2025 年第 4 期 第 20 卷

应用实时三维超声心动图联合组织运动二尖瓣环位移自动追踪技术评价高胆红素血症对新生儿左心功能的影响

The effect of hyperbilirubinemia on left heart function in newborns evaluation by real-time three-dimensional echocardiography combined with tissue motion mitral annular displacement automatic tracking technology

作者：陶莹1刘国辉1周杰2许建芳1齐银静1马海芹3

英文作者：Tao Ying1 Liu Guohui1 Zhou Jie2 Xu Jianfang1 Qi Yinjing1 Ma Haiqin3

单位：1内蒙古自治区妇幼保健院超声科，呼和浩特010050；2内蒙古自治区呼和浩特市妇幼保健院妇产科，呼和浩特010031；3内蒙古自治区妇幼保健院新生儿科，呼和浩特010050

英文单位：1Department of Ultrasound Inner Mongolia Maternal and Child Health Hospital Hohhot 010050 China; 2Department of Obstetrics and Gynecology Hohhot Maternal and Child Health Hospital Inner Mongolia Autonomous Region Hohhot 010031 China; 3Department of Neonatology Inner Mongolia Maternal and Child Health Hospital Hohhot 010050 China

关键词：高胆红素血症；实时三维超声；新生儿；左心功能

英文关键词：Hyperbilirubinemia;Real-timethree-dimensionalultrasound;Newborns;Leftheartfunction

• 摘要：

• 目的 应用实时三维超声心动图(RT-3DE)联合组织运动二尖瓣环位移自动追踪技术（TMAD）对相关指标进行评价，探讨高胆红素血症对新生儿左心功能的影响。方法 选取2022年6月至2023年6月在内蒙古自治区妇幼保健院新生儿科住院的高胆红素血症新生儿90例，按照总胆红素水平分为轻度黄疸组（总胆红素221～255 μmol/L）、中度黄疸组 （总胆红素256～341 μmol/L）和重度黄疸组（总胆红素≥342 μmol/L），各30例，选取同期健康足月新生儿30例作为对照组。分别经RT-3DE及TMAD等采集相关参数评价各组新生儿左心功能，并探讨各参数与新生儿左心室射血分数（LVEF）的相关性。结果 重度黄疸组二尖瓣口E峰峰值流速、E峰与A峰峰值流速比值、LVEF、左心室舒张末期容积、二尖瓣环室间隔瓣环位移（TMAD AP4 MV1）、左心室侧壁位瓣环位移(TMAD AP4 MV2)、收缩期二尖瓣环连线中点平均位移（TMAD Midpt）及二尖瓣环中点平均位移率（TMAD Midpt%）均低于其他各组，二尖瓣口A峰峰值流速、左心房射血分数高于其他各组（均P<0.05）。TMAD AP4 MV1、TMAD AP4 MV2、TMAD Midpt及TMAD Midpt%均与LVEF呈正相关(r=0.823、0.758、0.727、0.842，均P=0.001)，其中TMAD Midpt%相关性最好。结论 高胆红素血症达到一定程度会影响新生儿左心功能，RT-3DE联合TMAD技术可早期对新生儿左心功能进行评价，并且其测量指标与新生儿LVEF具有良好相关性。

• Objective Real-time three-dimensional echocardiography(RT-3DE) combined with tissue motion mitral annular displacement automatic tracking technology(TMAD) was used to evaluate relevant indicators and to explore the effect of hyperbilirubinemia on left heart function in newborns. Methods A total of ninety newborns with hyperbilirubinemia admitted to the Department of Neonatology, Inner Mongolia Maternal and Child Health Hospital from June 2022 to June 2023 were selected and divided into mild jaundice group(total bilirubin 221-255 μmol/L), moderate jaundice group(total bilirubin 256-341 μmol/L), and severe jaundice group(total bilirubin≥342 μmol/L) based on total bilirubin levels, with 30 cases in each group. Thirty healthy full-term newborns from the same period were selected as the control group. The left ventricular function of newborns in each group were evaluated by collecting relevant parameters such as RT-3DE and TMAD, and the correlation between each parameter and the left ventricular ejection fraction(LVEF) of the newborns were explored. Results The mitral valve E peak flow velocity, peak E to peak A velocity ratio, LVEF, left ventricular end diastolic volume, mitral annulus interventricular annular displacement(TMAD AP4 MV1), left ventricular sidewall annular displacement (TMAD AP4 MV2), mean midpoint displacement of the mitral annulus line during systole (TMAD Midpt), and mean midpoint displacement rate of the mitral annulus(TMAD Midpt%) in the severe jaundice group were all lower than those in the other groups, while the mitral valve A peak flow velocity and left atrial ejection fraction of the mitral orifice were higher than those in the other groups(all P<0.05). TMAD AP4 MV1, TMAD AP4 MV2, TMAD Midpt, and TMAD Midpt% were all positively correlated with LVEF(r=0.823, 0.758, 0.727, 0.842, all P=0.001), among which TMAD Midpt% showed the best correlation. Conclusion Hyperbilirubinemia to a certain extent can affect the left heart function of newborns. RT-3DE combined with TMAD can early evaluate left heart function in newborns, and its measurement indicators have a good correlation with LVEF of the newborns.