2期117-120,共4页
National Medical Journal of China
基金
浙江省卫生厅科技计划项目（20038162）
关键词
窒息
新生儿
心脏功能试验
超声检查
多普勒
评价研究
Asphyxia neonatorum
Heart function tests
Ultrasonography, Doppler
Evaluation studies
