临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (10): 747-.doi: 10.3969/j.issn.1000-3606.2017.10.008

• 综合报道 • 上一篇    下一篇

无创心指数检测在评价新生儿先天性心脏病 合并心力衰竭的临床应用价值#br#

袁勇华 1, 张爱民 2, 何学华 1, 徐俊 2, 黄芙蓉 2, 刘丽萍 1, 刘震宇 1,  夏晓辉 3, 吕梅 1, 朱潜力 1, 李艾桐 4   

  1. 1.湖南省人民医院儿童医学中心儿童心血管科(湖南长沙 410005);2.湖南省人民医院儿童医学中心 新生儿科(湖南长沙 410005);3.湖南省人民医院超声科(湖南长沙 410005); 4.湖南师范大学医学院2013级卓越医师班(湖南长沙 410005)
  • 收稿日期:2017-10-15 出版日期:2017-10-15 发布日期:2017-10-15
  • 通讯作者: 张爱民, 何学华  E-mail:274 7668854qq@.com,he_xh101@163.com
  • 基金资助:
    湖南省自然科学基金(No.13JJ5019)
     

Clinical value of noninvasive cardiac index test in the evaluation of neonatal congenital heart disease complicated with heart failure

YUAN Yonghua1, ZHANG Aimin2, HE Xuehua1, XU Jun2, HUANG Furong2, LIU Liping1, Liu Zhenyu1, XIA Xiaohui3, Lv Mei1, ZHU Qianli1, LI Aitong4   

  1. 1. Department of Pediatric Cardiology, Hunan People's Hospital, Changsha 410005, Hunan, China; 2. Department of Neonatal, Hunan People's Hospital, Changsha 410005, Hunan, China; 3. Department of Ultrasound, Hunan People's Hospital, Changsha 410005, Hunan, China; 4. Hunan Normal University Medical School 2013 Excellent Doctor Class, Changsha 410005, Hunan, China
  • Received:2017-10-15 Online:2017-10-15 Published:2017-10-15

摘要: 目的 探讨电子心力测量法心指数(CI)监测在评价新生儿先天性心脏病合并心力衰竭中的临床应用价值。 方法 选取2016年3月1日—2016年12月30日新生儿科收治的60例先天心脏病患儿,根据改良Ross心衰评分标准,分 为重度组(n=11)、中度组(n=15)、轻度组(n=34)及无心衰组(n=10);应用电子心力测量法测量各组患儿的CI,心脏超声 测量患儿左室射血分数(LVEF)、肺动脉压力(PAP),静脉采血检测氨基末端B型脑钠肽前体(NT-proBNP)。 结果 重度 组主要为2周龄以下患儿,轻、中度组大于2周龄患儿为主。各组间CI、LVEF、NT-proBNP和PAP的差异均有统计学意义, 其中重度组CI和LVEF值最低,其次为中度、轻度,无心衰组最高;重度组NT-proBNP和PAP值最高,其次为中度、轻度, 无心衰组最低。相关分析显示,CI与LVEF呈显著正相关(r=0.845, P<0.001),CI与NT-proBNP呈显著负相关(r=0.886, P<0.001);CI与PAP呈弱的负相关(r=0.595, P<0.001) 。结论 CI在一定程度上反应心衰程度,有一定的临床价值。

Abstract: Objective To explore the clinical value of the monitoring of electronic cardiac index (CI) in the evaluation of neonatal congenital heart disease complicated with heart failure. Methods Sixty neonates with congenital heart disease treated in neonatal department from March 1, 2016 to December 30, 2016 were selected, and divided into severe group (n=11), moderate group (n=15), mild group (n=34), and no heart failure group (n=10) according to the modified Ross heart failure score. CI was measured by electronic force measurement. Left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP) were measured by echocardiography. Venous blood sampling was collected to detect the N-terminal type B brain natriuretic peptide (NT-proBNP). Results The neonates in the severe group were mainly under 2-week-old, while those in the mild group and the moderate group were more than 2-week-old. The differences of CI, LVEF, NT-proBNP, and PAP among the groups were statistically different. The CI and LVEF values were lowest in the severe group, followed by moderate group and mild group, and the highest in no heart failure group. The NT-proBNP and PAP values were the highest in the severe group, followed by moderate group and mild group, and the lowest in no heart failure group. Correlation analysis showed that CI was positively correlated with LVEF (r=0.845, P<0.001), and negatively correlated with NT-proBNP (r=-0.886, P<0.001); CI and PAP were weakly negatively correlated (r=-0.595, P<0.001). Conclusions CI reflects the degree of heart failure to some extent and has some clinical value.