不同胎龄和出生体重新生儿左右心室Tei指数比较

Comparison of left and right ventricular Tei indexes in newborns of different gestational age and birth weight

目的比较不同胎龄和出生体重新生儿左右心室Tei指数及其参考范围。方法选择徐州市中心医院新生儿重症监护病房2019年2月至2021年6月收治、无需正压通气、无需使用血管活性药物的新生儿进行前瞻性研究, 均在出生>24 h且7 d内测量并计算Tei指数, 部分新生儿在第1次测量1~2周后复查。根据胎龄分为<32周组、32~36周组、≥37周组, 根据出生体重分为<1 500 g组、1 500~2 499 g组、≥2 500 g组, 根据测量日龄分为1~7 d组、>7 d组。应用SPSS 20.0统计软件, 采用t检验、单因素方差分析及相关性分析, 比较不同性别、胎龄、出生体重、日龄新生儿左右心室Tei指数, 分析日龄1~7 d新生儿Tei指数参考范围。结果最终纳入128例。<32周42例、32~36周43例、≥37周43例;<1 500 g 42例、1 500~2 499 g 42例、≥2 500 g 44例;早产儿>7 d复查63例, 足月儿>7 d复查31例。日龄1~7 d时, ≥37周组左右心室Tei指数小于32~36周组和<32周组(左心室:0.382±0.069比0.431±0.069、0.439±0.060, 右心室:0.373±0.038比0.431±0.035、0.452±0.064), 32~36周组右心室Tei指数小于<32周组, 差异有统计学意义(P<0.05);32~36周组与<32周组左心室Tei指数差异无统计学意义(P>0.05)。出生体重≥2 500 g组左右心室Tei指数小于1 500~2 499 g组和<1 500 g组(左心室:0.385±0.069比0.434±0.067、0.434±0.064, 右心室:0.376±0.039比0.431±0.043、0.450±0.061), 差异有统计学意义(P<0.05);1 500~2 499 g组与<1 500 g组差异无统计学意义(P>0.05)。早产儿和足月儿>7 d时左右心室Tei指数与1~7 d比较, 差异均无统计学意义(P>0.05)。日龄1~7 d时新生儿Tei指数参考范围均随胎龄和出生体重的增加而逐渐降低。结论足月儿和出生体重≥2 500 g新生儿左右心室Tei指数明显小于早产儿和低出生体重儿;日龄1~7 d时新生儿左右心室Tei指数参考范围与胎龄和出生体重均成负相关。

Objective To compare left and right ventricular Tei indexes and to determine the reference range in newborns of different gestational age(GA)and birth weight(BW).Methods From February 2019 to June 2021,newborns admitted to the Neonatal Intensive Care Unit of our hospital were enrolled.Tei indexes were measured and calculated during 24 h~7 d after birth and reexamined 1~2 weeks later in some of the newborns.The newborns were assigned into<32 w group,32~36 w group and≥37 w group according to their GA,<1500 g group,1500~2499 g group and≥2500 g group according to their BW,and early newborn group(1~7 d)and late newborn group(>7 d)according to their age of evaluation.The data were analyzed using t test,one-way analysis of variance(ANOVA)and correlation analysis with SPSS 20.0 statistical software.Results A total of 128 cases were included.42 cases in<32 w group,43 in 32~36 w group and 43 in≥37 w group.42 cases in<1500 g group,42 in 1500~2499 g group and 44 in≥2500 g group.Tei indexes were reexamined after 7 d of age in 63 preterm infants and in 31 full-term infants.The left and right ventricular Tei indexes of the≥37 w group were less than the 32~36 w group and the<32 w group in early newborns(left ventricular:0.382±0.069 vs.0.431±0.069 and 0.439±0.060,right ventricular:0.373±0.038 vs.0.431±0.035 and 0.452±0.064);the right ventricular Tei index of the 32~36 w group was significantly less than the<32 w group(P<0.05).No significant differences existed in the left ventricular Tei index between the 32~36 w group and the<32 w group(P>0.05).The left and right ventricular Tei indexes of the≥2500 g group were significantly less than the 1500~2499 g group and the<1500 g group(left ventricular:0.385±0.069 vs.0.434±0.067 and 0.434±0.064,right ventricular:0.376±0.039 vs.0.431±0.043 and 0.450±0.061)(P<0.05).No significant differences existed between the 1500~2499 g group and the<1500 g group(P>0.05).No significant differences existed in the left and right ventricular Tei indexes between the late newborn group and early newborn group(P>0.05).For early newborns(1~7 d of age),the reference range of Tei index gradually decreased along with the increase of GA and BW.Conclusions The left and right ventricular Tei indexes of full-term infants and infants with BW≥2500 g are less than preterm and low birth weight infants.The reference range of Tei index in early newborns shows negative correlation with GA and BW.