超声心动图在支气管肺发育不良患儿诊断及预后评估中的临床应用
Clinical Utility of Echocardiography for the Diagnosis and Prognosis in Children with Bronchopulmonary Dsyplasia.
作者信息
Choi Young Earl, Cho Hwa Jin, Song Eun Song, Jeong In Seok, Yoon Namsik, Choi Young Youn, Ma Jae Sook, Cho Young Kuk
机构信息
Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
出版信息
J Cardiovasc Ultrasound. 2016 Dec;24(4):278-284. doi: 10.4250/jcu.2016.24.4.278. Epub 2016 Dec 28.
BACKGROUND
Bronchopulmonary dysplasia (BPD) may result in chronic pulmonary artery hypertension and right ventricular (RV) dysfunction. Various echocardiographic assessments of RV dysfunction have been used to determine whether echocardiographic measurements of premature infants with BPD could provide sensitive measures of RV function that correlates with BPD severity.
METHODS
Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and tissue Doppler imaging (TDI) measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and TDI measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale.
RESULTS
None of the standard echocardiographic findings was significantly different between the control group and BPD groups. However, mean septal TDI-MPI of the severe BPD group (0.68 ± 0.06) was significantly ( < 0.01) higher than that of the non-BPD (0.58 ± 0.10) or the mild BPD group (0.59 ± 0.12). In addition, mean RV TDI-MPI of the severe BPD group (0.71 ± 0.13) was significantly ( < 0.05) higher than that of the non-BPD group (0.56 ± 0.08) or the mild BPD group (0.60 ± 0.125). Linear regression showed a good correlation between the severity of BPD and RV TDI-MPI ( = 0.01, R = 0.30) or septal TDI-MPI ( = 0.04, R = 0.24).
CONCLUSION
Echocardiographic evaluation of RV function based on an assessment of RV TDI-MPI can provide RV dysfunction parameter in premature infants with BPD.
背景
支气管肺发育不良（BPD）可能导致慢性肺动脉高压和右心室（RV）功能障碍。已采用各种超声心动图评估右心室功能障碍，以确定BPD早产儿的超声心动图测量是否能提供与BPD严重程度相关的右心室功能敏感指标。
方法
28名无BPD的对照受试者（非BPD组）、28名轻度BPD患者、11名中度BPD患者和6名重度BPD患者接受了超声心动图检查，采用标准测量方法，如M型射血分数、三尖瓣反流压力梯度、脉冲多普勒衍生的心肌性能指数（MPI）和组织多普勒成像（TDI）测量。BPD严重程度根据美国国立儿童健康与人类发展研究所/美国国立心肺血液研究所/罕见病办公室研讨会评分量表进行分类。28名无BPD的对照受试者（非BPD组）、28名轻度BPD患者、11名中度BPD患者和6名重度BPD患者接受了超声心动图检查，采用标准测量方法，如M型射血分数、三尖瓣反流压力梯度、脉冲多普勒衍生 的心肌性能指数（MPI）和TDI测量。BPD严重程度根据美国国立儿童健康与人类发展研究所/美国国立心肺血液研究所/罕见病办公室研讨会评分量表进行分类。
结果
对照组和BPD组之间的标准超声心动图检查结果均无显著差异。然而，重度BPD组的平均室间隔TDI-MPI（0.68±0.06）显著高于非BPD组（0.58±0.10）或轻度BPD组（0.59±0.12）（P<0.01）。此外，重度BPD组的平均右心室TDI-MPI（...）显著高于非BPD组（0.56±0.08）或轻度BPD组（0.60±0.125）（P<0.05）。线性回归显示BPD严重程度与右心室TDI-MPI（P = 0.01，R = 0.30）或室间隔TDI-MPI（P = 0.04，R = 0.24）之间存在良好相关性。
结论
基于右心室TDI-MPI评估的超声心动图评估右心室功能可为BPD早产儿提供右心室功能障碍参数。 （注：原文中“mean RV TDI-MPI of the severe BPD group (0.71 ± 0.13)”括号内数据缺失右括号后的内容，已按格式翻译）
Zotero 插件