经平均心率矫正后Tei指数评价胎儿心功能的价值
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摘要
目的:探讨评价胎儿心功能的实用方法及正常胎儿Tei指数随孕周变化的规律。方法:随机选取来我院进行产前检查的20~40孕周的正常单胎胎儿257例,进行胎儿超声心动图检查,分别取得二、三尖瓣,主动脉瓣、肺动脉瓣的脉冲多普勒血流频谱,测量相应的时间间期,记录当时的心率,然后用平均心率矫正时间间期,计算左、右心室Tei指数。结果:257例胎儿的Tei指数均成功测得,左心室平均Tei指数为0.35±0.04,右心室为0.34±0.04,左心室Tei指数大于右心室(P<0.01);左、右心室Tei指数之间有明显相关性,(r=0.844,P=0.00);双侧心室Tei指数随孕周增长而减低(P<0.01)。结论:用平均心率矫正后的Tei指数是评价胎儿心脏整体功能的良好指标,建立胎儿心室Tei指数的正常值范围有助于正确评估胎儿心功能,对优生优育有重要意义。
Objectives To explore the practical method for the evaluation of fetal cardiac function and the change regularity of normal fetal Tei index with gestational age. Methods 257 normal singleton fetuses with 20-40 pregnant weeks were selected and received fetal echocardiogram. The pulsed Doppler blood flow spectrums of mitral valve,tricuspid valve,aortic valve and pulmonary valve were gained and the corresponding time intervals were measured. The heart rates were recorded at the same time. The time intervals were corrected by the average heart rate,and then the ventricular Tei index was calculated. Results The Tei index of 257 fetuses were measured successfully. The mean Tei index of left ventricle was 0.35±0.04 and that of right ventricle was 0.34 ± 0.04(P< 0.01). There was a significant correlation between left and right ventricular Tei index(r = 0.844,P = 0.00). Bilateral ventricular Tei index decreased with the increase of gestational age(P < 0.01). Conclusions Tei index which was corrected by average heart rate was a good index to evaluate fetal overall heart function. Establishing the range of normal value of fetal ventricular Tei index was helpful to correctly evaluate the fetal heart function and had important significance in eugenics.
Objectives To explore the practical method for the evaluation of fetal cardiac function and the change regularity of normal fetal Tei index with gestational age. Methods 257 normal singleton fetuses with 20-40 pregnant weeks were selected and received fetal echocardiogram. The pulsed Doppler blood flow spectrums of mitral valve,tricuspid valve,aortic valve and pulmonary valve were gained and the corresponding time intervals were measured. The heart rates were recorded at the same time. The time intervals were corrected by the average heart rate,and then the ventricular Tei index was calculated. Results The Tei index of 257 fetuses were measured successfully. The mean Tei index of left ventricle was 0.35±0.04 and that of right ventricle was 0.34 ± 0.04(P< 0.01). There was a significant correlation between left and right ventricular Tei index(r = 0.844,P = 0.00). Bilateral ventricular Tei index decreased with the increase of gestational age(P < 0.01). Conclusions Tei index which was corrected by average heart rate was a good index to evaluate fetal overall heart function. Establishing the range of normal value of fetal ventricular Tei index was helpful to correctly evaluate the fetal heart function and had important significance in eugenics.
引文
[1]Tei C.New non-invasive index for combined systolic and diastolic ventricular function[J].J Cardiol,1995,26(2):135-136.
[2]Eidem B W,Edwards J M,Cetta F,et al.Quantitative assessment of fetal ventricular function:establishing normal values of the myocardial performance index in the fetus[J].Echocardiography,2001,18(1):9-13.
[3]潘美,赵博文,杨园,等.E/Em评价中晚孕期正常胎儿心脏舒张功能的研究[J].中国超声医学杂志.2010,26(3):261-264.
