无创心指数检测在评价新生儿先天性心脏病合并心力衰竭的临床应用价值

摘要

Objective To explore the clinical value of the monitoring of electronic cardiac index (CI) in the evaluation of neonatal congenital heart disease complicated with heart failure. Methods Sixty neonates with congenital heart disease treated in neonatal department from March 1, 2016 to December 30, 2016 were selected, and divided into severe group (n=11), moderate group (n=15), mild group (n=34), and no heart failure group (n=10) according to the modified Ross heart failure score. CI was measured by electronic force measurement. Left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP) were measured by echocardiography. Venous blood sampling was collected to detect the N-terminal type B brain natriuretic peptide (NT-proBNP). Results The neonates in the severe group were mainly under 2-week-old, while those in the mild group and the moderate group were more than 2-week-old. The differences of CI, LVEF, NT-proBNP, and PAP among the groups were statistically different. The CI and LVEF values were lowest in the severe group, followed by moderate group and mild group, and the highest in no heart failure group. The NT-proBNP and PAP values were the highest in the severe group, followed by moderate group and mild group, and the lowest in no heart failure group. Correlation analysis showed that CI was positively correlated with LVEF (r=0.845, P<0.001), and negatively correlated with NT-proBNP (r=-0.886, P<0.001); CI and PAP were weakly negatively correlated (r=-0.595, P<0.001). Conclusions CI reflects the degree of heart failure to some extent and has some clinical value.%目的 探讨电子心力测量法心指数(CI)监测在评价新生儿先天性心脏病合并心力衰竭中的临床应用价值.方法 选取2016年3月1日—2016年12月30日新生儿科收治的60例先天心脏病患儿,根据改良Ross心衰评分标准,分为重度组(n=11)、中度组(n=15)、轻度组(n=34)及无心衰组(n=10);应用电子心力测量法测量各组患儿的CI,心脏超声测量患儿左室射血分数(LVEF)、肺动脉压力(PAP),静脉采血检测氨基末端B型脑钠肽前体(NT-proBNP).结果 重度组主要为2周龄以下患儿,轻、中度组大于2周龄患儿为主.各组间CI、LVEF、NT-proBNP和PAP的差异均有统计学意义,其中重度组CI和LVEF值最低,其次为中度、轻度,无心衰组最高;重度组NT-proBNP和PAP值最高,其次为中度、轻度,无心衰组最低.相关分析显示,CI与LVEF呈显著正相关(r=0.845,P<0.001),CI与NT-proBNP呈显著负相关(r=0.886, P<0.001);CI与PAP呈弱的负相关(r=0.595,P<0.001).结论 CI在一定程度上反应心衰程度,有一定的临床价值.