左室压力-应变环技术评估妊娠期高血压疾病患者左室功能的临床价值  

Clinical value of left ventricular pressure-strain loop technology in the assessment of left ventricular function in patients with hypertensive disorder complicating pregnancy

作　　者：何美玲 贾春莲 谢满英 汪伟 甘玲 HE Meiling;JIA Chunlian;XIE Manying;WANG Wei;GAN Ling(Department of Ultrasound Imaging,the Xiangyang First People’s Hospital Affiliated to Hubei University of Medicine,Hubei 441000,China)

机构地区：[1]湖北医药学院附属襄阳市第一人民医院超声影像科,湖北省襄阳市441000 [2]湖北医药学院附属襄阳市第一人民医院产科,湖北省襄阳市441000

出　　处：《临床超声医学杂志》2023年第7期541-545,共5页Journal of Clinical Ultrasound in Medicine

基　　金：2021年度襄阳市医疗卫生领域科技计划项目(2021ZD16)。

摘　　要：目的探讨左室压力-应变环技术定量评估妊娠期高血压疾病患者左室功能的临床价值。方法选取于我院就诊的妊娠期高血压疾病患者38例(病例组)和孕龄与之匹配的健康孕妇42例(对照组),均行常规超声心动图检查,并应用左室压力-应变环技术测量左室整体纵向应变(GLS)、心肌整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)及整体做功效率(GWE),比较两组一般资料、常规超声心动图参数、GLS及心肌做功参数的差异。采用Spearman相关分析法分析心肌做功参数与收缩压和舒张压的相关性。绘制受试者工作特征(ROC)曲线分析各参数评估妊娠期高血压疾病患者左室功能受损的诊断效能。结果与对照组比较,病例组收缩压、舒张压、左房收缩末期内径、室间隔舒张末期厚度、左室后壁舒张期厚度、GWI、GCW、GWW均增高,GWE、GLS均降低,差异均有统计学意义(均P<0.05)。相关性分析显示,GWI、GCW、GWW与收缩压、舒张压均呈正相关,GWE、GLS与收缩压、舒张压均呈负相关(均P<0.05)。ROC曲线分析显示,GWI、GCW和GWW评估妊娠期高血压疾病患者左室功能受损的诊断效能均明显高于GLS和左室射血分数,尤以GCW和GWW的诊断效能最高,曲线下面积分别为0.766、0.882,灵敏度、特异度分别为75.0%、73.7%和75.0%、94.7%。结论左室压力-应变环技术在评估妊娠期高血压疾病患者左室功能受损方面具有一定的临床价值。Objective To explore the clinical value of left ventricular pressure-strain loop technology in quantitative assessment of left ventricular function in patients with hypertensive disorder complicating pregnancy.Methods Thirty-eight patients with hypertensive disorder complicating pregnancy(case group)and 42 healthy pregnant women with matched gestational age(control group)in our hospital were selected for routine echocardiography examination,while the left ventricular global longitudinal strain(GLS),myocardial global work index(GWI),global constructive work(GCW),global wasted work(GWW)and global work efficiency(GWE)were measured by left ventricular pressure-strain loop technique.The differences of general data,conventional echocardiographic parameters,GLS and myocardial work parameters were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between myocardial work parameters and systolic and diastolic blood pressure.Receiver operating characteristic(ROC)curve was drawn to analyze the parameters in evaluating the diagnostic efficacy of left ventricular function impairment in patients with hypertensive diseases during pregnancy.Results Compared with control group,systolic blood pressure,diastolic blood pressure,left atrial end-systolic diameter,ventricular septal end-diastolic thickness,left ventricular posterior wall diastolic thickness,GWI,GCW,GWW increased in case group,and GWE,GLS decreased,with statistical significances(all P<0.05).Correlation analysis showed that GWI,GCW,GWW were positively correlated with systolic and diastolic blood pressure,while GWE and GLS were negatively correlated with systolic and diastolic blood pressure(all P<0.05).ROC curve analysis showed that GWI,GCW and GWW were significantly more effective than GLS and left ventricular ejection fraction in diagnosing left ventricular function impairment in patients with hypertensive disorder complicating pregnancy,especially GCW and GWW,with areas under the curve of 0.766 and 0.882,respectively.The

关 键 词：超声心动描记术 左室压力-应变环 妊娠期高血压疾病 收缩功能 心室 左 

分 类 号：R540.45[医药卫生—心血管疾病] R714.25[医药卫生—内科学]