孕晚期体重控制不良对妊娠期高血压患者左心室功能的影响  

The effect of gestational weight gain on left ventricular function in patients with gestational hypertension in the third trimester

作　　者：吕晴 戴丽雅 周晨晖 叶玲红[2] 陈方红[2] LYU Qing;DAI Liya;ZHOU Chenhui;YE Linghong;CHEN Fanghong(Graduate School,Zhejiang Chinese Medical University,Hangzhou 310053,China;不详)

机构地区：[1]浙江中医药大学研究生院,杭州310053 [2]丽水市中心医院超声医学科

出　　处：《心电与循环》2022年第4期346-349,共4页Journal of Electrocardiology and Circulation

摘　　要：目的多普勒组织成像技术定量评估孕晚期体重控制不良对妊娠期高血压(HIP)患者左心室功能的影响。方法丽水市中心医院2019年1月至2020年10月收治孕晚期HIP患者78例,均行超声心动图和多普勒组织成像检查。根据孕期体重管理情况分为3组,即增重不足组26例、增重正常组27例、增重过多组25例;比较3组患者超声心动图参数[包括左心房内径(LAD)、室间隔舒张末期厚度、左心室舒张末期内径、左心室后壁舒张期厚度、左心室收缩末期内径、左心室射血分数、二尖瓣舒张晚期血流速度峰值、二尖瓣舒张早期血流速度峰值(E)]和多普勒组织成像参数[包括室间隔及侧壁舒张早期运动峰值(e’)、收缩期运动峰值(s’)及E/e’,平均E/e’,平均s’]。结果除LAD外,3组患者其余各项超声心动图参数比较,差异均无统计学意义(均P>0.05);增重过多组LAD明显高于增重正常组、增重不足组(均P<0.05)。3组患者室间隔E/e’、侧壁E/e’、平均E/e’比较,差异均有统计学意义(均P<0.05),其中增重过多组均明显高于增重正常组、增重不足组(均P<0.05);3组患者室间隔e’、室间隔s’、侧壁e’、侧壁s’、平均s’比较,差异均无统计学意义(均P>0.05)。结论孕期增重过多会加重孕晚期HIP患者左心室舒张功能障碍。Objective To evaluate the effect of gestational weight gain on left ventricular(LV)function in patients with gestational hypertension(GP)in the third trimester by tissue Doppler imaging.Methods Seventy-eight patients with GP in the third trimester were admitted to Lishui Center Hospital from January 2019 to October 2020.All patients underwent echocardiography examination and tissue Doppler imaging.They were divided into deficiency group(26cases),normal group(27 cases)and excess group(25 cases)according to the weight management during pregnancy.The echocardiographic parameters and tissue Doppler parameters were compared among the three groups.The echocardiographic parameters included left atrial diameter(LAD),interventricular septal thickness,LV end diastolic diameter,LV posterior wall diastolic thickness,LV end systolic diameter,LV ejection fraction,peak late diastolic velocity of mitral flow,and peak early diastolic velocity of mitral flow(E).The Tissue Doppler parameters included peak early diastolic velocity(e’),peak systolic velocity(s’)and E/e’of mitral annulus,mean E/e’and mean s’.Results Compared with deficiency group and normal group,LAD increased significantly in excess group(all P<0.05).There were no significant differences in other echocardiographic parameters among the three groups(all P>0.05).There were significant differences in interventricular septum E/e’,lateral wall E/e’and mean E/e’among the three groups(all P<0.05),among which the excess group was significantly higher than the deficiency group and the normal group(all P<0.05).There were no significant differences in interventricular septum e’,interventricular septum s’,lateral wall e’,lateral wall s’and mean s’among the three groups(all P>0.05).Conclusion Excessive gestational weight gain may aggravate left ventricular diastolic dysfunction in patients with GP in the third trimester.

关 键 词：妊娠期高血压 多普勒组织成像 左心室功能 孕期体重 

分 类 号：R714.246[医药卫生—妇产科学]