超声心动图Tei指数早期诊断小儿重症心肌炎的临床价值分析
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摘要
目的探讨超声心动图Tei指数诊断小儿重症心肌炎的临床应用价值。方法回顾性选取160例确诊重症病毒性心肌炎患儿(病例组),病例收集时间2014年1月至2016年12月;另选同期80例儿保科收集的健康儿童作为对照组。采用超声心动图检测两组心功能指标、Tei指数、血清心肌酶学指标并进行比较分析,观察Tei指数与血清学指标的相关性。结果病例组患儿左右心室的Tei指数、等容收缩间期(ICT)、等容舒张间期(IRT)测定值均显著的高于对照组,差异有统计学意义(P<0.05);病例组患儿左心室的射血时间(ET)显著的高于对照组(P<0.05),病例组患儿的右心室ET显著的低于对照组(P<0.05);病例组患儿血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I(c Tn I)、肌酸激酶(CK)、乳酸脱氢酶(LDH)水平均显著的高于对照组(P<0.05);病例组患儿血清CK、CK-MB、c Tn I、LDH水平与患儿左室Tei指数、右室Tei指数均呈显著的正相关关系(P<0.05)。结论超声心动图Tei指数诊断小儿重症心肌炎具有一定的临床价值,并且与患儿心肌酶学指标具有较好的相关性。
Objective To explore the clinical signficance of Tei index of echocardiography in diagnosis of severe myocarditis in infantile patients. Methods A total of 160 infantile patients with severe viral myocarditis during January 2014 to December 2016 were allocated in case group,and 80 healthy children in the same period were selected as control group. Echocardiography had been used to detect the cardiac function index of these 2 groups,Tei index,serum levels of myocardial enzymes were analyzed and compared. The correlation between Tei index and serological indexes had been analyzed and compared. Results Left and right ventricular Tei indexes,ICT and IRT in patients of case group were significantly higher than those of control group,and the difference was statistically significant( P < 0. 05). Left ventricular ET in case group was significantly higher than that of control group( P < 0. 05). Right ventricular ET in case group was significantly lower than that of control group( P< 0. 05). Serum levels of CK,CK-MB,c Tn I and LDH in case group were significantly higher than those of control group( P < 0. 05). The serum levels of CK,CK-MB,c Tn I,LDH and Tei indexes of left and right ventricles in infantile patients had posiive correlation( P < 0. 05).Conclusion The application of Tei index of echocardiography in diagnosis of infantile patients with severe myocarditis has certain clinical significance,and it has positive correlation with myocardial enzyme indices in infantile patients.
Objective To explore the clinical signficance of Tei index of echocardiography in diagnosis of severe myocarditis in infantile patients. Methods A total of 160 infantile patients with severe viral myocarditis during January 2014 to December 2016 were allocated in case group,and 80 healthy children in the same period were selected as control group. Echocardiography had been used to detect the cardiac function index of these 2 groups,Tei index,serum levels of myocardial enzymes were analyzed and compared. The correlation between Tei index and serological indexes had been analyzed and compared. Results Left and right ventricular Tei indexes,ICT and IRT in patients of case group were significantly higher than those of control group,and the difference was statistically significant( P < 0. 05). Left ventricular ET in case group was significantly higher than that of control group( P < 0. 05). Right ventricular ET in case group was significantly lower than that of control group( P< 0. 05). Serum levels of CK,CK-MB,c Tn I and LDH in case group were significantly higher than those of control group( P < 0. 05). The serum levels of CK,CK-MB,c Tn I,LDH and Tei indexes of left and right ventricles in infantile patients had posiive correlation( P < 0. 05).Conclusion The application of Tei index of echocardiography in diagnosis of infantile patients with severe myocarditis has certain clinical significance,and it has positive correlation with myocardial enzyme indices in infantile patients.
引文
[1]张兆.N端脑钠肽原联合Tei指数在急性冠脉综合征早期诊断及心功能动态评价中的临床研究[J].中国煤炭工业医学杂志,2014,7(7):1038-1042.
[2]李新祥,颜道茹,张敏青.超声心动图诊断肺心病的临床价值分析[J].医学影像学杂志,2013,23(10):1651-1653.
[3]倪荣,李丽丽.病毒性心肌炎的发病机制和治疗进展[J].中国煤炭工业医学杂志,2016,18(6):936-938.
