论文部分内容阅读
目的:探讨左心室Tei指数评估动脉导管未闭（PDA）介入治疗术后血流动力学变化的价值。方法:选取2017年5月至2019年5月安徽省儿童医院行介入治疗的PDA患儿50例（PDA组）和健康体检儿童27例（健康对照组）。比较两组左心室Tei指数、血浆B型利钠肽（BNP）、左心室舒张末内径（LVDD）、左心室射血分数（LVEF）等。结果:两组左心室Tei指数均与心率和年龄无相关（n P>0.05）。PDA组术前左心室Tei指数明显低于健康对照组[0.20（0.16，0.25）比0.27（0.20，0.30）]，差异有统计学意义（n P<0.05）。PDA组术后即刻、3 d、1个月和3个月左心室Tei指数明显高于术前[0.38（0.29，0.47）、0.32（0.26，0.40）、0.30（0.27，0.35）和0.32（0.26，0.37）比0.20（0.16，0.25）]，差异有统计学意义（n P<0.05）；术后即刻血浆BNP明显低于术前[288（126，433）ng/L比582（303，1 675） ng/L]，差异有统计学意义（n P<0.05）；术后3个月LVDD明显低于术前[（3.03 ± 0.54） cm比（3.38 ± 0.51） cm]，差异有统计学意义（n P<0.05）；术后即刻LVEF明显低于术前[（54.24 ± 6.09）%比（59.45 ± 5.93）%]，术后1、3个月明显高于术后即刻[（63.18 ± 4.71）%和（65.46 ± 4.78）%比（54.24 ± 6.09）%]，差异有统计学意义（n P0.05). The left ventricle Tei index before operation in PDA group was significantly lower than that in healthy control group: 0.20(0.16, 0.25) vs. 0.27(0.20, 0.30), and there was statistical difference (n P<0.05). In PDA group, the left ventricle Tei index immediately, 3 d, 1 month and 3 months after operation was significantly higher than before operation: 0.38(0.29, 0.47), 0.32(0.26, 0.40), 0.30(0.27, 0.35) and 0.32(0.26, 0.37) vs. 0.20(0.16, 0.25), and there was statistical difference (n P<0.05); the plasma BNP immediately after operation was significantly lower than before operation: 288 (126, 433) ng/L vs. 582 (303, 1 675) ng/L, and there was statistical difference (n P<0.05); the LVDD 3 months after operation was significantly lower than before operation: (3.03 ± 0.54) cm vs. (3.38 ± 0.51) cm, and there was statistical difference (n P<0.05); the LVEF immediately after operation was significantly lower than before operation: (54.24 ± 6.09)% vs. (59.45 ± 5.93)%, the LVEF 1 and 3 months after operation was significantly higher than that immediately after operation: (63.18 ± 4.71)% and (65.46 ± 4.78)% vs. (54.24 ± 6.09)%, and there were statistical differences (n P<0.05). The left ventricle Tei index before operation was negatively correlated with inner diameter of PDA and plasma BNP (n r = -0.362 and -0.388, n P = 0.013 and 0.009), and there was no correlation between LVDD and LVEF (n r = -0.192 and -0.283, n P = 0.229 and 0.053); the differences of Tei index before operation and immediately after operation (ΔTei) was positively correlated with inner diameter of PDA (n r = 0.325, n P = 0.030), and there was no correlation with BNP, LVDD and LVEF (n r = 0.234, 0.283 and -0.039, n P = 0.126, 0.076 and 0.798).n Conclusions:The left ventricle Tei index can quickly and accurately assess the change of hemodynamics after interventional therapy of PDA.