摘要
目的应用超声心动图压力-应变环(PSL)定量早产儿心肌做功的适应性变化。方法纳入早产儿109例和足月儿86例,早产儿根据胎龄分为极早产儿组37例和中晚期早产儿组72例,另将29例早产儿于校正胎龄足月时与同龄足月儿比较,回顾性分析各组的超声心动图压力-应变指标,包括整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE)、整体做功指数(GWI)和整体纵向应变(GLS),并采用Spearman相关分析其与胎龄、体重的相关性。结果与足月儿组比较,早产儿组GCW、GWE、GWI明显减低,差异有统计学意义(P<0.05);但GWW和GLS组间差异无统计学意义(P>0.05)。与中晚期早产儿组比较,极早产儿组GCW、GWE、GWI明显减低,差异有统计学意义(P<0.05);极早产儿组GWW高于中晚期早产儿组,差异有统计学意义(P<0.05);而GLS组间差异无统计学意义(P>0.05)。与同龄足月儿比较,早产儿校正胎龄足月时,GCW、GWE、GWI和GLS略升高,GWW略减低,但差异均无统计学意义(P>0.05)。全部新生儿GCW、GWE、GWI与胎龄增长呈正相关(P<0.05),但GWW、GLS与胎龄无相关性(P>0.05);全部新生儿GCW、GWE、GWI与体重的增长呈正相关(P<0.05),但GWW与体重呈负相关(P<0.05)。结论早产儿的左室心肌做功发育落后,表现为压力-应变指标减低,但校正胎龄足月后可达到足月儿水平。超声心动图PSL变化反映了早产儿出生后的适应性变化,有助于重症早产儿心脏功能的监测。
Objective To quantitatively assess the adaptive changes in myocardial performance of preterm infants using pressure-strain loop(PSL)analysis with echocardiography.Methods A total of 109 preterm infants and 86 full-term infants were included in the study.The preterm infants were divided into two groups based on gestational age:extremely preterm infants(37 cases)and moderately to late preterm infants(72 cases).Additionally,29 preterm infants were compared to age-matched full-term infants at corrected gestational age.The echocardiographic PSL indices,including global constructive work(GCW),global wasted work(GWW),global work efficiency(GWE),global work index(GWI),and global longitudinal strain(GLS),were retrospectively analyzed among the groups.Spearman correlation analysis was performed to assess their relationship with gestational age and body weight.Results Compared to the full-term infant group,the preterm infant group showed significantly reduced GCW,GWE,and GWI(P<0.05),but no significant differences were observed in GWW and GLS(P>0.05).When comparing the extremely preterm infant group with the moderately to late preterm infant group,GCW,GWE,and GWI were significantly reduced in the extremely preterm group(P<0.05),and GWW was higher in the extremely preterm group compared to the moderately to late preterm group(P<0.05).However,no significant differences were found in GLS between these two preterm groups(P>0.05).When comparing preterm infants at corrected gestational age with age-matched full-term infants,GCW,GWE,GWI,and GLS showed slight increases,while GWW showed a slight decrease,but these differences were not statistically significant(P>0.05).GCW,GWE,and GWI of all newborns were positively correlated with gestational age(P<0.05),but no correlation was observed between GWW,GLS,and gestational age(P>0.05).Additionally,GCW,GWE,and GWI were positively correlated with body weight(P<0.05),while GWW showed a negative correlation with body weight(P<0.05).Conclusion Myocardial work development in preterm infants lags behind that of full-term infants,as evidenced by reduced pressure-strain loop indices.However,after correcting for gestational age,myocardial work reaches a level comparable to that of full-term infants.Changes in echocardiographic PSL reflect the adaptive alterations in preterm infants after birth,which can be beneficial for monitoring cardiac function in critically ill preterm infants.
作者
黄龙龙
林妍冰
唐子鉴
陶宏伟
冯晋兴
夏焙
HUANG Long-long;LIN Yan-bing;TANG Zi-jian;TAO Hong-wei;FENG Jin-xing;XIA Bei(Shenzhen Pediatric Clinical College,Shantou University Medical College,Shenzhen 518000,Guangdong,China;不详)
出处
《广东医学》
CAS
2023年第8期975-980,共6页
Guangdong Medical Journal
基金
国家自然科学基金面上项目(62071309)
广东省高水平医院建设医学学科经费资助(深儿医科教[2023]7号)
深圳市科技计划项目(SGDX20201103095802007)。
关键词
超声心动图
压力-应变环
新生儿
早产儿
echocardiography
pressure-strain loops
neonates
preterm infants
