应用Tei指数评价胎儿心室功能的研究

Assessment of myocardial performance in fetuses by using Tei index

目的探讨正常胎儿左、右心室的Tei指数在评价胎儿心脏收缩和舒张功能中的作用及其影响因素。方法应用多普勒超声心动图检查妊娠18～42周的正常单胎胎儿225例，按孕周不同分为18～27周^＋6组、28～36周^＋6组和37—42周组，测定3组胎儿左、右心室的Tei指数的差异，并比较左、右心室Tei指数，探讨其与孕周和胎心率的关系。结果（1）妊娠18～27周^＋6、28～36周^＋6和37～42周3组胎儿的左心室平均Tei指数分别为0．37±0．08、0．27±0．05、0．22±0．05；右心室平均Tei指数分别为0．39±0．04、0．30±0．05、0．24±0．04。妊娠28～36周^＋6组右心室平均Tei指数高于左心室，两者比较，差异有统计学意义（P〈0．05）。其余两组左、右心室平均Tei指数比较，差异无统计学意义（P〉0．05）。（2）正常胎儿左、右心室的Tei指数均显示随着孕周的增加呈逐渐下降的趋势，与孕周呈负相关（左心室r=-0．755，P〈0．01；右心室r=-0．721，P〈0．01）。（3）正常胎儿Tei指数与胎心率无相关性（左心室r=0．133，P〉0．05；右心室r=0．100，P〉0．05）。结论Tei指数是一种方便、有效的综合评价胎儿心脏收缩和舒张功能的指标。

Objective To define the value of Tei index of normal fetuses and to estimate the influenee of gestational week and heart rate on the index. Methods Fetal eebocardiograms were performed on 225 normal single fetuses, whieh were divided into three groups （18 -27^＋, 28 - 36^＋ 37 -42 gestatianal weeks）. The Tei indexes of both left and right ventrieles （LV and RV） were measured by eolor Doppler ultrasonography, t test was used to eompare the Tei index between LV and RV. The eorrelation between Tei index, gestational week and fetal heart rate were analyzed. Results The Tei indexes in three different gestational week groups （ 18 - 27^＋, 28 -36^＋, 37 -42 gestational weeks ） were 0. 37 ± 0. 08, 0. 27 ± 0. 05, 0. 22 ± 0. 05 of LV and 0. 39 ± 0. 04, 0. 30 ± 0. 05, 0. 24 ± 0. 04 of RV respeetively. There was significant difference of Tei index of RV and LV during 28 - 36,6 gestational weeks（ P 〈0.05 ）. The Tei index of LV and RV deereased linearly with advaneing gestational week during 18-42 weeks （LV： r = -0. 755, PP 〈 0. 05 ; RV： r = -0. 721, P 〈 0. 05 ） in normal single fetuses. None of the fetal Tei indees of LVandRVwas related to fetal heart rate （LV： r =0.133, P〉0.05; RV： r =0.100, P〉0.05）. Conclusion Tei index may be useful, eonvenient and reliable in fetal eardiae funetion assessment.