Tei指数评价三尖瓣反流胎儿左心室功能

目的 采用Tei指数评估三尖瓣反流（TR）胎儿左心室功能，观察其预测不良妊娠结局的价值。方法 纳入78胎TR胎儿，根据反流程度分为轻度组（n=54）及中度组（n=24）；同期纳入60胎正常胎儿作为对照组。比较组间左心室等容收缩时间（ICT）、等容舒张时间（IRT）及射血时间（ET），计算Tei指数。绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC），评价Tei指数预测不良妊娠结局的效能。结果 轻度组各参数与对照组差异均无统计学意义（P均>0.05）；中度组左心室Tei指数、ICT+IRT明显高于对照组（P均<0.05）。轻、中度组胎儿出生孕周均小于对照组（P均<0.05），不良妊娠结局发生率均高于对照组（P均<0.05）。左心室Tei指数预测轻度组及中度组不良结局的AUC分别为0.52及0.65，敏感度分别为36.80%及58.30%，特异度分别为75.00%及83.30%。结论 Tei指数可用于评价单纯性TR胎儿左心室功能，进而预测TR胎儿不良结局，为临床干预提供重要依据。

Tei index for assessing left ventricular function of fetuses with tricuspid regurgitation

Objective To assess left ventricular function of fetuses with tricuspid regurgitation (TR) with Tei index, and to evaluate its value in predicting adverse pregnancy outcomes. Methods Seventy-eight TR fetuses were enrolled and divided into mild group (n=54) and moderate group (n=24) according to the degree of reflux, while 60 normal fetuses were taken as controls (control group). The isovolumic contraction time (ICT), isovolumic relaxation time (IRT) and ejection time (ET) of left ventricle were compared among groups, and Tei index was measured. Receiver operating characteristic (ROC) curves were plotted, and the areas under the curves (AUC) were calculated to evaluate the efficacy of Tei index for predicting adverse pregnancy outcomes. Results No significant difference of the above parameters was found between mild group and control group (all P>0.05). Tei index and ICT+IRT in moderate group were higher than those in control group (all P<0.05). The gestational weeks at birth of mild and moderate group were both smaller than that of control group (all P<0.05), and the incidences of adverse pregnancy outcomes of mild and moderate group were higher than those in control group (all P<0.05). The AUC of left ventricular Tei index for predicting adverse outcomes in mild group and moderate group was 0.52 and 0.65, the sensitivity was 36.80% and 58.30%, and the specificity was 75.00% and 83.30%, respectively. Conclusion Tei index could be used to evaluate left ventricular function of simple TR fetuses and predict adverse outcomes of TR fetuses, providing important basis for clinical intervention.