Résumé
Objective:To evaluate the clinical value of tissue doppler imaging Tei index in evaluating the degree of myocardial injury, right cardiac function after neonatal asphyxia.Methods:From March 2018 to May 2019, 62 cases of neonatal asphyxia hospitalized in the undergraduate department of Yiwu Central Hospital were classified as asphyxia group.According to Apgar score of birth, they were further divided into 41 cases of mild asphyxia group, 21 cases of severe asphyxia group.And 30 healthy full-term neonates delivered in our Hospital during the same period were selected as normal control group.The Newborn's Tei index, as well as the different severity asphyxia neonatal serum myocardial injury indicators[amino terminal brain natriuretic peptide(NT-proBNP), troponin(cTn-Ⅰ), creatine kinase isoenzyme(CK-MB), lactate dehydrogenase(LDH)], ultrasonic right heart function parameters[right ventricular ejection fraction(RVEF), E, A value and E/A ratio] were compared.Pearson test was used to evaluate the correlation between Tei index, myocardial injury indicators and right cardiac function parameters in neonatal asphyxia cases.Results:The Tei index of the asphyxiation group was (0.38±0.05), which was higher than (0.27±0.04) of the control group ( t=10.521, P<0.05), and the Tei index of the severe asphyxiation group was (0.43±0.06), which was higher than (0.34±0.05) of the mild asphyxiation group ( t=6.264, P<0.05). In neonatal asphyxia cases, the NT-proBNP, cTnI, CK-MB, LDH levels in the severe asphyxia group were (1 164.27±231.64)ng/L, (0.33±0.05)μg/L, (27.11±3.65)U/L, (298.20±37.57)U/L, respectively, which were higher than those in the mild asphyxia group [(590.38±73.91)ng/L, (0.25±0.04)μg/L, (18.36±2.34)U/L, (200.71±24.39)U/L] ( t=14.576, 6.839, 11.463, 12.338, all P<0.05). The ultrasonic RVEF level, E/A ratio in the severe asphyxia group were (52.94±6.10)%, (0.94±0.11), respectively, which were lower than those in the mild asphyxia group [(56.83±5.97)%, (1.02±0.13)] ( t=2.411, 2.547, all P<0.05). Correlation analysis found that Tei index was positively correlated with NT-proBNP, cTn-Ⅰ, CK-MB, LDH levels, and negatively correlated with RVEF level, and positively correlated with E/A ratio in neonatal asphyxia cases( r=0.745, 0.598, 0.703, 0.665, -0.711, -0.692, all P<0.05). Conclusion:Abnormal increasing of Tei index in neonatal asphyxia cases can objectively reflect the extent of myocardial injury and right heart function decline in children.