[4]Younoszai A K,Saudek D E,Emery S P,et al.Evaluation of myocardial mechanics in the fetus by velocity vector imaging[J].J Am Soc Echocardiography,2008,21(5):470-474.
[5]庞慧燕,姜志荣.超声心动图评价胎儿心功能的研究进展[J].中华临床医师杂志:电子版,2011,5(7),2036-2038.
[6]Friedman D,Buyon J,Kim M,et al.Fetal cardiac function assessed by Doppler myocardial performance index(Tei Index)[J].Ultrasound Obstet Gynecol,2003,21(1):33-36.
[7]黎云,温岩,孙晓峰.应用Tei指数评价妊娠期糖尿病胎儿心功能的研究[J].中国妇幼保健,2009,24(22):3104-3106.
[8]钱晓芹,顾建娟.正常中孕胎儿心功能的超声评价[J].中国产前诊断杂志:电子版.2010,2(4):24-27.
[9]Falkensammer C B,Paul J,Huhta J C,et al.Fetal congestive heart failure:correlation of Tei index and Cardiovascular score[J].J Perinat Med.2001,29(5):390-398.
[10]储晨,桂永浩,施立晔.用脉冲多普勒Tei指数评价正常胎儿心功能价值探讨[J].中国实用儿科杂志,2008,23(5):356-358
[11]Tsutsumi T,Ishii M,Eto G,et al.Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index[J].Pediatrics International,1999,41(6):722-727.
[12]陈倩,孙晓峰,刘慧娟.应用Tei指数评价胎儿心室功能的研究[J].中华妇产科杂志,2006,41(6):387-390.
[13]邵素霞,张雷,段相林.不同月龄人胎心肌细胞超微结构变化[J].解剖科学进展.2001,7(1):30-32.
[2]Eidem B W,Edwards J M,Cetta F,et al.Quantitative assessment of fetal ventricular function:establishing normal values of the myocardial performance index in the fetus[J].Echocardiography,2001,18(1):9-13.
[3]潘美,赵博文,杨园,等.E/Em评价中晚孕期正常胎儿心脏舒张功能的研究[J].中国超声医学杂志.2010,26(3):261-264.
[4]Younoszai A K,Saudek D E,Emery S P,et al.Evaluation of myocardial mechanics in the fetus by velocity vector imaging[J].J Am Soc Echocardiography,2008,21(5):470-474.
[5]庞慧燕,姜志荣.超声心动图评价胎儿心功能的研究进展[J].中华临床医师杂志:电子版,2011,5(7),2036-2038.
[6]Friedman D,Buyon J,Kim M,et al.Fetal cardiac function assessed by Doppler myocardial performance index(Tei Index)[J].Ultrasound Obstet Gynecol,2003,21(1):33-36.
[7]黎云,温岩,孙晓峰.应用Tei指数评价妊娠期糖尿病胎儿心功能的研究[J].中国妇幼保健,2009,24(22):3104-3106.
[8]钱晓芹,顾建娟.正常中孕胎儿心功能的超声评价[J].中国产前诊断杂志:电子版.2010,2(4):24-27.
[9]Falkensammer C B,Paul J,Huhta J C,et al.Fetal congestive heart failure:correlation of Tei index and Cardiovascular score[J].J Perinat Med.2001,29(5):390-398.
[10]储晨,桂永浩,施立晔.用脉冲多普勒Tei指数评价正常胎儿心功能价值探讨[J].中国实用儿科杂志,2008,23(5):356-358
[11]Tsutsumi T,Ishii M,Eto G,et al.Serial evaluation for myocardial performance in fetuses and neonates using a new Doppler index[J].Pediatrics International,1999,41(6):722-727.
[12]陈倩,孙晓峰,刘慧娟.应用Tei指数评价胎儿心室功能的研究[J].中华妇产科杂志,2006,41(6):387-390.
[13]邵素霞,张雷,段相林.不同月龄人胎心肌细胞超微结构变化[J].解剖科学进展.2001,7(1):30-32.