【摘要】 目的:探讨组织多普勒Tei指数对先天性心脏病(CHD)患儿右心功能的评定价值。方法:对46例患儿(按肺动脉压力是否升高分为肺动脉高压组及无肺动脉高压组)及33例正常儿分别应用组织多普勒法与血流多普勒法测定右室Tei指数(TDI-Tei指数、PWD-Tei指数)进行对比研究。结果:①与对照组比较,无肺动脉高压组右室PWD-Tei指数及TDI-Tei指数值均升高(0.32±0.05 vs 0.30±0.04;0.34±0.06 vs 0.31±0.04),前者差异无统计学意义(P>0.05),后者差异有统计学意义(P<0.05)。肺动脉高压组右室PWD-Tei指数及TDI-Tei指数均明显高于无肺动脉高压组(0.51±0.11 vs 0.32±0.05,P<0.001;0.55±0.12 vs 0.34±0.06,P<0.001)。②各组内右室PWD-Tei指数、TDI-Tei指数间均具有良好的相关性。③患病组右室TDI-Tei指数较PWD-Tei指数与PASP间的相关性更佳(r=0.86,P<0.001 vsr=0.79,P<0.001)。TDI-Tei指数评判CHD患儿肺动脉高压的敏感度及特异度均高于PWD-Tei指数(敏感度:78%vs 71%;特异度:90%vs 87%)。结论:组织多普勒Tei指数可较敏感的反映CHD患儿的右心功能变化,是评价右室整体功能的较好指标,且可提示CHD患儿合并肺动脉高压的存在与否。更多还原

【Abstract】 Objective:To explore the value of right ventricular function evaluation in tissue Doppler-derived Tei index(TDI-Tei) in children with congenital heart disease(CHD).Methods:The right ventricular Tei indexes(TDI-Tei index and PWD-Tei index) of 46 CHD children(divided into pulmonary hypertension group and non-pulmonary hypertension group according to their pulmonary arterial systolic pressure) and 33 healthy children were measured by tissue Doppler method and Doppler flow imaging method and compared.Results:①The right ventricular PWD-Tei index in non-pulmonary hypertension group was higher than that in control group(0.32±0.05 vs 0.30±0.04),without significant difference(P>0.05);the right ventricular DTI-Tei index in non-pulmonary hypertension group was higher than that in control group(0.34±0.06 vs 0.31±0.04)(P<0.05).The right ventricular PWD-Tei index and DTI-Tei index in pulmonary hypertension group were higher than those in non-pulmonary hypertension group(0.51±0.11 vs 0.32±0.05,P<0.001;0.55±0.12 vs 0.34±0.06,P<0.001).②There was correlation between right ventricular PWD-Tei index and DTI-Tei index in each group.③Compared with right ventricular PWD-Tei index(γ=0.79,P<0.001),a better correlation was observed between right ventricular TDI-Tei index and pulmonary arterial systolic pressure(γ=0.86,P<0.001).For evaluating pulmonary hypertension of CHD children,the sensitivity and specificity of DTI-Tei index were higher than those of PWD-Tei index(sensitivity: 78% vs 71%;specificity:90% vs 87%).Conclusion:Tissue Doppler-derived Tei index can reflect the changes of right ventricular function of CHD children sensitively,which is a useful index for evaluating total function of right ventricle and indicative index of CHD children combined with pulmonary hypertension or not.更多还原