超声心动图评价重度子痫前期孕妇左室形态和功能的临床意义  

Assessment the change of left ventricular morphology and function in pregnant women with severe preeclampsia by echocardiography

作　　者：寿列军[1] 解左平[1] 金社红[1] 谭乳燕[1] 谢乐燕 袁华[1] 汪惠琴[1] 李红梅[1] 

机构地区：[1]浙江省绍兴市妇幼保健院超声科,浙江绍兴312000

出　　处：《中国优生与遗传杂志》2017年第11期92-94,共3页Chinese Journal of Birth Health & Heredity

基　　金：浙江省公益性技术应用研究计划项目(2015C33296);绍兴市公益性技术应用研究计划项目(2014B70060)

摘　　要：目的评价重度子痫前期患者左室形态及功能变化,并探讨二尖瓣舒张早期E波峰值流速与舒张早期二尖瓣环心肌运动峰值速度之比(E/Ea)、收缩期二尖瓣环心肌运动峰值速度(Sa)评价重度子痫前期患者早期左室功能异常的临床意义及其与N-端脑利钠肽前体(NT-pro BNP)的相关性。方法 36例重度子痫前期患者和51例血压正常孕妇(对照组)。运用超声心动图测量左室形态参数,包括舒张末期左室前后径(LVDd)、舒张末期室间隔厚度(IVSd)、舒张末期左室后壁厚度(LVPWd);运用超声心动图测量左室功能参数,包括射血分数(LVEF)、二尖瓣瓣口舒张早期E波峰值流速与舒张晚期A波峰值流速比值(E/A)、收缩期二尖瓣环左室侧壁处心肌运动峰值速度(Sa),舒张早期二尖瓣环左室侧壁处心肌运动峰值速度(Ea),计算E与Ea比值(E/Ea)。同时检测血浆N-端脑利钠肽前体浓度。结果与对照组比较,重度子痫前期组左室形态各参数均明显增加,差异有统计学意义(P<0.01);重度子痫前期组Sa明显降低,E/Ea明显增大,差异有统计学意义(P<0.01),E/A减小,差异有统计学意义(P<0.05)。NT-pro BNP与E/Ea呈正相关(r值为0.58,P<0.05);NT-pro BNP与Sa呈负相关(r值为-0.69,P<0.05)。结论重度子痫前期患者可以导致左室形态和功能发生变化,应用超声心动图测量E/Ea、Sa与NT-pro BNP相关性良好,可以作为评价左室功能的早期指标,Objective：To assess the change of left ventricular morphology and function in severe preeclampsia,and to investigate the clinical value of ratio of mitral valve diastolic early E wave peak velocity and early diastolic myocardial motion peak velocity in the mitral annulus（E/Ea）,systolic myocardial motion peak velocity in the mitral annulus（Sa）in evaluating early left ventricular dysfunction in patients with severe preeclampsia and its correlation with the N-terminal brain natriuretic peptide precursor（NT-pro BNP）. Methods：There were 36 cases of severe preeclampsia and 51 cases of normotensive pregnant women（control group）in this study. the parameters of left ventricular structure were measured by using echocardiography,including left ventricular diameter at end diastole（LVDd）,interventricular septal thickness at end diastole（IVSd）,left ventricular posterior wall thickness at end diastole（LVPWd）;the parameters of left ventricular function were measured by using echocardiography,including left ventricular ejection fraction（LVEF）,ratio of mitral valve diastolic early E wave peak velocity and diastolic late A wave peak velocity（E/A）,systolic myocardial motion peak velocity of left ventrical lateral wall in the mitral annulus（Sa）,early diastolic myocardial motion peak velocity of left ventrical lateral wall in the mitral annulus（Ea）,ratio of E and Ea（E/Ea）were calculated. And plasma NT-pro BNP concentration were detected. Results：Compared with the control group,the parameters of left ventricular morphology in severe preeclampsia group were significantly increased,the difference was statistically significant（P 0.01）;In severe preeclampsia group Sa significantly decreased,E/Ea significantly increased,the difference was statistically significant（P〈0.01）,E/A decreased,the difference was statistically significant（P〈0.05）. NT-pro BNP was positively correlated with E/Ea（r value was 0.58,P〈0.05）;NT-pro BNP was negatively correlated with Sa（r value wa

关 键 词：超声心动描记术 组织多普勒 N-端脑利钠肽前体 重度子痫前期 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R714.244[医药卫生—内科学]