实时三维超声心动图评估妊娠期高血压疾病患者左心功能的临床价值及与血清炎症细胞因子和子宫动脉阻力指数的相关性  

Clinical value of real-time three-dimensional echocardiography in evaluation of left cardiac function in patients with hypertensive disorder complicating pregnancy and the correlations with serum inflammatory cytokines and uterine artery resistance index

作　　者：张银红 何慧辽 寇红菊[1] 王丹菡 ZHANG Yin-Hong;HE Hui-Liao;KOU Hong-Ju(Department of Ultrasound Imaging,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou,Zhejiang 325027,China)

机构地区：[1]温州医科大学附属第二医院超声影像科,浙江温州325027 [2]温州医科大学附属第二医院妇产科,浙江温州325027

出　　处：《中国妇幼保健》2021年第14期3376-3379,共4页Maternal and Child Health Care of China

基　　金：浙江省卫生和计划生育委员会医药卫生科技计划项目(2019KY109)。

摘　　要：目的分析实时三维超声心动图(RT-3DE)评估妊娠期高血压疾病(HDCP)患者左心功能的临床价值及与血清炎症细胞因子和子宫动脉阻力指数(RI)的相关性.方法选取2017年1月-2019年6月温州医科大学附属第二医院收治的175例HDCP孕妇,按病情严重程度分为A组(妊娠期高血压组,89例)、B组(轻度子痫前期组,40例)、C组(重度子痫前期组,46例),另选取同期进行体检的50例正常孕妇作为对照组.比较4组孕妇的左心功能、血清炎症细胞因子水平及子宫动脉RI.结果对照组孕妇左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及左心房最大容积(LAVmax)分别为(85.60±9.02)ml、(28.96±1.03)ml及(34.39±6.48)ml,A组孕妇LVEDV、LVESV及LAVmax分别为(88.45±6.34)ml、(30.15±1.45)ml及(36.07±5.44)ml,B组孕妇LVEDV、LVESV及LAVmax分别为(90.52±9.51)ml、(33.30±1.11)ml及(40.85±7.51)ml,C组孕妇LVEDV、LVESV及LAVmax分别为(94.11±7.11)ml、(35.60±1.20)ml及(43.52±9.14)ml.4组孕妇LVEDV、LVESV及LAVmax比较差异均有统计学意义(F=10.358,P=0.000;F=290.838,P=0.000;F=18.765,P=0.000).对照组孕妇血清白细胞介素-4(IL-4)、白细胞介素-12(IL-12)及超敏C-反应蛋白(hs-CRP)水平分别为(16.24±4.64)pg/ml、(17.99±5.12)pg/ml及(8.22±2.92)mg/L,A组孕妇血清IL-4、IL-12及hs-CRP水平分别为(13.46±3.28)pg/ml、(23.14±5.98)pg/ml及(15.52±5.33)mg/L,B组孕妇血清IL-4、IL-12及hs-CRP水平分别为(10.38±2.76)pg/ml、(32.27±10.22)pg/ml及(20.76±5.00)mg/L,C组孕妇血清IL-4、IL-12及hs-CRP水平分别为(8.48±2.13)pg/ml、(42.90±12.67)pg/ml及(30.15±5.82)mg/L.4组孕妇血清IL-4、IL-12及hs-CRP水平比较差异均有统计学意义(F=50.154,P=0.000;F=84.394,P=0.000;F=168.950,P=0.000).A组、B组、C组及对照组孕妇子宫动脉RI分别为(0.33±0.05)、(0.42±0.08)、(0.50±0.09)及(0.26±0.03),差异有统计学意义(F=106.184,P=0.000).Pearson相关性分析结果显示:HDCP孕妇血清IL-4水平和LVEDV、LVESV及LAVmax均呈负相关Objective To analyze the clinical value of real-time three-dimensional echocardiography(RT-3DE)in evaluation of left cardiac function in patients with hypertensive disorder complicating pregnancy(HDCP)and the correlations with serum inflammatory cytokines and uterine artery resistance index(RI).Methods A total of 175 HDCP pregnant women treated in the Second Affiliated Hospital of Wenzhou Medical University from January 2017 to June 2019 were selected and divided into group A(hypertension during pregnancy,89 cases),group B(mild preeclampsia,40 cases),and group C(severe preeclampsia,46 cases)according to severity of the disease,50 normal pregnant women after physical examination were selected as control group.Left heart function,serum inflammatory cytokines,and uterine artery RI were compared among the four groups.Results The levels of left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),and left atrial maximum volume(LAVmax)in control group were(85.60±9.02)ml,(28.96±1.03)ml,and(34.39±6.48)ml,respectively;the levels of LVEDV,LVESV,and LAVmax in group A were(88.45±6.34)ml,(30.15±1.45)ml,and(36.07±5.44)ml,respectively;the levels of LVEDV,LVESV,and LAVmax in group B were(90.52±9.51)ml,(33.30±1.11)ml,and(40.85±7.51)ml,respectively;the levels of LVEDV,LVESV,and LAVmax in group C were(94.11±7.11)ml,(35.60±1.20)ml,and(43.52±9.14)ml,respectively.There were statistically significant differences in the levels of LVEDV,LVESV,and LAVmax among the four groups(F=10.358,P=0.000;F=290.838,P=0.000;F=18.765,P=0.000).The levels of serum interleukin-4(IL-4),interleukin-12(IL-12),and high-sensitivity C-reactive protein(hs-CRP)in control group were(16.24±4.64)pg/ml,(17.99±5.12)pg/ml,and(8.22±2.92)mg/L,respectively;the levels of serum IL-4,IL-12,and hs-CRP in group A were(13.46±3.28)pg/ml,(23.14±5.98)pg/ml,and(15.52±5.33)mg/L,respectively;the levels of serum IL-4,IL-12,and hs-CRP in group B were(10.38±2.76)pg/ml,(32.27±10.22)pg/ml,and(20.76±5.00)mg/L,respectively;the levels of ser

关 键 词：实时三维超声心动图 妊娠期高血压疾病 左心功能 炎症细胞因子 子宫动脉阻力指数 

分 类 号：R714.24[医药卫生—妇产科学]