中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
CHINESE JOURNAL OF PERINATAL MEDICINE
2010年
3期
209-212
,共4页
雷晓燕%孙永红%董皎%王三萍
雷曉燕%孫永紅%董皎%王三萍
뢰효연%손영홍%동교%왕삼평
窒息%新生儿%每搏输出量%肌酸激酶%乳酸脱氢酶类
窒息%新生兒%每搏輸齣量%肌痠激酶%乳痠脫氫酶類
질식%신생인%매박수출량%기산격매%유산탈경매류
Asphyxia neonatorum%Stroke volume%Creatine kinase%Lactate dehydrogenases
目的 探讨新生儿窒息后Tei指数与血清心肌酶的关系.方法 超声心动图测定44例轻度窒息新生儿、27例重度窒息新生儿及20例正常新生儿的二尖瓣口舒张期血流频谱E峰、A峰及E/A值、左心室射血分数、等容收缩间期、等容舒张间期及Tei指数,同时取其静脉血测定天冬氨酸氨基转移酶、肌酸激酶及其同工酶、乳酸脱氢酶、羟丁酸脱氢酶和肌钙蛋白T水平.组间差异比较采用单因素方差分析,两两比较用q检验,Tei指数与血清心肌酶间的关系采用直线相关分析.结果 (1)Tei指数、等容收缩间期及等容舒张间期在重度窒息组分别为0.62±0.13、(47±7)ms和(52±8)ms,均高于轻度窒息组[分别为0.51±0.14、(41±6)ms和(43±6)ms],轻度窒息组高于正常对照组[分别为0.39±0.12、(34±6)ms和(37±6)ms],差异均有统计学意义(P均<0.01).(2)天冬氨酸氨基转移酶、肌酸激酶及其同工酶、乳酸脱氢酶、羟丁酸脱氢酶和肌钙蛋白T在轻度窒息组高于正常对照组(P<0.01),重度窒息组高于轻度窒息组(P<0.01).(3)Tei指数、等容收缩间期及等容舒张间期均与血清心肌酶水平呈正相关(P<0.01).其中Tei指数与肌酸激酶及其同工酶和肌钙蛋白T相关性更明显(r分别为0.762、0.821、0.778,P均<0.01).结论 Tei指数可与血清心肌酶联合应用,评价新生儿窒息后心肌损害患儿的心脏功能,更可准确和动态监测与评估心功能不全的程度.
目的 探討新生兒窒息後Tei指數與血清心肌酶的關繫.方法 超聲心動圖測定44例輕度窒息新生兒、27例重度窒息新生兒及20例正常新生兒的二尖瓣口舒張期血流頻譜E峰、A峰及E/A值、左心室射血分數、等容收縮間期、等容舒張間期及Tei指數,同時取其靜脈血測定天鼕氨痠氨基轉移酶、肌痠激酶及其同工酶、乳痠脫氫酶、羥丁痠脫氫酶和肌鈣蛋白T水平.組間差異比較採用單因素方差分析,兩兩比較用q檢驗,Tei指數與血清心肌酶間的關繫採用直線相關分析.結果 (1)Tei指數、等容收縮間期及等容舒張間期在重度窒息組分彆為0.62±0.13、(47±7)ms和(52±8)ms,均高于輕度窒息組[分彆為0.51±0.14、(41±6)ms和(43±6)ms],輕度窒息組高于正常對照組[分彆為0.39±0.12、(34±6)ms和(37±6)ms],差異均有統計學意義(P均<0.01).(2)天鼕氨痠氨基轉移酶、肌痠激酶及其同工酶、乳痠脫氫酶、羥丁痠脫氫酶和肌鈣蛋白T在輕度窒息組高于正常對照組(P<0.01),重度窒息組高于輕度窒息組(P<0.01).(3)Tei指數、等容收縮間期及等容舒張間期均與血清心肌酶水平呈正相關(P<0.01).其中Tei指數與肌痠激酶及其同工酶和肌鈣蛋白T相關性更明顯(r分彆為0.762、0.821、0.778,P均<0.01).結論 Tei指數可與血清心肌酶聯閤應用,評價新生兒窒息後心肌損害患兒的心髒功能,更可準確和動態鑑測與評估心功能不全的程度.
목적 탐토신생인질식후Tei지수여혈청심기매적관계.방법 초성심동도측정44례경도질식신생인、27례중도질식신생인급20례정상신생인적이첨판구서장기혈류빈보E봉、A봉급E/A치、좌심실사혈분수、등용수축간기、등용서장간기급Tei지수,동시취기정맥혈측정천동안산안기전이매、기산격매급기동공매、유산탈경매、간정산탈경매화기개단백T수평.조간차이비교채용단인소방차분석,량량비교용q검험,Tei지수여혈청심기매간적관계채용직선상관분석.결과 (1)Tei지수、등용수축간기급등용서장간기재중도질식조분별위0.62±0.13、(47±7)ms화(52±8)ms,균고우경도질식조[분별위0.51±0.14、(41±6)ms화(43±6)ms],경도질식조고우정상대조조[분별위0.39±0.12、(34±6)ms화(37±6)ms],차이균유통계학의의(P균<0.01).(2)천동안산안기전이매、기산격매급기동공매、유산탈경매、간정산탈경매화기개단백T재경도질식조고우정상대조조(P<0.01),중도질식조고우경도질식조(P<0.01).(3)Tei지수、등용수축간기급등용서장간기균여혈청심기매수평정정상관(P<0.01).기중Tei지수여기산격매급기동공매화기개단백T상관성경명현(r분별위0.762、0.821、0.778,P균<0.01).결론 Tei지수가여혈청심기매연합응용,평개신생인질식후심기손해환인적심장공능,경가준학화동태감측여평고심공능불전적정도.
Objective To study the relationship between Tei index and the myocardial enzymes in newborns with myocardial damage due to asphyxia. Methods Forty-four newborns with mild asphyxia,27 newborns with severe asphyxia and 20 healthy newborns hospitalized in our hospital from January 2005 to December 2008 were enrolled in this study.The peak E and peak A and E/A ratio at mitral valve,the ejection fraction,isovolumetric contraction time,isovolumetric relaxation time and Tei index were measured by conventional echocardiography,and aspartate aminotransferase,creatine kinase,lactate dehydrogenase,hydroxybutyrate dehydrogenase and creatine phosphate kinase isoenzyme,and cardiac troponin T were tested also.One-way ANOVA was used to analyze the difference between groups. Results Tei index,isovolumetric contraction time and isovolumetric relaxation time in the severe asphyxia newborns were 0.62±0.13,(47±7)ms and(52±8)ms,higher than those in the mild asphyxia newborns[0.51±0.14,(41±6)ms and(43±6)ms],those in the mild asphyxia newborns were higher than in the healthy newborns[0.39±0.12,(34±6)ms and (37±6)ms] (all P<0.01).Aspartate aminotransferase,lactate dehydrogenase,hydroxybutyrate dehydrogenase,creatine kinase and its isoenzymes and cardiac troponin T in the severe asphyxia newborns were higher than in the mild asphyxia newborns and healthy group(P<0.01).Tei index,isovolumetric contraction time and isovolumetric relaxation time were positively related to the myocardial enzymes.The positive relationships were more statistically significant in Tel index,creatine kinase,its isoenzymes and cardiac troponin T(r=0.762,0.821,0.778,P<0.01).Conclusions Combination of Tei index and myocardial enzymes can not only be applied to assess the cardiac function in newborns with myocardial damage due to asphyxia,but also to evaluate the degree of cardiac dysfunction accurately and dynamically.
