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目的探讨Tei指数在评价早产儿右室心功能中的作用及其影响因素,为临床评估及治疗提供依据。方法对早产儿和足月儿各50例进行心脏组织多普勒(tissue Dopplerimaging,TDI)检查,测定右室射血分数(RVEF)、肺动脉收缩压(PASP)、三尖瓣口舒张早期峰值(E峰)、舒张晚期峰值(A峰),计算E/A值结果 ,同时记录右房室瓣环处的组织多普勒频谱图,测定等容收缩期时间(ICT)与等容舒张期时间(IRT)之和(ICT+IRT)及射血期时间(ET),公式(ICT+IRT)/ET计算Tei指数。结果早产儿与足月儿RVEF值及E/A比值差异无统计学医院(P>0.05),早产儿右室Tei指数较足月儿明显升高(0.48±0.07VS0.38±0.05,P<0.01)。新生儿右室Tei指数随孕周及出生体重增加逐渐下降(孕周r=-0.78,P<0.01;体重r=-0.73,P<0.01),与心率、体表面积无明显相关性(P>0.05)。结论右室Tei指数是评价早产儿右室心功能早期变化简便而敏感的多普勒超声新指标,优于传统超声指标。
Objective To investigate the role of Tei index in assessing right ventricular function in preterm infants and its influencing factors so as to provide evidence for clinical evaluation and treatment. Methods 50 cases of preterm infants and term infants were examined by tissue Doppler pulsatile TDI. RVEF, PASP and early diastolic tachycardia peak of tricuspid valve were measured E peak) and peak (A peak) of late diastole. The E / A value was calculated. The tissue Doppler spectrum of right atrial annulus was recorded. The isovolumetric systolic time (ICT) and isovolumic diastolic time (ICT + IRT) and ejection duration (ET), and formula (ICT + IRT) / ET were used to calculate the Tei index. Results There was no significant difference in RVEF and E / A between preterm and term infants (P> 0.05). The Tei index of right ventricle in premature infants was significantly higher than that in full infants (0.48 ± 0.07 vs 0.38 ± 0.05, P < 0.01). The Tei index of newborn right ventricle decreased gradually with gestational age and birth weight gain (gestational week r = -0.78, P <0.01; body weight r = -0.73, P <0.01), but had no significant correlation with heart rate and body surface area 0.05). Conclusion The Tei index of right ventricle is a simple and sensitive new index to evaluate the early changes of right ventricular function in preterm infants, which is superior to the traditional ultrasound.