超声心动图评价正常妊娠母体心脏结构和收缩功能的适应性变化  

Assessment of maternal cardiac structure and adaptability change of left ventricular systolic function during normal pregnancy by echocardiography

作　　者：曹丽[1] 南会兰[1] 王佩显[2] 

机构地区：[1]天津医科大学总医院干部病房,天津市300052 [2]天津医科大学总医院心内科,天津市300052

出　　处：《临床超声医学杂志》2009年第8期526-529,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声心动图技术在检测正常妊娠期母体心脏结构与左室收缩功能中的应用价值。方法彩色多普勒超声测量85例正常妊娠妇女和30例健康未孕妇女的心脏结构及收缩功能的各项参数，各组间进行比较。结果左右心房径、右室径、主动脉内径随妊娠期增加而逐渐增大，孕晚期增至最大（P〈0．01）。孕晚期左室舒张末径（LVEDd）较孕早中期明显增大（P〈0．01），左室收缩末径（LVEDs）两组间比较差异无统计学意义；随妊娠期增加左室壁逐渐增厚，左室心肌质量（LVM）增加，两组间比较P〈0．01；每搏输出量自孕中期开始升高并维持。心输出量于孕晚期升至最高（P〈0．01），左室射血分数（LVEF）于孕中期升高，且中晚期组间无明显差异，总外周阻力随孕期逐级减低（P〈0．01）。左室收缩末室壁应力与左室周边缩短速率的比值孕中期较对照组减低（P〈0．01）。结论超声心动图能够无创、准确评价正常妊娠期间母体心血管系统的适应性变化。Objective To investigate the application value of echocardiography in maternal cardiac structure and left ventricular systolic function during normal pregnancy. Methods Eighty - five normal pregnant women and 30 contrast subjects were enrolled in this study. Their cardiac structure and parameters of left ventricular systolic function were measured by color Doppler ultrasound, then the results were compared. Results With the gestation period increased, the left atrial and right atrial dimension, right ventricular dimension and aortic diameter were significantly increased. And the largest was in the third trimester （P 〈0.01 ）. LVEDd in third trimester was larger than that in the second trimester（ P 〈 0.01 ） ;There was no significant difference in LVEDs between the two groups. While with the gestation period increased, the left ventricular wall was thickening, the mass of left ventricular muscle was increased （ P 〈 0.01 ） ; SV began to increase from second trimester, and maintained until term. CO incrased to the highest level in third trimester （P 〈0.01 ）. EF% was incrased in second trimester, and there was no significant difference between second trimester group and third trimester groap（P 〉0.01 ）, TPR decreased during all three trimesters of pregnancy. Compared with control group, the ratio of left ventricular wall stress and peripheral velocity was decreased （P 〈 0.01 ）. Conclusion Eehocardiography can assess adaptability change of maternal cardiovascular system during normal pregnancy non -invasively and accurately.

关 键 词：超声心动描记术 正常妊娠 心脏结构 心功能 

分 类 号：R540.45[医药卫生—心血管疾病] R542.22[医药卫生—内科学]