[4]梁娜,王富发,杨金平.超声Tei指数评价矽肺患者右心室功能的价值[J].广西医学,2012,34(9):1184-1185.
[5]陈宇倩,刘佳,赵华,等.二尖瓣瓣环位移联合TEI指数评价尿毒症患者左室功能的可行性分析[J].大连医科大学学报,2016,38(1):77-80.
[6]马海红,李洪英,胡雪梅,等.彩色超声心动图检查在高原心脏病肺动脉高压诊断中的临床价值[J].中国医学装备,2016,13(10):52-55.
[7]刘光德,刘培中,李深福,等.Tei指数联合心电图、颈动脉超声与冠心病诊断价值研究[J].临床和实验医学杂志,2015,14(16):1353-1355.
[8]蔚俊丽,刘晓蓉,高瑞锋,等.应用实时三维超声心动图及Tei指数评价妊娠期高血压疾病患者左心功能的临床研究[J].中国药物与临床,2016,16(10):1429-1431.
[9]金师珍,陈烁,朱伟,等.Tei指数在左心室心肌致密化不全的应用[J].岭南心血管病杂志,2015,21(5):640-642.
[10]高洁,吴莉华,梅冬,等.左心室Tei指数评价心电图ST段下移患者左心功能的临床价值[J].临床超声医学杂志,2012,14(1):47-49.
[11]徐烨华,段立玲,熊爱琴,等.心力衰竭患者组织多普勒Tei指数与临床心功能参数的相关性分析[J].宁夏医科大学学报,2014,36(11):1205-1207.
[12]徐慧聪,李红娟,戴洁琛,等.慢性心力衰竭气虚类证与Tei指数的关系探讨[J].中西医结合心脑血管病杂志,2014,12(3):276-277.
[13]孙惠文.妊娠高血压综合征患者左室Tei指数与心率变异的临床研究[J].现代中西医结合杂志,2013,22(26):2867-2868.
[14]孟亦真,李劼,马琳,等.超声心动图诊断右心衰竭的判别分析[J].重庆医学,2016,45(27):3838-3840.
[2]李新祥,颜道茹,张敏青.超声心动图诊断肺心病的临床价值分析[J].医学影像学杂志,2013,23(10):1651-1653.
[3]倪荣,李丽丽.病毒性心肌炎的发病机制和治疗进展[J].中国煤炭工业医学杂志,2016,18(6):936-938.
[4]梁娜,王富发,杨金平.超声Tei指数评价矽肺患者右心室功能的价值[J].广西医学,2012,34(9):1184-1185.
[5]陈宇倩,刘佳,赵华,等.二尖瓣瓣环位移联合TEI指数评价尿毒症患者左室功能的可行性分析[J].大连医科大学学报,2016,38(1):77-80.
[6]马海红,李洪英,胡雪梅,等.彩色超声心动图检查在高原心脏病肺动脉高压诊断中的临床价值[J].中国医学装备,2016,13(10):52-55.
[7]刘光德,刘培中,李深福,等.Tei指数联合心电图、颈动脉超声与冠心病诊断价值研究[J].临床和实验医学杂志,2015,14(16):1353-1355.
[8]蔚俊丽,刘晓蓉,高瑞锋,等.应用实时三维超声心动图及Tei指数评价妊娠期高血压疾病患者左心功能的临床研究[J].中国药物与临床,2016,16(10):1429-1431.
[9]金师珍,陈烁,朱伟,等.Tei指数在左心室心肌致密化不全的应用[J].岭南心血管病杂志,2015,21(5):640-642.
[10]高洁,吴莉华,梅冬,等.左心室Tei指数评价心电图ST段下移患者左心功能的临床价值[J].临床超声医学杂志,2012,14(1):47-49.
[11]徐烨华,段立玲,熊爱琴,等.心力衰竭患者组织多普勒Tei指数与临床心功能参数的相关性分析[J].宁夏医科大学学报,2014,36(11):1205-1207.
[12]徐慧聪,李红娟,戴洁琛,等.慢性心力衰竭气虚类证与Tei指数的关系探讨[J].中西医结合心脑血管病杂志,2014,12(3):276-277.
[13]孙惠文.妊娠高血压综合征患者左室Tei指数与心率变异的临床研究[J].现代中西医结合杂志,2013,22(26):2867-2868.
[14]孟亦真,李劼,马琳,等.超声心动图诊断右心衰竭的判别分析[J].重庆医学,2016,45(27):3838-3840.