右心改良心肌做功指数在评价辅助生殖技术胎儿右心室功能中的应用  

Application value of right modified myocardial performance index in evaluating fetal right ventricular function in assisted reproductive technology

作　　者：吴娟[1] 朱姿琪 栗河舟[1] 王铭[1] 高静[1] 王新霞[1] 刘云[1] Wu Juan;Zhu Ziqi;Li Hezhou;Wang Ming;Gao Jing;Wang Xinxia;Liu Yun(Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,郑州450052

出　　处：《中华超声影像学杂志》2022年第12期1035-1039,共5页Chinese Journal of Ultrasonography

基　　金：2020年度河南省医学科技攻关计划(联合共建)项目(LHGJ20200447);2019年度河南省医学科技攻关计划(联合共建)项目(LHGJ20190376)。

摘　　要：目的:探讨右心改良心肌做功指数(Mod-RMPI)评价辅助生殖技术(ART)胎儿右心室功能的应用价值。方法:选取2021年11月至2022年2月于郑州大学第三附属医院行胎儿超声心动图检查的64例辅助生殖技术受孕胎儿(ART组)及80例自然受孕胎儿(对照组),孕周20~28周。比较ART组与对照组Mod-RMPI、三尖瓣E/A比值(TV-E/A)的差异;应用多元线性回归分析法分析ART组孕妇年龄、体质指数(BMI)、孕次产次与Mod-RMPI的相关性;绘制ROC曲线检验Mod-RMPI对不良妊娠结局的预测效能。结果:①与对照组相比,ART组Mod-RMPI、心室等容舒张时间(IRT)、心室等容收缩时间(ICT)、孕妇BMI增加,心室射血时间(ET)缩短,差异有统计学意义(均P<0.05);心室总耗时(TST)、TV-E/A与对照组相比,差异无统计学意义(P>0.05)。②孕妇年龄、BMI、孕次产次与Mod-RMPI无相关性(P>0.05)。③ROC曲线分析Mod-RMPI预测不良妊娠结局的曲线下面积为0.748,最佳截断值为0.465,敏感性为0.778,特异性为0.608。结论:ART可影响胎儿右室功能,Mod-RMPI具有较好的一致性和重复性,并且对预测不良妊娠结局具有一定的价值。Objective To explore the application value of right modified myocardial work index(Mod-RMPI)in assessing fetal right ventricular function in assisted reproductive technology(ART).Methods Sixty-four fetuses conceived by assisted reproduction(ART group)and 80 fetuses with spontaneously conceived(SC)pregnancies(control group)from November 2021 to February 2022 underwent echocardiography in the Third Affiliated Hospital of Zhengzhou University were enrolled,gestational ranges from 20 to 28 weeks.The differences of Mod-RMPI,tricuspid valve E/A ratio(TV-E/A)were compared between the ART group and the control group;The correlation between maternal age,body mass index(BMI),pregnancy,and delivery and Mod-RMPI in the ART group was analyzed by applying multiple linear regression analysis;The receiver operating characteristic(ROC)curves were used to test the predictive efficacy of Mod-RMPI for adverse pregnancy outcomes.Results①Compared with the control group,Mod-RMPI,isovolumetric relaxation time(IRT),isovolumetric contraction time(ICT)and BMI were increased in ART group with statistically significant difference,ventricular ejection time(ET)were decreased,the difference was(all P<0.05).But there were no significant differences in total spent time(TST)and TV-E/A compared with the control group(P>0.05).②There were no correlations between maternal age,BMI,gravidity,and times of bearing birth and Mod-RMPI(P>0.05).③The ROC curve analysis showed the area under the curve of Mod-RMPI for predicting adverse pregnancy outcome was 0.748,the optimal cut-off value was 0.465,the sensitivity was 0.778,and the specificity was 0.608.Conclusions ART can affect fetal right ventricular function.Mod-RMPI has good consistency and repeatability,and has certain value in predicting adverse pregnancy outcome.

关 键 词：辅助生殖技术 胎儿 心室功能 右 改良心肌做功指数 

分 类 号：R714.5[医药卫生—妇产科学] R714.8[医药卫生—临床医学]