早发型与晚发型重度子痫前期患者左室舒张功能的超声心动图评价  

Echocardiographic evaluation of left ventricular diastolic function in patients with early-onset and late-onset severe preeclampsia

作　　者：许建萍[1] 丁琳茹 窦水秀 赵晓宇 杜亚倩 张映安[2] 何银芳[2] XU Jianping;DING Linru;DOU Shuixiu;ZHAO Xiaoyu;DU Yaqian;ZHANG Ying’an;HE Yinfang(Department of Ultrasound,the First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院超声科,太原市030001 [2]山西医科大学第一医院妇产科,太原市030001

出　　处：《临床超声医学杂志》2020年第2期103-107,共5页Journal of Clinical Ultrasound in Medicine

基　　金：山西省重点研发计划项目(社会发展)(201903D321195)

摘　　要：目的应用超声心动图评价早发型与晚发型重度子痫前期患者左室舒张功能的变化。方法选取我院确诊的重度子痫前期(左室射血分数均≥50%)患者83例,依据发病孕周不同分为PE1组(早发型,孕周<34周)48例和PE2组(晚发型,孕周≥34周)35例,另选同期与PE1组孕周相匹配的36例健康妊娠妇女为对照组N1组,与PE2组孕周相匹配的37例健康妊娠妇女为对照组N2组。各组均行常规超声心动图检查获取:二尖瓣口舒张早期峰值流速(E)、二尖瓣口舒张晚期峰值流速(A)并计算E/A比值,二尖瓣环舒张早期间隔侧和侧壁侧运动峰值(eS’、eL’)、舒张晚期间隔侧和侧壁侧运动峰值(aS’、aL’)并计算平均值(eM’、aM’)、eM’/aM’及E/eM’值;获取左房最大容积(LAVmax),并用体表面积标化得到左房容积指数(LAVI)。比较分析各组上述参数间的差异。结果与对照组N1组比较,PE1组E/A、eM’、eM’/aM’均减低,A、E/eM’、IVRT、LAVI均升高,差异均有统计学意义(均P<0.05);与对照组N2组比较,PE2组E/A、eM’、eM’/aM’均减低,A、E/eM’、IVRT、LAVI均升高,差异均有统计学意义(均P<0.05);与PE1组比较,PE2组E、E/A、eM’、E/eM’、IVRT、LAVI均减低,A、aM’、eM’/aM’均升高,但差异均无统计学意义;与对照组N1组比较,对照组N2组E、A、eM’、aM’、eM’/aM’均减低,E/A、E/eM’、LAVI、IVRT均升高,但差异均无统计学意义。结论早发型与晚发型重度子痫前期患者左室舒张功能均减低;与晚发型相比,早发型患者左室舒张功能有减低的趋势。Objective To explore the changes of left ventricular diastolic function in patients with early-onset andlate-onset severe preeclampsia(EOSP,LOSP)by echocardiography.MethodsEighty-three patients of severe preeclampsia(left ventricular ejection fraction≥50%)were selected.On the basis of gestational week at the onset of disease,these patientswere divided into two groups:PE1 group(48 cases,the EOSP who were diagnosed before 34 gestational weeks)and PE2 group(35 cases,the LOSP who were diagnosed at or after 34 gestational weeks).Seventy-three healthy pregnancy were selected as thecontrol group,thirty-six of these were selected as the N1 group who were gestational weeks-matched with PE1,other thirty-seven matching the gestational week of the PE2 group were selected as the N2 group.Conventional echocardiography wereperformed and parameters were acquired including:early peak mitralflow velocity(E),late peak mitral flow velocity(A),earlymitral annulus diastolic septal wall and lateral wall motion peaks(eS’,eL’),late diastolic septal and lateral wall motion peaks(aS’,aL’),and then calculated E/A ratio,eM’,aM’,eM’/aM’ratio and E/eM’ratio.Left atrial maximum volume(LAVmax)wasacquired,and LAVI was obtained by body surface area indexed.The differences between the above parameters in each groupwere analyzed and compared.ResultsCompared with N1 group,E/A,eM’,eM’/aM’were decreased,A,E/eM’,IVRT,LAVI wereincreased in PE1 group(all P<0.05).Compared with N2 group,E/A,eM’,eM’/aM’were decreased,A,E/eM’,IVRT,LAVI wereincreased in PE2 group(all P<0.05).Compared with PE1 group,E,E/A,eM’,E/eM’,IVRT,LAVI were decreased,A,aM’,eM’/aM’were increased in PE2 group(all P<0.05).Compared with N1 group,E,A,eM’,aM’,eM’/aM’were decreased,E/A,E/eM’,LAVI,IVRT were increased in N2 group(all P<0.05).ConclusionLeft ventricular diastolic function is reduced both in EOSP andLOSP patients.Compared with LOSP,left ventricular diastolic function is inclined to decrease in EOSP.

关 键 词：超声心动描记术 舒张功能 心室 左 子痫前期 

分 类 号：R540.45[医药卫生—心血管疾病] R714.24[医药卫生—内科学]