超声评估妊娠期高血压疾病孕妇左心功能改变及其与子宫动脉阻力指数的相关性  

Assessment of Changes in Left Heart Function in Pregant Women with Hypertensive Disorder By Ultrasound and Correlations with Resistance Index of Uterine Helicine Arteries

作　　者：龚儒杰[1] 姚莉萍 朱向明[1] GONG Rujie;YAO Liping;ZHU Xiangming(Department of Ultrasonography,Yijishan Hospital,Wannan Medical College,Wuhu,241001,China;不详)

机构地区：[1]皖南医学院弋矶山医院超声医学科,安徽芜湖241001 [2]上海交通大学医学院附属新华医院崇明分院超声科,上海200092

出　　处：《中国医学影像学杂志》2019年第9期709-713,共5页Chinese Journal of Medical Imaging

基　　金：皖南医学院重点科研项目培育基金（WK2017ZF01）;安徽省中央引导地方科技发展专项项目（2017070802D152）

摘　　要：目的利用超声评价妊娠期高血压疾病(HDP)孕妇左心功能及其与子宫动脉阻力指数(RI)的变化,并探讨两者之间的相关性。资料与方法选择90例HDP孕妇,根据其病情严重程度分为妊娠期高血压(GH)组、轻度子痫前期和重度子痫前期3组,每组各30例;另选取正常孕妇30名为对照组。孕28~38周期间,应用超声定量分析并比较各组左心功能参数的变化及其与子宫动脉RI的关系。结果4组孕妇一般资料比较差异均无统计学意义(P>0.05);轻度及重度子痫前期孕妇左心室射血分数分别为(60.1±3.1)%和(57.8±2.8)%,均低于对照组和GH组的(67.1±2.8)%和(68.4±3.3)%(P<0.05)。HDP各组孕妇左心房容积指数、左心室等容舒张时间(IVRT)、舒张早期二尖瓣前向血流峰值速度/舒张早期二尖瓣环运动峰值速度、子宫动脉RI均高于对照组(P均<0.05)。3组HDP孕妇左心室等容舒张时间与子宫动脉RI具有相关性(r=0.57~0.70,P均<0.01)。结论HDP孕妇左心室收缩功能有下降趋势且子宫动脉RI逐渐增高,重症子痫前期孕妇左心室舒张功能明显减低;并且IVRT与子宫动脉RI具有相关性。Purpose To assess the changes in left heart function and resistance index(RI)of uterine arteries in patients with hypertensive disorder of pregnancy(HDP)by ultrasonography,and to explore the relationship between them.Materials and Methods Ninety pregnant women with HDP were selected and divided into three groups according to the severity of the disease,gestational hypertension(GH)group,mild pre-eclampsia group and severe pre-eclampsia group,with 30 cases in each group;30 normal pregnant women were selected as the normal control group.Between 28 and 38 weeks of pregnancy,ultrasonic quantitative analysis was conducted and the changes of left heart function parameters in each group and their relationship with RI of uterine arteries were compared.Results There were no significant differences in the general data of the pregnant women in the four groups(P>0.05).The left ventricular ejection fraction of mild and severe preeclampsia pregnant women was(60.1±3.1)%and(57.8±2.8)%,respectively;which were lower than those of control group and GH group(67.1±2.8)%and(68.4±3.3)%(P<0.05).The left atrial volume index,left ventricular isovolumetric relaxation time,E/E'ratio,RI of uterine arteries of pregnant women with HDP in the groups were higher than those of the normal control group,and the differences were statistically significant(P<0.05).There were positive correlations between isovolumetric relaxation time and RI of uterine arteries in three groups of women with HDP(r=0.57-0.70,P<0.01).Conclusion The left ventricular systolic function of pregnant women with HDP decreases and the RI of uterine arteries increases gradually.The left ventricular diastolic function of severe preeclampsia pregnant women decreases significantly.Isovolumetric relaxation time is correlated with the RI of uterine arteries.

关 键 词：高血压 妊娠性 超声心动描记术 超声心动描记术 三维 心室功能 左 子宫动脉 血管阻力 孕妇 女(雌)性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714[医药卫生—诊断学]