彩色M型多普勒评价妊娠期高血压疾病左室舒张功能的研究

Assessment left ventricular diastolic function by Color M-mode Doppler in pregnant women with hypertensive disorder complicating pregnancy

目的评价妊娠期高血压疾病左室形态及功能变化,并探讨彩色M型多普勒测量舒张早期左室内血流传播速度(FPV)评价妊娠期高血压疾病患者早期左室舒张功能异常的临床意义。方法97例妊娠期高血压患者、94例轻度子痫前期患者、95例重度子痫前期患者和101例血压正常孕妇(对照组)。运用超声心动图测量左室形态和功能参数,包括左室前后径(LVDd)、室间隔厚度(IVSd)、左室后壁厚度(LVPWd)、相对室壁厚度(RWT)和左室质量指数(LVMI);射血分数(LVEF)、二尖瓣瓣口舒张早期E波峰值流速(VE)、舒张晚期A波峰值流速(VA)、E波与A波峰值流速比值(VE/VA);舒张早期左室血流传播速度。结果与对照组比较,重度子痫前期组左室形态各参数明显大于正常对照组,差异有统计学意义(P<0.01)。左室功能参数与对照组比较,轻度子痫前期组FPV减低,差异有统计学意义(P<0.05);重度子痫前期组VE/VA、FPV减低,VA增高,差异有统计学意义(P<0.05)。结论妊娠期高血压疾病可以导致左室形态和舒张功能发生变化,并且左室舒张功能可先于左室形态发生改变,FPV可以作为评价左室舒张功能的早期敏感指标。

Objective:To assess the change of left ventricular morphology and function in hypertensive disorder complicating pregnancy,and to investigate the clinical value of left ventricular flow propagation velocity in early diastole(FPV)measured by color M-mode Doppler in evaluating early left ventricular diastolic?dysfunction in patients with hypertensive disorder complicating pregnancy.Methods:There were 97 cases of pregnancy induced hypertension,94 cases of mild preeclampsia,95 cases of severe preeclampsia and 101 cases of normotensive pregnant women(control group)in this study.the parameters of left ventricular structure and function were measured by using echocardiography,including left ventricular diameter(LVDd),interventricular septal thickness(IVSd),left ventricular posterior wall thickness(LVPWd),relative wall thickness(RWT)and left ventricular mass index(LVMI);left ventricular ejection fraction(LVEF),E wave peak velocity of mitral valvular flow(VE),A wave peak velocity of mitral valvular flow(VA),VE/VA,Left ventricular flow propagation velocity in early diastole(FPV).Results:Compared with the control group,the parameters of left ventricular morphology in severe preeclampsia group were significantly increased,the difference was statistically significant(P<0.01);In mild preeclampsia group FPV decreased,the difference was statistically significant(P<0.05).In severe preeclampsia group VE/VA,FPV decreased,VA increased,the difference was statistically significant(P<0.05).Conclusions:Hypertensive disorder complicating pregnancy can lead to changes in the morphology and function of the left ventricle,and left ventricular function can be changed ahead of left ventricular morphology.FPV can be used as an early sensitive index for evaluating left ventricular diastolic function.