【摘要】 目的探讨Tei指数和三尖瓣血流频谱评价左向右分流型先天性心脏病(CHD)患儿右心功能的价值。方法根据心室负荷将47例左向右分流型CHD患儿分为左心型组(30例)和右心型组(17例),应用三尖瓣血流频谱及Tei指数评价右心室功能,并与50例正常儿童进行对比研究。结果与正常组比较,CHD患儿42例三尖瓣血流频谱呈双峰型,均为舒张早期最大流速(EV)/舒张晚期最大流速(AV)>1;左心型组AV、A波流速积分(AVI)升高,右心型组EV、AV、E波流速积分(EVI)、AVI、E波减速时间(EDT)增大;左心型组右室等容舒张时间(IRT)和等容收缩时间(ICT)+IRT延长;右心型组ICTI、RT和ICT+IRT延长,右室射血时间(RVET)降低;两组CHD患儿右室Tei指数均增大;Tei指数与ICTI、RTI、CT+IRT间呈显著性正相关(r=0.642,0.734,0.862 P均<0.01),与RVET间呈负相关(r=-0.481 P<0.01)。结论Tei指数能更简便、敏感、准确、综合评价右心室整体功能,与三尖瓣血流频谱结合可更全面了解CHD患儿右心功能。更多还原

【Abstract】 Objective To study the value of Tei index assessment of right ventricular function in children with left to right congenital heart disease(CHD),comparing with tricuspid flow spectrum.Methods Forty-seven children with left to right CHD,who were divided into 2 groups according to their ventricular volume load,and 50 normal subjects were studied respectively using the pulsed wave Doppler spectrum of tricuspid flow.Right ventricular Tei index was also calculated.Results Compared with the normal children,E wave velocity(EV)/A wave velocity(AV)>1 were presented in 42 children with CHD,whose tricuspid flow spectrum had two peaks.AV,AV integral(AVI) were increased significantly in the left ventricular overload CHD group;EV,AV,EV integral(EVI),AVI,E wave deceleration time(EDT) were increased in the right ventricular overload CHD group;isovolumetic relaxation time(IRT) and isovolumetric contraction time(ICT) plus IRT in the left ventricular overload CHD group were significantly prolonged;ICT,IRT and ICT plus IRT were significantly prolonged and right ventricular ejection time(RVET) was significantly shortened in the right ventricular overload CHD group.Tei index in all children with CHD was significantly increased.Tei index showed significant positive correlation with ICT,IRT,IRT plus ICT(r=0.642,0.734,0.862 all P<0.01) and negative correlation with RVET(r=-0.481 P<0.01).Conclusions Tei index can estimate right ventricular systolic and diastolic functions easily and correctly with high sensitivity in children with CHD.Evaluation on right ventricular function using tricuspid flow spectrum and Tei index in children with left to right CHD will be more comprehensive.更多还原