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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-pro BNP)。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-pro BNP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-pro BNP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-pro BNP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。
Objective To investigate the clinical value of cardiac monitoring (CI) monitoring in neonates with congenital heart disease complicated with heart failure. Methods Sixty children with congenital heart disease admitted to neonatology department from March 1, 2016 to December 30, 2016 were divided into severe group (n = 11), moderate group (n = 15), mild group (n = 34) and no heart failure group (n = 10). The CI, echocardiographic measurement of left ventricular ejection fraction (LVEF) Pulmonary artery pressure (PAP) and venous blood were collected to detect NT-proBNP. The results of severe group mainly for children under 2 weeks of age, mild to moderate group more than 2 weeks of age-based children. The differences of CI, LVEF, NT-pro BNP and PAP in each group were statistically significant, with the lowest values of CI and LVEF in severe group, followed by moderate, mild and no heart failure group; NT-pro BNP And PAP value highest, followed by moderate, mild, no heart failure group the lowest. Correlation analysis showed that there was a significant positive correlation between CI and LVEF (r = 0.845, P <0.001), negative correlation between CI and NT-pro BNP (r = 0.886, P <0.001) r = 0.595, P <0.001). Conclusion CI to a certain extent, reflect the degree of heart failure, have some clinical value.