全容积成像技术评价重度子痫前期患者左心室重构对收缩同步性的影响  

Effection of left ventricular remodeling on systolic synchronization in patients with severe preeclampsia by full-volume imaging technology

作　　者：许建萍[1] 杜亚倩 赵晓宇[2] 徐楠 王丹丹[2] 张映安[3] 何银芳[3] Xu Jianping;Du Yaqian;Zhao Xiaoyu;Xu Nan;Wang Dandan;Zhang Ying′an;He Yinfang(Department of Ultrasonography,the First Hospital of Shanxi Medical University,Taiyuan 030001,China;Shanxi Medical University,Taiyuan 030001,China;Department of Gynaecology and Obstetrics,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030001 [2]山西医科大学,太原030001 [3]山西医科大学第一医院妇产科,太原030001

出　　处：《中华超声影像学杂志》2021年第3期207-212,共6页Chinese Journal of Ultrasonography

基　　金：山西省重点研发计划项目(社会发展)(201903D321195)。

摘　　要：目的应用全容积成像技术评价重度子痫前期(SPE)患者左室重构对收缩同步性的影响。方法随机选取2016年12月至2019年12月于山西医科大学第一医院就诊的SPE患者109例,分为收缩同步(SS)组35例和收缩不同步(SD)组74例,选取同期健康孕妇34例为正常妊娠(NP)组。收集入选者的一般临床资料,使用全容积成像技术获取左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)、左室球形指数(SpI)、左室质量指数(LVMI)、左室收缩不同步指数(SDI)等参数。分别应用双变量相关、多元线性逐步回归分析和二元Logistic回归分析研究SPE患者左室重构对收缩同步性的影响。结果①双变量相关分析显示LVEDV、LVESV、SpI、LVMI与SDI呈正相关(r=0.335、0.361、0.635、0.680,均P<0.01);②对可能的影响因素(年龄、体质指数、收缩压、高血压病程、降压解痉治疗、妊娠期糖尿病、亚临床甲状腺功能减退症、LVEF)进行校正后,多元线性回归分析显示SpI、LVMI是SDI的独立预测因子(β=0.228、0.319,均P<0.01);③二元Logistic回归分析进一步显示SpI、LVMI与左室收缩同步性独立相关[OR(95%CI)=1.288(1.039~1.598)、1.102(1.019~1.192),均P<0.05]。结论SPE患者左室重构导致左室收缩同步性下降,可早期反映亚临床心肌功能损害;全容积成像技术可准确评价SPE患者的左室收缩同步性。Objective To evaluate the effects of left ventricular remodeling on systolic synchronization in patients with severe preeclampsia(SPE)by full-volume imaging technology.Methods One hundred and nine patients with SPE were randomly selected as SPE group in the First Hospital of Shanxi Medical University from December 2016 to December 2019,which were further divided into systolic synchrony(SS)group(n=35)and systolic dyssynchrony(SD)group(n=74).And 34 healthy pregnant women during the same period were selected as normal pregnancy(NP)group.The clinical datas were collected.Parameters including left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),spherical index(SpI),left ventricular mass index(LVMI)and systolic dyssynchrony index(SDI)were obtained by full-volume imaging technology.The effects of left ventricular remodeling on systolic synchronization in patients with SPE were analyzed by bivariate correlation,multiple linear stepwise regression analysis and binary Logistic regression analysis,respectively.Results①Bivariate correlation analysis showed that LVEDV,LVESV,SpI and LVMI were positively correlated with SDI(r=0.335,0.361,0.635,0.680;all P<0.01).②After adjustment for age,body mass index,systolic blood pressure,course of hypertension,antihypertensive and antispasmodic treatments,gestational diabetes mellitus,subclinical hypothyroidism,LVEF,multiple linear regression analysis showed that SpI and LVMI were independent predictors of SDI(β=0.228,0.319;all P<0.01).③Binary Logistic regression analysis showed that SpI and LVMI were independently correlated with left ventricular systolic dyssynchrony[OR(95%CI)=1.288(1.039-1.598),1.102(1.019-1.192);all P<0.05].Conclusions Left ventricular remodeling in patients with SPE leads to the decrease of left ventricular systolic synchronization,which can reflect subclinical myocardial dysfunction early.Full volume imaging technology can accurately evaluate left ventricular systolic synchronization

关 键 词：超声心动描记术 子痫前期 全容积成像技术 左室质量指数 球形指数 同步性 

分 类 号：R714.244[医药卫生—妇产科学] R445.1[医药卫生—临床医学]