不同胎龄新生儿早期心功能的变化

Comparing with Cardiac Function of the Early Infants of Different Gestational Age

目的探讨不同胎龄新生儿早期心功能指标的差异。方法将110例新生儿根据不同胎龄分为4组，第1组为孕37～41周足月儿30例；第2组孕35～36^＋6周早产儿30例；第3组孕33～34^＋6周早产儿30例；第4组孕28～32^＋6周早产儿20例，4组患儿日龄均为生后1～7d。应用彩色多普勒超声心动图动态观察4组患儿生后第1～7天的心功能变化．包括心脏泵血功能指标及各瓣口流速指标。结果第1组左室射血分数（EF）高于第4组（P〈0．05）；心输出量（CO）第2、3、4组均低于第1组，3、4组低于第2组，第4组低于第3组（均P〈0．05）；主动脉瓣口峰值（AV）流速1、2组均高于第3、4组（均P〈0．05）；肺动脉口峰值（PV）流速第1组均高于其他3组（P〈0．05）。生后第1天，AV与出生体质量呈正相关（r=0．40，P〈0．001）；CO与出生体质量及胎龄呈正相关（r=0．70，P〈0．001；r=0．71，P〈0．001）。结论不同胎龄新生儿心功能指标存在不同的差异，主要体现在CO和AV两个方面。

Objective To investigate deviation of the early infants of different gestational age. Methods One hundred and ten cases of the early infants were divided into four groups according to the gestational age. the first group consisted of 37 to 41w term infants（n= 30）, the second group did of 35 to 36^＋6w preterm infants（n=30）,the third group did of 33 to 34^＋6w preterm infants（n=30）,and the fourth group did of 28 to 32^＋6w preterm infants（n=20）. Age of four group were 1-7 d. The color Doppler echocardigraphy was applied to estimate the heart function between the first and seventh day of birth in each case. The indexes of blood-pumping function and flow rate of all valve orifices were measured. Results The left ventricular ejection fraction（EF）of first group was higher than fourth group（P〈0.05）. Cardiac output（CO）of first group was higher than that of any others groups（P〈0.05） ,CO of second group was higher than that of third and fourth group（P〈0.05） ,and CO was higher in the third group than that in the fourth group（P〈 0.05）. The aortic valve blood velocity of the first and second group was faster than that of the third and fourth group（all P〈0.05） ,while the pulmonary valve blood velocity of the first group was faster than others groups（P〈0.05）. At the first day of birth,the aortic valve blood velocity had a positive relationship with the weight of infants（r= 0.40, P〈0. 001 ）. The index of bloodpumping function had positive correlation to the weight of birthday and the age of infants （r =0.70,P〈0. 001 and r=0.71, P〈0. 001, respectively）. Conclusion There is deviation in bloodpumping function and flow rate of valve orifices between the first group and the third,the fourth groups,while the deviation between the first group and the second group lies in CO and AV.