三维斑点追踪技术联合Tei指数评价妊娠晚期子痫前期患者的左心室功能  

Three-dimensional speckle tracking imaging combined with Tei index in evaluating left ventricular function in late pregnant patients with preeclampsia

作　　者：徐立新 潘高云 朱张茜 尤利益 李选峰 XU Lixin;PAN Gaoyun;ZHU Zhangqian(Department of Ultrasonography,Wenzhou People’s Hospital,Wenzhou 325000,China)

机构地区：[1]温州市人民医院超声科

出　　处：《浙江医学》2019年第16期1727-1730,1735,I0006,共6页Zhejiang Medical Journal

基　　金：温州市科技计划公益性社会发展（医疗卫生）项目（Y20160471）

摘　　要：目的探讨三维斑点追踪成像技术(3D-STI)及Tei指数评价妊娠晚期子痫前期患者左心室功能变化的价值。方法选取轻度子痫前期患者31例(PP-A组)、重度子痫前期患者29例(PP-B组)及健康妊娠晚期孕妇30例为对照组(PN组)。采用脉冲多普勒获取二尖瓣瓣环侧壁处二尖瓣瓣环运动曲线,测量射血时间(ET)、等容收缩时间(ICT)及等容舒张时间(IRT),计算Tei指数;应用3D超声心动图技术获取并计算出三维左心室射血分数(LVEF),用3D-STI技术获取并计算出左心室整体纵向应变(GLS)、左心室整体圆周应变(GCS)、左心室整体径向应变(GRS)、左心室整体面积应变(GAS),并比较各组数据间的差异。结果与PN组比较,PP-B组、PP-A组Tei指数升高,差异有统计学意义(P<0.05),且PP-B组与PP-A组比较,Tei指数升高,差异有统计学意义(P<0.05)。PP-A组GLS较PN组低,差异有统计学意义(P<0.05),PP-A组GCS、GRS、GAS与PN组比较差异均无统计学意义(均P>0.05);PP-B组GLS、GCS、GRS、GAS较PN组低,差异均有统计学意义(均P<0.05),且PP-B组GLS、GCS、GRS、GAS较PP-A组低,差异均有统计学意义(均P<0.05);而3组孕妇LVEF比较差异无统计学意义(P>0.05)。结论3D-STI技术联合Tei指数能发现妊娠晚期子痫前期患者LVEF正常情况下左心室心肌功能的早期改变,其中以GLS及Tei指数较敏感。Objective To assess the early changes of left ventricular function in late pregnant patients with preeclampsia by three-dimensional speckle tracking imaging(3D-STI)and Tei index.Methods Thirty one patients with mild preeclampsia(PP-A group),30 patients with severe preeclampsia(PP-B group)and 30 healthy pregnant women(PN group)were enrolled in this study.Parameters of tissue Doppler imaging echocardioaphy including Tei index;and parameters of 3D-STI including 3D left ventricular ejection fraction(3D-LVEF),left ventricular global area strain(GAS),left ventricular global circumferential strain(GCS),left ventricular global radial strain(GRS),left ventricular global longitudinal strain(GLS)were calculated and compared among groups.Results Compared with PN group,Tei index increased in PP-A and PP-B groups(P<0.05);and compared with PP-A group,Tei index increased in PP-B group(P<0.05).Compared with PN group,GLS decreased in PP-A group(P<0.05),but GCS,GRS and GAS were no significant different between two groups(P>0.05).Compared with PN groups,GLS,GCS,GRS and GAS decreased in PP-B group(P<0.05).Compared with PP-A groups,GLS,GCS,GRS and GAS were decreased in PP-B group(P<0.05).There were no significant differences in the 3D-LVEF among PP-A,PP-B and PN groups(P>0.05).Conclusion 3D-STI combined with Tei index can detect the early changes of left ventricular function in late preeclampsia patients with normal left ventricular ejection fraction,the GLS and Tei are more sensitive indicators.

关 键 词：三维斑点追踪成像技术 子痫前期 左心室功能 

分 类 号：R54[医药卫生—心血管疾病]