CAJ | 학술논문

目的：探讨不同胎龄早产新生儿心脏几何形态学及血流动力学的超声心动图征象及影响因素。 　　方法：本研究共纳入150例早产儿（试验组）和150例足月新生儿（对照组），以胎龄为界将试验组新生儿分为3个亚组即28~32+6周亚组（n=48）、33~34+6周亚组（n=56）和35~36+6周亚组（n=46），对照组分为37~38+6周亚组（n=80）和39~41+6周亚组（n=70）。采用Philips iE33型彩色多普勒超声心动图诊断仪测量左心室舒张末期内径、左心室收缩末期内径、室间隔厚度、左心室后壁厚度、左心室舒张末期容积、左心室收缩末期容积、每搏输出量、左心室射血分数、左心室缩短分数及心输出量，并计算测算心搏指数及心脏指数、舒张期心肌质量、左心室质量指数（LVMI）、左心室相对厚度、左心室重构指数（LVRI）及舒张末期容积指数。 　　结果：在体表面积校正后，各亚组的心脏几何形态学及血流动力学参数差异均无统计学意义（P>0.05）。日龄（P=0.001）、身长（P=0.001）及体重（低出生体重儿：P=0.012；正常出生体重儿：P=0.003；巨大儿：P=0.016）是新生儿LVMI的独立影响因素。人体测量学指标及基本的生命体征指标对新生儿LVRI的影响在各胎龄亚组间的差异无统计学意义（χ2=42.88，P=0.076），但对LVMI影响在各亚组间的差异有统计学意义（χ2=123.6，P<0.001）。 　　结论：超声心动图评估早产儿心脏几何形态学和血流动力学指标对新生儿心脏的发育及成熟程度的评价具有重要临床意义。
목적：탐토불동태령조산신생인심장궤하형태학급혈류동역학적초성심동도정상급영향인소。 　　방법：본연구공납입150례조산인（시험조）화150례족월신생인（대조조），이태령위계장시험조신생인분위3개아조즉28~32+6주아조（n=48）、33~34+6주아조（n=56）화35~36+6주아조（n=46），대조조분위37~38+6주아조（n=80）화39~41+6주아조（n=70）。채용Philips iE33형채색다보륵초성심동도진단의측량좌심실서장말기내경、좌심실수축말기내경、실간격후도、좌심실후벽후도、좌심실서장말기용적、좌심실수축말기용적、매박수출량、좌심실사혈분수、좌심실축단분수급심수출량，병계산측산심박지수급심장지수、서장기심기질량、좌심실질량지수（LVMI）、좌심실상대후도、좌심실중구지수（LVRI）급서장말기용적지수。 　　결과：재체표면적교정후，각아조적심장궤하형태학급혈류동역학삼수차이균무통계학의의（P>0.05）。일령（P=0.001）、신장（P=0.001）급체중（저출생체중인：P=0.012；정상출생체중인：P=0.003；거대인：P=0.016）시신생인LVMI적독립영향인소。인체측량학지표급기본적생명체정지표대신생인LVRI적영향재각태령아조간적차이무통계학의의（χ2=42.88，P=0.076），단대LVMI영향재각아조간적차이유통계학의의（χ2=123.6，P<0.001）。 　　결론：초성심동도평고조산인심장궤하형태학화혈류동역학지표대신생인심장적발육급성숙정도적평개구유중요림상의의。
Objective: To explore the echocardiographic cardiac geometric morphology and hemodynamics in premature infants at different gestational age with the inlfuencing factors. Methods: A total of 150 premature infants and 150 full-term control infants were enrolled in this study. Based on gestational age, premature infants were divided into 3 groups:①(28-32+6 ) weeks,②(33-34+6 ) weeks,③(35-36+6) weeks; and full term control infants were divided into 2 groups:①’(37-38+6) weeks and②’ (39-41+6) weeks respectively. An iE33 Philips ultrasound examination was conducted to measure left ventricular end-diastolic diameter (LVEDD), LVESD, interventricular septum thickness, posterior wall thickness, left ventricular end-diastolic volume (LVEDV), LVESV, stroke volume, LVEF, left ventricular fractional shortening (LVFS), cardiac output, stroke index, cardiac index, left ventricular mass, left ventricular mass index (LVMI), left ventricular relative wall thickness, left ventricular remodeling index (LVRI) and LVEDVI. Results: With adjusted body surface area, all parameters for cardiac geometric morphology and hemodynamics were similar among different groups,P>0.05. The day-old age (P=0.001), height (P=0.001) and body weight for low weight born infant (P=0.012), for normal weight born infant (P=0.003), for giant infant (P=0.016) were the independent inlfuencing factors for LVMI. The impact of anthropometry and the basic life indexes were similar on LVRI among groups (χ2=42.88,P=0.076), while the covariates were different on LVMI among groups (χ2=123.6,P<0.001). Conclusion: Cardiac morphology and hemodynamics measured by echocardiography has important clinical meaning for assessing the development and maturity of neonatal hearts in premature infants.