应用Tei指数评价胎儿心室功能的研究

目的探讨正常胎儿左、右心室的Tei指数在评价胎儿心脏收缩和舒张功能中的作用及其影响因素。方法应用多普勒超声心动图检查妊娠18~42周的正常单胎胎儿225例,按孕周不同分为18~27周+6组、28~36周+6组和37~42周组,测定3组胎儿左、右心室的Tei指数的差异,并比较左、右心室Tei指数,探讨其与孕周和胎心率的关系。结果(1)妊娠18~27周+6、28~36周+6和37~42周3组胎儿的左心室平均Tei指数分别为0·37±0·08、0·27±0·05、0·22±0·05;右心室平均Tei指数分别为0·39±0·04、0·30±0·05、0·24±0·04。妊娠28~36周+6组右心室平均Tei指数高于左心室,两者比较,差异有统计学意义(P<0·05)。其余两组左、右心室平均Tei指数比较,差异无统计学意义(P>0·05)。(2)正常胎儿左、右心室的Tei指数均显示随着孕周的增加呈逐渐下降的趋势,与孕周呈负相关(左心室r=-0·755,P<0·01;右心室r=-0·721,P<0·01)。(3)正常胎儿Tei指数与胎心率无相关性(左心室r=0·133,P>0·05;右心室r=0·100,P>0·05)。结论Tei指数是一种方便、有效的综合评价胎儿心脏收缩和舒张功能的指标。

Assessment of myocardial performance in fetuses by using Tei index

OBJECTIVE: To define the value of Tei index of normal fetuses and to estimate the influence of gestational week and heart rate on the index. METHODS: Fetal echocardiograms were performed on 225 normal single fetuses, which were divided into three groups (18 approximately 27(+6), 28 approximately 36(+6), 37 approximately 42 gestational weeks). The Tei indexes of both left and right ventricles (LV and RV) were measured by color Doppler ultrasonography. t test was used to compare the Tei index between LV and RV. The correlation between Tei index, gestational week and fetal heart rate were analyzed. RESULTS: The Tei indexes in three different gestational week groups (18 approximately 27(+6), 28 approximately 36(+6), 37 approximately 42 gestational weeks) were 0.37 +/- 0.08, 0.27 +/- 0.05, 0.22 +/- 0.05 of LV and 0.39 +/- 0.04, 0.30 +/- 0.05, 0.24 +/- 0.04 of RV respectively. There was significant difference of Tei index of RV and LV during 28 approximately 36(+6) gestational weeks (P < 0.05). The Tei index of LV and RV decreased linearly with advancing gestational week during 18 - 42 weeks (LV: r = -0.755, PP < 0.05; RV: r = -0.721, P < 0.05) in normal single fetuses. None of the fetal Tei indexes of LV and RV was related to fetal heart rate (LV: r = 0.133, P > 0.05; RV: r = 0.100, P > 0.05). CONCLUSION: Tei index may be useful, convenient and reliable in fetal cardiac function assessment.