超声心动图技术对新生儿左心功能评估作用的分析

Analysis on effect of echocardiography in evaluation of neonatal left ventricular function

目的：探讨超声心动图技术对于患有新生儿常见疾病的新生儿左心功能评估作用。方法：采用回顾性分析法，选取2010年11月～2013年11月新生儿科足月顺产新生儿100例，其中低氧血症患儿70例，母亲患有妊娠期糖尿病22例，先天性甲状腺功能低下8例，同时选取同期产科健康、足月顺产新生儿100例进行对照。分别在多普勒组织成像法模式下测定两组新生儿的二尖瓣环收缩期运动速度（Sa）、舒张期早期／晚期运动速度（Ea、Aa）及舒张期早期／舒张期晚期运动速度比值（Ea／Aa）。在M超声心动图模式下测定左室短轴缩短率（LVFS）和左室射血分数（LVEF）。采取脉冲多普勒技术（PWD）测量二尖瓣口血流舒张早期及舒张晚期峰值速度（Em、Am）并计算Em／Am。测定两组新生儿的ICT（等容收缩期）＋IRT（等容舒张期），ET（射血时间）并计算Tei指数。结果：患病组的Sa、Ea、及Ea／Aa均显著低于对照组，P〈0．01，且患病组的Aa显著高于对照组，P〈0．01；患病组的LVFS、LVEF、Em、Am和Era／Am均显著低于对照组，P〈0．01。患病组的左心Tel指数大于正常组,P〈0．0l，（ICT＋IRT）大于正常组，ET小于正常组，P〈0．01。结论：患有新生儿常见疾病的新生儿左心收缩和舒张功能较正常新生儿显著下降，超声心动图技术可以敏感地反映新生儿左心功能异常变化。

Objective： To explore the effect of echocardiography in evaluation of left Ventricular function among neonates with common diseases. Methods： One hundred full term neonates of natural labor were selected from department of neonatology in the hospital from November 2010 to November 2013 and analyzed retrospectively, including 70 neonates with hypoxemia, 22 neonates of mothers with gestational diabetes mellitus; 8 neonates with congenital hypothyroidism dysfunction; 100 full term neonates of natural labor in department of neo- natology in the hospital during the same time were selected as control group; under Doppler tissue imaging model, systolic mitral annular velocity （Sa）, diastolic early/late velocity （Ea, Aa）, and early/late diastolic velocity ratio （Ea/Aa） in the two groups were measured; left ventricular fractional shortening （LVFS） and left ventricular ejection fraction （LVEF） were measured under M ultrasonic cardiogram model; PWD was used to measure early diastolic mitral flow and peak late diastolic velocity （Em, Am） and calculate Em/Am;isovolumetric contraction phase （ICT） ＋ isovolumic relaxation phase （IRT）, and ejection time （ET） were measured; Tel index was calculated. Results： Sa, Ea, and Ea/Aa in case group were statistically significantly lower than those in control group （P 〈 0.01 ）, Aa in case group was statistically significantly higher than that in control group （P 〈 0.01 ） ; LVFS, LVEF, Em, Am, Ern/Am case group were statistically significantly lower than those in control group （P 〈 0. 01 ） ; left ventricular Tei index in case group was statistically significantly higher than that in control group （P 〈0. 01 ） ; ICT ＋ IRT in case group was statistically significantly higher than that in control group （P 〈 0. 01 ） ; ET in case group was statistically significantly lower than that in control group （ P 〈 0. 01 ） . Conclusion： Compared with normal neonates, left ventricular systolic and diastolic function of neonates with common diseases decrease significantly, echocardiography can reflect change of left ventricular dysfunction sensitively.