Tei指数评估先天性心脏病胎儿左心室功能的应用价值

Application Value of Tei Index in Evaluating Fetal Left Ventricular Function in Congenital Heart Disease

目的探讨Tei指数评估先天性心脏病(CHD)胎儿左心室功能的应用价值。方法收集2017年6月~2018年10月于我院经胎儿超声心动图诊断为CHD胎儿44例作为病例组,根据心胸面积比值大小分为心胸比正常(n=29)和心胸比增大(n=15);另选取同期同孕龄正常妊娠胎儿60例作为正常对照组。利用M型超声心动图和脉冲多普勒观察所有胎儿左室短轴缩短率(LVFS)、左室射血分数(LVEF),二尖瓣口E/A值及左心室的Tei指数(LVTei)。结果病例组胎儿LVEF低于正常对照组胎儿,LVTei高于正常对照组胎儿,差异有统计学意义(P<0.05);两组胎儿LVFS、E/A比较,差异无统计学意义(P>0.05)。病例组中心胸比正常胎儿LVTei高于正常对照组,差异有统计学意义(P<0.05);病例组中心胸比正常胎儿与正常对照组LVEF、LVFS及E/A比较,差异无统计学意义(P>0.05)。病例组中心胸比增大胎儿LVTei高于心胸比正常及正常对照组胎儿,LVEF、LVFS及E/A低于心胸比正常及正常对照组胎儿,差异有统计学意义(P<0.05)。结论Tei指数测量方法简单,可重复性强,可作为评估CHD胎儿左心功能的指标,为早期评估患儿预后提供可靠依据,并指导患儿围产期的治疗。

Objective To investigate the application value of Tei index in evaluating left ventricular function in congenital heart disease (CHD).Methods From June 2017 to October 2018,44 cases of CHD fetus were diagnosed as fetal cases by fetal echocardiography.According to the ratio of cardiothoracic area,the cardiothoracic ratio was normal (n=29) and the ratio of cardiothoracic ratio was increased(n=15);60 cases of normal pregnancy with the same gestational age were selected as the normal control group.All fetal left ventricular short axis shortening rate (LVFS),left ventricular ejection fraction (LVEF),mitral valve E/A value,and left ventricular Tei index (LVTei) were observed using M-mode echocardiography and pulsed Doppler.Results The fetal LVEF in the case group was lower than that in the normal control group,and the LVTei was higher than that in the normal control group,the difference was statistically significant (P<0.05).There was no significant difference in the LVFS and E/A between the two groups (P>0.05).In the case group,the central chest was higher than the normal fetus LVTei than the normal control group,the difference was statistically significant (P<0.05).There was no significant difference between the normal group and the normal control group LVEF,LVFS and E/A (P>0.05).In the case group,the chest height ratio of the fetus was higher than that of the normal and normal control group.The LVEF,LVFS and E/A were lower than those of the normal and normal control group,the difference was statistically significant (P<0.05).Conclusion The Tei index measurement method is simple and reproducible.It can be used as an index to evaluate the left ventricular function of CHD,provide a reliable basis for early assessment of the prognosis of children,and guide the treatment of perinatal period.