三维斑点追踪成像技术动态评价妊娠高血压患者左心室收缩功能的临床研究  

Dynamic evaluation of left ventricular systolic function in patients with pregnancy-induced hypertension by three-dimensional speckle tracking imaging

作　　者：杨建享 闫景彬 何飞 Yang Jianxiang;Yan Jingbin;He Fei(Department of Ultrasound,Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine,Wenzhou 325000,Zhejiang Province,China;Department of Internal Medicine-Cardiovascular Diseases,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,温州325000 [2]温州市中西医结合医院心血管内科,温州325000

出　　处：《中国基层医药》2022年第1期101-105,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省温州市基础性科技计划项目(Y20190674)。

摘　　要：目的观察三维斑点追踪成像技术用于动态评价妊娠高血压(HDCP)患者左心室收缩功能的临床效果。方法选择温州市中西医结合医院2019年7月至2020年6月进行产前检查并最终分娩的HDCP患者50例和同期健康妊娠者50例为研究对象,所有研究对象进行常规超声心动图检查和三维斑点追踪成像检查,记录左心室收缩功能相关参数,比较不同受试者组间常规超声检测参数和三维斑点追踪成像参数。结果HDCP治疗前心率(HR)、左室舒张末期内径(LVD)、舒张末期室间隔厚度(IVSD)、舒张末期左室后壁厚度(LVPWD)和左室射血分数(LVEF)与HDCP治疗后、HDCP产后3个月以及正常妊娠组比较,均差异无统计学意义(均P>0.05)。HDCP患者治疗前左室心肌整体纵向应变(LVGLS)[(-18.41±2.23)%]、左室心肌整体圆周应变(LVGCS)[(31.29±3.09)%]、左室心肌整体径向应变(LVGRS)[(-19.37±2.19)%]和左室心肌整体面积应变(LVGAS)[(-26.61±3.18)%]检测数据的绝对值均显著低于正常妊娠组水平[(-26.03±2.79)%、(37.45±3.68)%、(-24.59±2.74)%和(-39.23±3.96)%](t=6.31~14.87,均P<0.05)。HDCP患者治疗后LVGLS[(-24.79±2.68)%]、LVGCS[(35.94±3.25)%]、LVGRS[(-22.48±2.41)%]和LVGAS[(-37.54±3.38)%]检测数值的绝对值和产后3个月[(-25.64±2.72)%、(36.63±3.47)%、(-23.91±2.69)%和(-38.49±3.64)%]均较治疗前水平显著增加(t=4.08~10.59,P<0.05),与正常妊娠组水平比较,均差异无统计学意义(t=0.47~1.19,P=0.182~0.652>0.05)。HDCP患者LVGLS、LVGCS、LVGRS和LVGAS检测数值的绝对值与LVEF检测数值均呈正相关(r=0.638~0.775,P=0.009~0.041<0.05)。结论三维斑点追踪成像技术可对HDCP患者左室收缩功能受损情况进行动态评估,有利于指导早期干预治疗及预后评价,具有较高的临床应用价值。Objective To investigate the clinical efficacy of three-dimensional speckle tracking imaging in the dynamic evaluation of left ventricular systolic function in patients with pregnancy-induced hypertension.Methods 50 patients with pregnancy-induced hypertension,who received prenatal examination in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from July 2019 to June 2020 and finally gave birth,were included in the observation group.An additional 50 healthy pregnant women who concurrently received prenatal examination were included as controls.All participants underwent routine echocardiography and three-dimensional speckle tracking imaging examinations.Parameters related to left ventricular systolic function were recorded.Routine echocardiography parameters and three-dimensional speckle tracking imaging parameters were compared between the observation and control groups.Results There were no significant differences in routine echocardiography parameters(including heart rate,left ventricular end-diastolic diameter,interventricular septum thickness in end-diastole,left ventricular posterior wall thickness in diastole,and left ventricular ejection fraction)between before treatment,after treatment,and 3 months after delivery in the observation group,and between observation and control groups before treatment(all P>0.05).The absolute values of left ventricular global longitudinal strain(LVGLS)[(-18.41±2.23)%vs.(-26.03±2.79)%],left ventricular global circumferential strain(LVGCS)[(31.29±3.09)%vs.(37.45±3.68)%],left ventricular global radial strain(LVGRS)[(-19.37±2.19)%vs.(-24.59±2.74)%],and left ventricular global area peak systolic strain(LVGAS)[(-26.61±3.18)%vs.(-39.23±3.96)%]measured before treatment were significantly lower in the observation group than in the control group(t=6.31-14.87,all P<0.05).The absolute values of LVGLS,LVGCS,LVGRS,and LVGAS in the observation group were significantly higher after treatment[(-24.79±2.68)%,(35.94±3.25)%,(-22.48±2.41)%,(-37.54±3.38)%]and 3 m

关 键 词：高血压 妊娠性 超声心动描记术 三维 三维斑点追踪成像技术 心室功能 左 早期诊断 预后 危险性评估 

分 类 号：R714.246[医药卫生—妇产科学]