经平均心率矫正后Tei指数评价胎儿心功能的价值

The value of Tei index corrected by average heart rate in evaluating fetal cardiac function

目的：探讨评价胎儿心功能的实用方法及正常胎儿Tei指数随孕周变化的规律。方法：随机选取来我院进行产前检查的20—40孕周的正常单胎胎儿257例，进行胎儿超声心动图检查，分别取得二、三尖瓣，主动脉瓣、肺动脉瓣的脉冲多普勒血流频谱，测量相应的时间间期，记录当时的心率。然后用平均心率矫正时间间期，计算左、右心室Tei指数。结果：257例胎儿的Tei指数均成功测得．左心室平均Tei指数为0．35±0．04，右心室为O．34±0．04，左心室Ri指数大于右心室（尸〈001）；左、右心室Tei指数之间有明显相关性。（r=0．844，P=O．00）；双侧心室Tei指数随孕周增长而减低（P〈0．01）。结论：用平均心率矫正后的Tei指数是评价胎儿心脏整体功能的良好指标，建立胎儿心室Tei指数的正常值范围有助于正确评估胎儿心功能．对优生优育有重要意义。

Objectives To explore the practical method for the evaluation of fetal cardiac function and the change regularity of normal fetal Tei index with gestational age. Methods 257 normal singleton fetuses with 20-40 pregnant weeks were selected and received fetal echocardiogram. The pulsed Doppler blood flow spectrums of mitral valve, tricuspid valve, aortic valve and pulmonary valve were gained and the corresponding time intervals were measured. The heart rates were recorded at the same time. The time intervals were corrected by the average heart rate, and then the ventricular Tel index was calculated. Results; The Tel index of 257 fetuses were measured successfully. The mean Tei index of left ventricle was 0.35±0.04 and that of right ventricle was 0.34 ± 0.04 （P〈 0.01）. There was a significant correlation between left and right ventricular Tei index （r = 0.844, P = 0.00）. Bilateral ventricular Tel index decreased with the increase of gestational age （P 〈 0.01）. Conclusions Tei index which was corrected by average heart rate was a good index to evaluate fetal overall heart function. Establishing the range of normal value of fetal ventricular Tel index was helpful to correctly evaluate the fetal heart function and had important significance in eugenics.