心肌做功技术在妊娠合并慢性高血压患者左心室收缩功能中的评价作用  

Assessment of left ventricular systolic function in pregnant women with chronic hypertension by myocardial work

作　　者：王维英[1] 王净[2] 缪晓云[1] 杨鎏[1] 张晓黎[1] 马根山[1] WANG Weiying;WANG Jing;MIAO Xiaoyun;YANG Liu;ZHANG Xiaoli;MA Genshan(Department of Cardiology,Zhongda Hospital,Southeast University,Nanjing 210009,China;Department of Obstetrics,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院心内科,江苏南京210009 [2]东南大学附属中大医院产科,江苏南京210009

出　　处：《东南大学学报（医学版）》2022年第3期415-421,共7页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:应用心肌做功技术对妊娠合并慢性高血压患者的左心室收缩功能进行定量评价。方法:选取40例妊娠合并慢性高血压患者为病例组,选取同期40例正常妊娠者为对照组。自动功能成像(AFI)模式下获得左心室心肌整体纵向应变(GLS)、心肌整体做功指数(GWI)、整体无用功(GWW)、整体有用功(GCW)及整体做功效率(GWE)。采用独立样本t检验比较两组间差异,运用受试者工作特征(ROC)曲线分析心肌做功参数评价效能,采用组内相关系数(ICC)进行同一检查者和不同检查者间测量心肌做功参数的一致性检验。结果:与对照组相比,病例组GWI、GWW和GCW明显增高,GLS和GWE明显降低,差异均有统计学意义(P<0.05)。ROC曲线分析显示,在评价左心室收缩功能的指标中GLS和心肌做功参数诊断敏感度与特异度明显优于左心室射血分数(LVEF),其中GWW和GWE最佳。ICC分析显示同一检查者和不同检查者间获得的心肌做功参数具有良好的一致性。结论:心肌做功技术是一种无创、定量、敏感评价妊娠合并慢性高血压患者左心室收缩功能的有效方法。Objective:To quantitatively assess the left ventricular systolic function in pregnant women with chronic hypertension by myocardial work.Methods:Forty pregnant women with chronic hypertension were selected as case group and 40 healthy pregnant women were selected as control group at the same period.Tracing analysis by automatic functional imaging(AFI)was conducted to obtain left ventricular global longitudinal strain(GLS),global work index(GWI),global wasted work(GWW),global constructive work(GCW)and global work efficiency(GWE).The differences between the two groups were compared by independent-samples t test.Receiver operating characteristic(ROC)curves were used to evaluate the efficacy of myocardial work indices.Intraclass correlation coefficients were used to analyze the correlation between myocardial work indices obtained by the same echocardiographer and the different echocardiographers.Results:Compared with the control group,the values of GWI,GWW and GCW were higher in case group(P<0.05).The values of GLS and GWE were lower in case group(P<0.05).The ROC curves showed that myocardial work indices and GLS were superior than left ventricular ejection fraction(LVEF),GWW and GWE were the best of all the parameters in the assessment of left ventricular systolic function in pregnant women with chronic hypertension.ICC results showed that the values of myocardial work indices obtained by the same echocardiographer and the different echocardiographers were consistent.Conclusion:Myocardial work is a non-invasive,quantitative and sensitive method to assess the left ventricular systolic function in pregnant women with chronic hypertension.

关 键 词：心肌做功 应变 妊娠 慢性高血压 左室收缩功能 

分 类 号：R714.246[医药卫生—妇产科学]