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目的通过测定左心室射血分数(EF),探讨拉萨地区窒息缺氧对藏族新生儿心脏功能的影响。方法应用彩色超声心动图对39例窒息藏族新生儿(窒息组)出生2~3 d(治疗前)进行左心室EF测定,经治疗7~10 d(治疗后)复查,并以37例年龄、体质量相近的健康藏族新生儿作为健康对照组。对2组藏族新生儿进行经皮氧饱和度(TcSPO2)动态监测。结果窒息组治疗前TcSPO2为(74.410±4.566)%,健康对照组为(88.660±3.086)%,2组比较差异有统计学意义(P=0.026)。经治疗后,窒息组TcSPO2与健康对照组比较无统计学差异(P=1.230)。窒息组EF治疗前为(60.460±7.582)%,健康对照组为(71.360±6.077)%,短轴缩短率治疗前为(34.000±4.822)%,健康对照组为(41.820±4.766)%,两组比较差异均有统计学意义(P=0.010,0.012);经治疗后,2组EF和短轴缩短率比较,差异均无统计学意义(P=0.130,0.210)。结论窒息缺氧可引起藏族新生儿心肌损伤,心脏功能下降,左心室EF、TcSPO2明显降低,经治疗可以逆转。提示左心室EF、TcSPO2可作为反映窒息新生儿心脏受损和低氧血症的指标。
Objective To investigate the influence of asphyxia and hypoxia in Lhasa on the cardiac function of Tibetan newborn by measuring left ventricular ejection fraction (EF). Methods Thirty-nine neonates with asphyxia (asphyxia group) were enrolled in this study. Left ventricular EF was measured at 2 to 3 days (before treatment) and was observed after 7 to 10 days (after treatment) Healthy Tibetan neonate with similar body mass as healthy control group. Peripheral oxygen saturation (TcSPO2) was dynamically monitored in 2 Tibetan neonate. Results Before treatment, TcSPO2 was (74.410 ± 4.566)% in the asphyxia group and (88.660 ± 3.086)% in the healthy control group. There was significant difference between the two groups (P = 0.026). After treatment, asphyxia group TcSPO2 compared with the healthy control group was no significant difference (P = 1.230). In the asphyxia group, EF was (60.460 ± 7.582)% before treatment, (71.360 ± 6.077)% in the healthy control group, (34.000 ± 4.822)% before the short axis shortening, and (41.820 ± 4.766)% in the healthy control group (P = 0.010, 0.012). After treatment, there was no significant difference between two groups in EF and short axis shortening rate (P = 0.130,0.210). Conclusions Asphyxia and hypoxia can cause myocardial damage and cardiac function in neonates of Tibetan people. The EF and TcSPO2 of left ventricle decrease obviously and can be reversed after treatment. Tip left ventricular EF, TcSPO2 can be used as a reflection of neonatal asphyxia heart damage and hypoxemia indicators.