胎儿心脏定量分析技术对妊娠期高血压患者胎儿早期心功能损害的评估  

Assessment of early fetal cardiac function impairment in patients with gestational hypertension

作　　者：杨道玲 周一波[1] 王戏丹 陈静婉 陈傅华 陶肖樱 YANG Daoling;ZHOU Yibo;WANG Xidan;CHEN Jingwan;CHEN Fuhua;TAO Xiaoying(Department of Ultrasound Medicine,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,Zhejiang,China;Department of Ultrasound,Jinhua Maternal and Child Health Care Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]浙江大学医学院附属金华医院超声医学科,浙江金华321000 [2]金华市妇幼保健院超声医学科,浙江金华321000

出　　处：《中国现代医生》2025年第2期20-23,共4页China Modern Doctor

基　　金：浙江省医药卫生厅科技项目(2024KY500);浙江省金华科技局重点项目(2021-3-125)。

摘　　要：目的探讨胎儿心脏定量分析(heart quantification,HQ)技术评估妊娠期高血压(gestational hypertension,GH)患者胎儿心脏形态和功能的临床应用价值。方法选取2020年3月至2024年3月孕龄20~40周GH孕妇85例作为观察组,根据孕妇的血压、尿蛋白及症状将观察组分为GH组35例,子痫前期轻度(mild preeclampsia,MPE)组28例、子痫前期重度(severe preeclampsia,SPE)组22例,另采用随机数字表法选择孕龄匹配的正常孕妇150名作为对照组;应用胎儿HQ技术获取两组胎儿心脏形态指标和功能指标并进行统计分析。结果各组胎儿四腔心整体球形指数(global spherical index,GSI)差异有统计学意义(P<0.05),SPE组胎儿心脏更圆。各组患者面积变化率(fractional area change,FAC)、心肌做功指数(myocardial performance index,MPI,又称Tei指数)、整体纵向应变(global longitudinal strain,GLS)、右心室Tei指数比较,差异有统计学意义(P<0.05)。SPE组、MPE组胎儿的右心室GLS绝对值低于对照组,SPE组胎儿右心室Tei指数大于对照组。结论胎儿HQ技术可快速、方便地定量评估胎儿心脏形态和功能。GH不仅使胎儿心脏形态发生变化,且影响胎儿心脏功能,对胎儿右心系统的影响大于左心室。Objective To explore clinical application value of fetal heart quantification(HQ)technology in evaluating morphology and function of fetal heart in gestational hypertension pregnancy patients.Methods A total of 85 women with gestational hypertension(GH)during gestational age of 20-40 weeks from March 2020 to March 2024 had been selected as experimental group.According to blood pressure,urine protein,and symptoms of pregnant women,experimental group was divided into GH group(n=35),mild preeclampsia(MPE)group(n=28),and severe preeclampsia(SPE)group(n=22).Additionally,150 normal pregnant women with matched gestational age were randomly selected as control group.Fetal HQ technique was adopted to obtain cardiac morphological and functional indicators of groups,and statistical analysis was conducted.Results There was statistically significant difference in global spherical index(GSI)in each group(P<0.05).Patients in SPE group had rounder fetal hearts.Bariance analysis was performed on fractional area change(FAC),Tei index,and global longitudinal strain(GLS)for each group of patients.There were statistically significant differences in right ventricular GLS and right ventricular Tei index(P<0.05).The absolute value of right ventricular GLS in SPE group and MPE group was lower than that in control group,while right ventricular Tei index in SPE group was higher than that in control group.Conclusion Fetal HQ technique provides quick and easy quantitative assessment of fetal heart shape and function.Gestational hypertension not only changes the fetal heart morphology,but also affects the fetal heart function,and the fetal right heart system is more affected than the fetal left heart.

关 键 词：妊娠期高血压 胎儿心脏定量分析 面积变化率 整体球形指数 

分 类 号：R714.24[医药卫生—妇产科学]