Tei指数评价妊娠期高血压患者左心室功能及其与N-端脑钠肽前体的相关性  

Evaluation of left ventricular function in hypertensive disorder complicating pregnancy by Tei index and its correlation with serum N-terminal brain natriuretic peptide precursor level

作　　者：谭乳燕[1] 解左平[1] 寿列军[1] TAN Ruyan;XIE Zuoping;SHOU Liejun(Department of Diagnostic Ultrasound,Shaoxing Women and Children’s Hospital,Shaoxing 312000,China)

机构地区：[1]绍兴市妇幼保健院超声科,312000

出　　处：《浙江医学》2020年第21期2288-2291,共4页Zhejiang Medical Journal

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：目的探讨左心室Tei指数(LVTei)评价妊娠期高血压患者左心室功能异常的临床意义及其与N-端脑利钠肽前体(NT-proBNP)的相关性。方法选取2017年1月至2019年3月在绍兴市妇幼保健院住院分娩的81例妊娠期高血压患者(其中妊娠期高血压25例、轻度子痫前期25例、重度子痫前期31例)及同期29例无基础疾病及妊娠合并症的孕妇为对照组。运用超声心动图测量左心室功能参数,包括左心室射血分数(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(VE/VA);肺静脉收缩期S波峰值流速(PVs)、舒张期D波峰值流速(PVd)、S波峰值流速与D波峰值流速比值(PVs/PVd)、心房收缩期Ar波峰值流速(PVa)以及Ar波持续时间与舒张晚期A波持续时间之差(ArD-AT);组织多普勒测量LVTei。同时检测静脉血NT-proBNP水平。结果与对照组比较,轻度子痫前期组和重度子痫前期组LVTei增高,ArD-AT延长,自然对数转换后的NT-proBNP(Ln NT-proBNP)升高,差异均有统计学意义(均P<0.05)。相关性分析显示:LVTei与Ln NT-proBNP呈正相关(r=0.422,P<0.05)。结论利用组织多普勒测量LVTei可作为评价妊娠期高血压患者左心室功能的敏感指标。Objective To investigate the clinical value of Tei index measured by tissue Doppler in evaluating left ventricular dysfunction in patients with hypertensive disorder complicating pregnancy and its correlation with serum N-terminal brain natriuretic peptide precursor(NT-proBNP)levels.Methods A total of 81 pregnant women with gestational hypertension who were admitted for delivery in our hospital from January 2017 to March 2019 were enrolled in the study and 29 normal pregnant women with no underlying disease or pregnancy complications in the same period were selected as the control group.Among 81 pregnant women with gestational hypertension there were 25 cases of pregnancy-induced hypertension,25 cases of mild preeclampsia,31 cases of severe preeclampsia.The parameters of left ventricular function were measured by echocardio-graphy,including left ventricular ejection fraction(LVEF),the ratio of E wave peak velocity of mitral valvular flow and A wave peak velocity of mitral valvular flow(VE/VA),S wave peak velocity of pulmonary venous flow(PVs),D wave peak velocity of pulmonary venous flow(PVd),PVs/PVd,Ar wave peak velocity of pulmonary venous flow(PVa),the difference between Ar wave duration and A wave duration(ArD-AT);the left ventricular Tei index(LVTei)measured by tissue Doppler.Meanwhile,serum NT-proBNP concentrations were determined.Results Compared with the control group,in mild preeclampsia group and in severe preeclampsia group the LVTei increased,ArD-AT prolonged,the natural logarithmic transformation of NT-proBNP(Ln NT-proBNP)increased(all P<0.05).LVTei was positively correlated with Ln NT-proBNP(r=0.422,P<0.05).Conclusion Tei index can be used as a sensitive indicator to evaluate function of left ventricle in hypertensive disorder complicating pregnancy.

关 键 词：左心室Tei指数 妊娠期高血压疾病 左心室功能 

分 类 号：R714.246[医药卫生—妇产科学]