早产儿和窒息儿肺动脉高压时肺静脉血流频谱的分析

目的利用超声心动图技术对早产儿和窒息儿肺动脉高压时肺静脉血流频谱进行检测分析。方法对出生后48 h内存在肺动脉高压的早产儿和窒息儿133例(其中轻度42例,中度75例,中度16例)及正常对照组52例,利用超声多普勒技术检测对比分析肺静脉血流频谱参数变化。结果轻度肺动脉高压组肺静脉血流频谱各参数与正常组比较,差异无统计学意义(P0.05),中度和重度肺动脉高压组肺静脉频谱中心室收缩期峰值速度(Sp)值明显低于正常对照组,心室收缩期峰值速度(Dp)、心房收缩期速度和持续时间(Ar、AT)值明显高于正常对照组,差异有统计学意义(P0.05);轻、中度肺动脉高压组的二尖瓣E/A值低于正常对照组,但差异无统计学意义(P0.05),重度肺动脉高压组E/A值明显低于正常对照组,差异有统计学意义(P0.05);轻、中度肺动脉高压组的EF值低于正常对照组,但差异无统计学意义(P0.05),重度肺动脉高压组EF值明显低于正常对照组,差异有统计学意义(P0.05)。结论早产儿和窒息儿肺动脉高压时肺静脉频谱变化与肺动脉高压程度相关,肺静脉血流频谱可以为临床进一步了解肺动脉高压时左心功能早期受损情况提供参考指标。

Study on analysis of pulmonary venous flow pattern in non-asphyxia preterm infants and asphyxia infants with pulmonary hyperten-sion

Objective To detect and analyze the pulmonary venous flow pattern of prematures and asphyxia infants with pulmonary hypertension by echocardiography. Methods A total of 133 cases of prematures and asphyxia infants with pulmonary hypertension within 48 hours after birth（ including 42 mild cases,75 middle cases and 16 serious cases）and 52 healthy individuals were allocated in this study,ultrasonic Doppler technique had been used for contrast analysis of parameters of pulmonary venous flow pattern. Results There was no statistically significant difference between mild pulmonary hypertension group and normal control group in each parameter of pulmonary venous flow pattern（ P ﹥0. 05）;but there was statistically significant difference between middle and serious pulmonary hypertension groups with normal control group,pulmonary vein spectrum Sp values were significantly lower than those of normal control group,and Dp,Ar and AT values were significantly higher than those of normal control group（ P ﹤0. 05）. There was no statistically significant difference in mitral E/A ratio of mild and middle pulmonary hypertension groups,they were lower than those of normal control group（ P ﹥0. 05）;but there was statistically significant difference between serious pulmonary hypertension group with normal control group in E/A ratio（ P ﹤0. 05）. There was no statistically significant difference between mild and middle pulmonary hypertension groups with normal control group in mitral EF ratio（ P ﹥0. 05）;but there was statistically significant difference between serious pulmonary hypertension group with normal control group in EF ratio（ P ﹤0. 05）. Conclusion The changes in pulmonary venous flow pattern in prematures and asphyxia infants with pulmonary hypertension are correlated with the degree of severity of pulmonary hypertension,and it can provide reference for further understanding of early damage of left heart function during pulmonary hypertension.