超声心动图评价新生儿的左室功能

Assessment of Left Ventricular Function by Echocardiography in Newborn Infants

目的应用彩色多普勒超声心动图(CDE)探讨正常新生儿左室功能的特点及影响因素。方法采用Phil-ips IE33彩色多普勒超声诊断仪检测50例正常新生儿左室功能,测量指标包括左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、每搏输出量(SV)、左室射血分数(LVEF)、左室短轴缩短率(LVSF)、二尖瓣口舒张早期与舒张晚期血流充盈速度比(二尖瓣E/A,MVE/A),观察和比较早产儿与足月儿的左室功能的变化,并采用多元线性回归分析探讨左室功能的影响因素。结果①胎龄为28～36+4周早产儿组的LVESV、LVEDV、SV、LVEF、LVSF及MVE/A均低于胎龄为37～40+1周足月儿组,差异均有统计学意义(P均<0.05);②SV、LVEF、LVSF及MVE/A与出生体重呈正相关(r分别为0.518,0.382,0.343及0.452;P均<0.05);另外,SV、LVEF、LVSF及MVE/A与胎龄也呈正相关(r分别为0.462,0.331,0.310及0.369;P均<0.05)。结论早产儿左室收缩和舒张功能均低于足月儿;出生体重和胎龄是影响新生儿左室功能的重要因素。

Objective To investigate the features and influence factors of the left ventricular function in normal newborn infants by using color Doppler echocardiography （CDE）. Methods The left ventricular function was examined by Philips IE33 color Doppler ultrasonic diagnostic apparatus in 50 cases of normal newborn infants. The parameters of the left ventricular function ineluded left ventricular end systolic volume （ LVESV ）, left ventricular end diastolic volume （ LVEDV ）, stroke volume （ SV ）, left ventricular ejection fraction（LVEF） ,left ventricular systolic function（LVSF） ,the ratio of early（E） and late（A） diastolic velocities of bicuspid valves（MVE/A）. The change characteristics of the left ventrieular function were observed and compared between preterm infants and term infants. The influence factors of the left ventdcular function were determined by multiple linear regression analysis. Results （1）The LVESV, LVEDV, SV, LVEF, LVSF and MVE/A of premature group at gestational age of 28 - 36 weeks were lower than those of full-term group at gestational age of 37 - 40 weeks, respectively （ P 〈 0.05 ）. （2）The SV, LVEF, LVSF and MVE/A were positively related to birth weight（ r = 0. 518 ,0. 382 ,0343 and 0. 452 ,respectively ,P 〈 0.05 ） ;While the SV, LVEF, LVSF and MVE/A were positively related to gestational age too（ r = 0.462,0. 331,0.310 and 0. 369, respectively, P 〈 0. 05）. Conclusion The left ventricular systolic and diastolic function of preterm infants is lower than that of full-term infants. The birth weight and gestational age are the important influerlce factors of the left ventricular function in newborn infants.