Lu D F, Liu Y F, Tong X M, Zhang H, Shi S, Zhang Y H
Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China.
Department of Epidemiology Center, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Er Ke Za Zhi. 2020 Dec 2;58(12):989-994. doi: 10.3760/cma.j.cn112140-20200629-00672.
To establish reference ranges for M-mode echocardiography in preterm infants within 7 days after birth based on different gestational age (GA) and birth weight. This retrospective study analyzed M-mode echocardiographic values of 489 premature infants, who were admitted to the neonatal intensive care unit of Department of Pediatrics, Peking University Third Hospital from March 2017 to February 2020. These infants were divided into four groups according to GA:<28 weeks, 28-31weeks, 32-33weeks and 34-36weeks; and five groups according to birth weight:<1 000 g, 1 000-1 499 g, 1 500-1 999 g, 2 000-2 499 g and ≥2 500 g. The M-mode values among groups were compared by independent sample K-W test, and based on which, the 95% confidence interval () and the Z-value reference ranges were established. The gestational age of these infants was 32.0 (24.0-36.7) weeks, and the birth weight was 1 700 (650-3 180) g. The interventricular septum end-diastolic thickness (IVSd), left ventricular posterior wall end-diastolic thickness (LVPWd), left atrial diameter (LAD), left ventricular end-diastolic diameter (LVED), left ventricular end-systolic diameter (LVES), right ventricular outflow tract (RVOT) and the right ventricular end-diastolic diameter (RVED), were all correlated with GA and birth weight ( = 0.209, 0.216, 0.430, 0.608, 0.495, 0.464, 0.447; = 0.275, 0.288, 0.445, 0.609, 0.496, 0.499, 0.464;all <0.01). While the left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) had no correlation with GA or birth weight (all <0.05). Within the first 7 days after birth, the greater the GA and birth weight, the greater the inner diameters of the heart chambers, and the thicker the ventricular wall. The LVEF and LVFS maintained a high and stable level within the first week of life (95%: 67%-69%, 34%-36%). According to different GA and birth weight, the reference ranges for chamber diameters, interventricular septal thickness and left ventricular wall thickness within 7 days were established. The 95% and Z score ranges for M-mode echocardiographic measurements established based on gestational age and birth weight can provide a reliable reference for preterm infants aged 0-7 days.
基于不同胎龄(GA)和出生体重,建立出生后7天内早产儿M型超声心动图的参考范围。这项回顾性研究分析了2017年3月至2020年2月在北京大学第三医院儿科新生儿重症监护病房收治的489例早产儿的M型超声心动图值。这些婴儿根据GA分为四组:<28周、28 - 31周、32 - 33周和34 - 36周;根据出生体重分为五组:<1000g、1000 - 1499g、1500 - 1999g、2000 - 2499g和≥2500g。采用独立样本K - W检验比较组间M型值,并在此基础上建立95%置信区间()和Z值参考范围。这些婴儿的胎龄为32.0(24.0 - 36.7)周,出生体重为1700(650 - 3180)g。室间隔舒张末期厚度(IVSd)、左心室后壁舒张末期厚度(LVPWd)、左心房内径(LAD)、左心室舒张末期内径(LVED)、左心室收缩末期内径(LVES)、右心室流出道(RVOT)和右心室舒张末期内径(RVED)均与GA和出生体重相关(分别为r = 0.209、0.216、0.430、0.608、0.495、0.464、0.447;r = 0.275、0.288、0.445、0.609、0.496、0.499、0.464;均P<0.01)。而左心室射血分数(LVEF)和左心室缩短分数(LVFS)与GA或出生体重无相关性(均P<0.05)。出生后前7天内,GA和出生体重越大,心腔内径越大,心室壁越厚。LVEF和LVFS在出生后第一周内保持较高且稳定的水平(95%:67% - 69%,34% - 36%)。根据不同的GA和出生体重,建立了出生后7天内心腔直径、室间隔厚度和左心室壁厚度的参考范围。基于胎龄和出生体重建立的M型超声心动图测量的95%置信区间和Z评分范围可为0 - 7天的早产儿提供可靠的参考。