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目的:评价单纯动脉导管未闭及室间隔缺损患儿手术前后左心不同源Tei指数(频谱多普勒Tei指数及组织运动多普勒Tei指数)的变化及其影响因素。方法:对象分别为27例动脉导管未闭(PDA)患儿及32例单纯室间隔缺损(VSD)患儿,手术治疗前后分别利用不同方法测量患儿Tei指数(即PW-Tei及TDI-Tei)、左室射血分数(EF)、主动脉峰值流速(Vp)、左室收缩末期内径(LVESD)及左室舒张末期内径(LVEDD)等数值。结果:Tei指数与EF值、Vp等变化呈负相关,PDA及VSD患儿术后PW-Tei及TDI-Tei指数均较术前有明显提高,其中TDI-Tei值与缺损内径值相关性高于PW-Tei。结论:与使用频谱多普勒(PW)法一样,应用TDI法测取Tei指数时,一样受到前负荷改变的影响,且与缺损内径相关性更高,因此无论使用何种测取方法,在使用Tei指数评估心功能变化时都需考虑到前负荷的变化。
OBJECTIVE: To evaluate the changes of Tei index (Tei index of spectral Doppler and T-Doppler) and its influencing factors before and after surgery in patients with simple patent ductus arteriosus and ventricular septal defect. Methods: Twenty-seven children with patent ductus arteriosus (PDA) and 32 children with simple ventricular septal defect (VSD) were enrolled in this study. Tei index (PW-Tei and TDI-Tei ), Left ventricular ejection fraction (EF), aortic peak velocity (Vp), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) were calculated. Results: The Tei index was negatively correlated with changes of EF and Vp. The PW-Tei and TDI-Tei index of PDA and VSD children were significantly higher than those before operation, and the correlation between TDI-Tei value and defect diameter was high At PW-Tei. CONCLUSIONS: As with the spectral Doppler (PW) method, the TDI method of Tei index is similarly affected by the change of preload and has a higher correlation with the defect inner diameter. Therefore, no matter what kind of measurement method is used, The use of Tei index assessment of cardiac function changes must be taken into account before the load changes.