组织多普勒成像和时间-空间相关成像评价孕晚期子痫前期胎儿心脏功能的应用价值  

Value of tissue Doppler and spatio-temporal image correlation for evaluating fetal cardiac function in late pregnancy with pre-eclampsia

作　　者：葛婷婷[1] 林晓娟[1] 赵旭[2] GE Tingting;LIN Xiaojuan;ZHAO Xu(Center of Prenatal Diagnosis Center,Gansu Provincial Maternity and Child-care Hospital,Lanzhou 730050,China;不详)

机构地区：[1]甘肃省妇幼保健院产前诊断中心,兰州市730050 [2]北京大学民航临床医学院妇产科

出　　处：《临床超声医学杂志》2023年第1期29-33,共5页Journal of Clinical Ultrasound in Medicine

基　　金：北京市科学委员会首都临床特色应用研究与成果推广项目(Z171100001017139)。

摘　　要：目的应用组织多普勒成像(TDI)和时间-空间相关成像(STIC)评价孕晚期子痫前期孕妇的胎儿心脏功能,探讨其临床应用价值。方法选取于我院产检并确诊的孕晚期子痫前期孕妇121例,其中轻度子痫前期孕妇61例(MPE组),重度子痫前期孕妇60例(SPE组),另选同期孕晚期正常妊娠孕妇115例为正常对照组,按照孕28~31^(+6)周、32~35^(+6)周、36~40周3个时间段分别应用TDI和STIC连续评估各组胎儿心脏功能,测量二、三尖瓣环舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)、收缩期运动速度(Sa),以及等容收缩时间、等容舒张时间及射血时间,计算左、右室Tei指数和短轴缩短分数(SF),以及二、三尖瓣环Ea/Aa,比较各组上述参数的差异。结果SPE组、MPE组孕28~31^(+6)周、32~35^(+6)周、36~40周二、三尖瓣环Sa、Ea/Aa及左、右室SF均小于正常对照组,左、右室Tei指数均大于正常对照组,差异均有统计学意义(均P<0.05)。SPE组孕36~40周左、右室SF均小于MPE组,左室Tei指数大于MPE组,差异均有统计学意义(均P<0.05);SPE组孕28~31^(+6)周、32~35^(+6)周、36~40周右室Tei指数均大于MPE组,差异均有统计学意义(均P<0.05)。结论应用TDI和STIC可以评价孕晚期子痫前期孕妇的胎儿心脏收缩、舒张和整体功能减低,胎儿长期暴露于高血压的宫内环境中可导致其心脏功能受损。Objective To evaluate fetal cardiac function in pregnant women with pre-eclampsia in late pregnancy by tissue Doppler imaging(TDI)and spatio-temporal image correlation(STIC)techniques,and to explore their clinical application value.Methods One hundred and twenty-one pregnant women with preeclampsia in late pregnancy who were diagnosed in our hospital were selected,including 61 pregnant women with mild preeclampsia(MPE group)and 60 pregnant women with severe preeclampsia(SPE group),and 115 pregnant women with normal pregnancy in late pregnancy were selected as the normal control group,TDI and STIC were used to evaluate the fetal cardiac function in 3 time periods continuously:28~31^(+6)weeks,32~35^(+6)weeks and 36~40 weeks of gestation,respectively.The peak early diastolic velocity(Ea),peak late diastolic velocity(Aa),and peak systolic velocity(Sa)of the mitral and tricuspid annulus,as well as isovolumic systolic time,isovolumic diastolic time,and ejection time were measured,the left and right ventricular Tei index and short-axis shortening fraction(SE),as well as Ea/Aa of the mitral and tricuspid annulus were calculated,the differences of the above parameters in each group were compared.Results In the SPE and MPE groups,the Sa,Ea/Aa of mitral and tricuspid annular,the left and right ventricular SF at 28~31^(+6)weeks,32~35^(+6)weeks,and 36~40 weeks of gestation were lower than those in the normal control group,and the left and right ventricular Tei index were higher than those in the normal control group,with statistically significant differences(all P<0.05).The left and right ventricular SF in the SPE group were lower than those in the MPE group at 36~40 weeks of gestation,the left ventricular Tei index in the SPE group was higher than that in the MPE group,and the differences were statistically significant(all P<0.05).The right ventricular Tei index in the SPE group was higher than that in the MPE group at 28~31^(+6)weeks,32~35^(+6)weeks,and 36~40 weeks of gestation,the differences were statistically significant

关 键 词：超声心动描记术 组织多普勒成像 时间-空间相关成像 子痫前期 心功能 胎儿 

分 类 号：R540.45[医药卫生—心血管疾病] R714.2[医药卫生—内科学]