应用组织运动二尖瓣环位移技术评估单胎及双胎妊娠孕妇左心室功能的研究  

Evaluation of Left Ventricular Function in Singleton and Twin Pregnancy by Tissue Tracking Mitral Annular Displacement

作　　者：刘惠娟 徐瑞 吴阳 于亚萍 李炎菲海 纪学芹 Liu Huijuan;Xu Rui;Wu Yang;Yu Yaping;Li Yanfeihai;Ji Xueqin(General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Ultrasound Medicine,Peking University First Hospital Ningxia Women and Children's Hospital,Yinchuan 750001,China)

机构地区：[1]宁夏医科大学总医院,银川市750004 [2]北京大学第一医院宁夏妇女儿童医院超声医学科,银川市750001

出　　处：《中国超声医学杂志》2024年第7期775-778,共4页Chinese Journal of Ultrasound in Medicine

基　　金：2022年度宁夏回族自治区重点研发计划(No.2022CMG02023)。

摘　　要：目的 应用组织运动二尖瓣环位移(TMAD)评估单胎及双胎妊娠孕妇左心室功能,探讨其在左心功能评价方面的应用价值。方法 纳入北京大学第一医院宁夏妇女儿童医院超声医学科定期产检的孕妇共139例,正常单胎妊娠孕妇87例,正常双胎妊娠孕妇41例,双胎妊娠并发症孕妇11例,孕期行常规超声心动图及TMAD定量评估左心室功能。结果 (1)正常双胎妊娠孕妇检查时体质量、体质量指数均明显高于单胎妊娠孕妇(P<0.05)。(2)双胎并发症孕妇组左心室舒张功能IVSe′低于单胎正常孕妇组及双胎正常孕妇组(P<0.05);左心室舒张功能IVSa′双胎并发症孕妇组低于双胎正常孕妇组,双胎正常孕妇组高于单胎正常孕妇组(P<0.05);双胎正常孕妇组侧壁a′高于单胎正常孕妇组(P<0.05)。(3)TMAD所测左心室收缩功能参数中,双胎并发症孕妇组二尖瓣环室间隔点最大位移(TMAD-sep)高于双胎正常孕妇组,双胎正常孕妇组高于单胎正常孕妇组(P<0.01);双胎正常孕妇组侧壁点最大位移(TMAD-lat)、室间隔-侧壁点连线中点最大位移(TMAD-midpt)及其占左心室长径百分比(TMAD-midpt%)均高于单胎正常孕妇组(P<0.01)。结论 TMAD定量评估左心室收缩功能具有更高的灵敏度,TMAD与常规超声心动图定量方法相比对图像的质量要求低、测量简便,可用作为评估孕妇左心室功能的指标,TMAD-sep是可以反映左心室收缩功能异常的敏感指标。Objective To evaluate the left ventricular function of singleton and twin pregnant women by tissue tracking mitral annulus displacement(TMAD),and to explore its application value in the evaluation of left ventricular function.Methods The pregnant women who were included in the regular prenatal ultrasound examination in the Department of Ultrasound Medicine of Peking University First Hospital Ningxia Women and Children′s Hospital,139 pregnant women were enrolled,including 87 normal singleton pregnant women,41 normal twin pregnant women and 11 pregnant women with complicated twin pregnancy.The left ventricular function was quantitatively evaluated by routine echocardiography and tissue tracking mitral annulus displacement during pregnancy.Results Left ventricular diastolic function(IVSe′) of complicated pregnant women with twins was lower than that of the group with normal singletons or normal twins.IVSa′ in the group with complicated twins was higher than that of the group with normal twins.Lateral wall a′ of the group with normal twins was higher than that of the group with normal singletons.The parameters of left ventricular systolic function measured by TMAD,such as TMAD-sep was higher in the complicated twins group than those in the normal twins group,while the normal twins group had higher TMAD-sep than in the group with singleton.TMAD-lat,TMAD-midpt and TMAD-midpt% were all higher in the group with normal twins than those with normal singleton pregnancy,with the difference being statistically significant.Conclusions TMAD is more sensitive in quantitative evaluation of left ventricular systolic function.Compared with the conventional echocardiographic quantitative methods,TMAD has lower requirements for image quality,simple measurement,so it can be used as an index to evaluate left ventricular function in pregnant women.TMAD-sep is a sensitive indicator that can reflect abnormal left ventricular systolic function.

关 键 词：组织运动二尖瓣环位移 双胎妊娠 左心功能 超声心动图 

分 类 号：R714.2[医药卫生—妇产科学] R540.45[医药卫生—临床医学]