实时超声三维斑点追踪成像用于妊娠期高血压疾病患者早期心功能损伤评价的临床研究  

Application of real-time three-dimensional speckle tracking echocardiography in the evaluation of early cardiac function damage in patients with pregnancy induced hypertension

作　　者：陈明明 杨建享 Chen Mingming;Yang Jianxiang(Department of Ultrasound,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州市中西医结合医院超声科,浙江省325000

出　　处：《中国基层医药》2021年第11期1652-1657,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省温州市基础性科研项目(Y20190674)。

摘　　要：目的观察实时超声三维斑点追踪成像用于评估妊娠期高血压疾病(HDCP)患者早期心功能损伤的临床价值。方法选择2018年1月至2020年6月于温州市中西医结合医院进行产前检查并最终分娩的HDCP患者65例(HDCP患者组)和同期健康孕妇65例(健康妊娠组)为研究对象,分别于孕24~26周和孕32~34周,对所有研究对象进行常规超声心动图检查和实时超声三维斑点追踪成像检查,比较HDCP患者与健康孕妇在不同妊娠时期的常规心脏超声检测参数和实时超声三维斑点追踪成像参数差异情况。结果HDCP患者组孕24~26周左心室常规超声指标检测数值与健康妊娠组差异均无统计学意义(t=0.793~1.748;P=0.129~0.458);而HDCP患者孕32~34周左室内径(LVD)、左室舒张末期室间隔厚度(IVSD)和左室舒张末期左室后壁厚度(LVPWD)[(34.97±2.66)mm、(11.96±1.85)mm、(12.07±1.73)mm]均显著高于同期健康妊娠组[(31.56±2.58)mm、(9.17±1.70)mm、(9.23±1.62)mm]及HDCP患者孕24~26周水平[(32.36±2.61)mm、(10.15±1.79)mm、(10.19±1.64)mm](t=5.437、6.274、6.319、3.621、4.017、5.241,均P<0.001);HDCP患者组孕32~34周左室射血分数(LVEF)(54.36±4.71)%,显著低于同期健康妊娠组的(63.27±5.04)%及HDCP患者孕24~26周的(59.65±4.62)%,差异均有统计学意义(t=7.682、5.483,均P<0.001)。HDCP患者孕24~26周和孕32~34周左室心肌整体纵向应变(LVGLS)、左室心肌整体圆周应变(LVGCS)、左室心肌整体径向应变(LVGRS)和左室心肌整体面积应变(LVGAS)等实时超声三维斑点追踪成像指标的绝对值[(23.45±2.58)%、(34.09±3.28)%、(22.03±2.31)%、(34.73±3.58)%、(18.63±2.42)%、(30.74±3.07)%、(19.56±2.28)%、(25.85±3.37)%]均显著低于健康妊娠组[(26.27±2.74)%、(37.62±3.61)%、(24.67±2.59)%、(39.41±3.96)%、(26.10±2.81)%、(37.56±3.64)%、(24.82±2.59)%、(40.16±3.96)%](t=4.415、5.013、4.724、6.253、10.736、8.592、7.627、14.319,均P<0.001),且HDCP患者孕32~34周LVGLS、LVGCS、Objective To investigate the clinical value of real-time three-dimensional speckle tracking echocardiography in the evaluation of early cardiac function damage in patients with pregnancy induced hypertension.Methods Sixty-five pregnant women with pregnancy induced hypertension(patient group)and 65 healthy pregnant women(healthy group)who received prenatal examination and delivered between January 2018 and June 2020 in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine were included in this study.The patient and healthy groups were subjected to routine echocardiography and real-time three-dimensional speckle tracking echocardiography at 24-36 and 32-34 weeks of gestation.The imaging parameters of routine echocardiography and real-time three-dimensional speckle tracking echocardiography measured at different periods of gestation were compared between the two groups.Results At 24-36 weeks of gestation,there were no significant difference in routine echocardiography parameters of the left ventricle between patient and healthy groups(t=0.793-1.748;P=0.129-0.458).Left ventricular diameter(LVD),intra-ventricular septum diastole(IVSD)and left ventricular posterior wall diameter(LVPWD)in the patient group at 32-34 weeks of gestation were(34.97±2.66)mm,(11.96±1.85)mm,(12.07±1.73)mm,respectively,which were significantly greater than those in the healthy group at the same time[(31.56±2.58)mm,(9.17±1.70)mm,(9.23±1.62)mm]and those in the patient group at 24-36 weeks of gestation[(32.36±2.61)mm,(10.15±1.79)mm,(10.19±1.64)mm,t=5.437,6.274,6.319,3.621,4.017,5.241,all P<0.001].Left ventricular ejection fraction(LVEF)in the patient group at 32-34 weeks of gestation was(54.36±4.71)%,which was significantly lower than(63.27±5.04)%in the healthy group at the same time and(59.65±4.62)%in the healthy group at 24-36 weeks of gestation(t=7.682,5.483,both P<0.001).At 24-36 and 32-34 weeks of gestation,the absolute values of real-time three-dimensional speckle tracking echocardiography parameters left ventri

关 键 词：高血压 妊娠性 三维斑点追踪成像技术 心脏超声检查 心功能损伤 不良妊娠结局 妊娠期并发症 早期诊断 临床效果 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.246[医药卫生—诊断学]