超声心动图评价新生儿持续性肺动脉高压的临床研究

目的 观察新生儿持续性肺动脉高压（PPHN）心脏构型及左心功能指标参数,探讨持续性肺动脉高压对新生儿心脏构型及左心功能的影响.方法 选择持续性肺动脉高压患儿 25例,其中轻度组（11例）、中度组（9例）、重度组（5例）,将新生儿黄疸患儿23例设为对照组,超声心动图测量左房内径（LAD）、左室舒张末内径（LVDd）、右室舒张末内径（RVDd）、右房内径（RAD）等指标,对其超声心动图结果进行对比分析.结果 与对照组相比,肺动脉高压组均有左室舒张功能减退（均P ＜0.05）,肺动脉高压组RVDd轻度（8.45±1.21） mm、中度（9.56±0.88） mm、重度（11.40±1.94） mm]、RAD轻度（11.27±1.34） mm、中度（13.00±1.87）mm、重度（15.80±1.78）mm]增大,并随肺动脉高压程度加重增大,差异均有统计学意义（t =2.53、7.09、2.14、4.77、2.88、2.04、4.59、7.12、2.34、5.12、3.07,均P＜0.05）,重度纽LVDd（14.80±2.16）mm,较对照组的（15.26±1.83）mm及轻度组（16.55±1.50）mm、中度组（15.67±1.87）mm减小,差异均有统计学意义（t=3.76、4.80、3.74,均P＜0.05）.结论 超声心动图是PPHN重要的无创诊断方法,它不仅可准确测量肺动脉压,还能提供心脏构型及功能指标,对临床判断病情轻重、指导治疗有重要价值.

Clinical research of echocardiography in the assessmet of persistent pulmonary hypertension of the newborns

Objective To observe the parameters of echocardiography in persistent pulmonary hypertension of the newborn（PPHN）,and to discuss the influence of persistent pulmonary hypertension on cardiac geometry and left ventricular function. Methods 25 cases with PPHN were selected, including 11 mild,9 moderate,and 5 severe cases. Another 23 cases of neonatal jaundice were selected as control group. The left atrium diameter（LAD） ,left ven- tricular end diastolic diameter （LVDd）, right ventricular end diastolic diameter （RVDd）, right atrium diameter （RAD）, left ventricular posterior wall thickness （LVPW）, interventrieular septum thickness （IVS） were measured by eehocardiography. The results of echocardiography were analyzed. Results Compared with the control group, the RVDd and RAD of PPHN group were significantly increased, RVDd and RAD dilated with the increasing of pulmonary artery systolic pressure in PPHN group（ t = 2.53,7.09,2.14,4.77,2.88,2.04,4.59,7.12,2.34,5.12,3.07, all P 〈0.05 ） ;LVDd decreased in severe group （14.80 _± 2.16）mm compared with that in the control group （15.26_± 1.83 ） mm, mild （ 16.55 ± 1.50） mm and moderate group （ 15.67 ± 1.87 ） mm （ t = 3.76,4.80,3.74, all P 〈 0.05 ）. Conclusion Eehocardiography is one of the most important method to diagnose PPHN,and can be observed in new- borns with non-invasive cardiac changes directly. It has important value in judgement of severity degree, and provide a reliable basis for clinical diagnosis and treatment.