妊娠期高血压左室全容积成像与胎儿脐动脉血流关系的研究

Study on the relationship between left ventricular full-volume imaging of pregnant women with hypertension disorder complicating pregnancy and fetal umbilical artery blood flow

目的:探讨全容积三维超声心动图(FV3DE)评价妊娠期高血压疾病(HDCP)孕妇左室舒缩功能的临床价值及HDCP左室功能与胎儿脐动脉血流参数间的关系。方法:采用FV3DE测定HDCP组35例左室收缩舒张功能等参数,检测该组脐动脉频谱,并与正常妊娠组相应指标进行对照。结果:两组年龄、孕龄、心率比较差异无统计学意义(P>0.05)。与对照组比较,HDCP组MAP、TPR、LVM、LVEDV、LVESV增高,LVSV、PFR减低(P<0.05),LVCO、LVEF、PER略减低(P>0.05),脐血流PI、RI、S/D增高(P<0.05)。HDCP组LVCO与MAP、TPR呈显著负相关(P<0.01),与心率、LVM、LVEDV、LVSV、LVEF、PER呈显著正相关(P<0.01),PER与LVEF呈显著正相关(P<0.01)。HDCP组PI、RI、S/D与MAP、TPR、LVM、LVESV呈显著正相关(P<0.01),与LVSV、PFR呈显著负相关(P<0.01)。结论:FV3DE左室功能参数结合胎儿脐血流频谱可用于临床早期评估HDCP左室功能及胎儿宫内状态。

Objective： To explore the clinical value of full- volume three- dimensional echocardiography（ FV3DE） in evaluating left ventricular systolic and diastolic function of pregnant women with hypertension disorder complicating pregnancy（ HDCP） and the relationship between left ventricular function of pregnant women with HDCP and blood flow parameters of fetal umbilical artery. Methods： FV3 DE was used to detect parameters of left ventricular systolic and diastolic function of 35 pregnant women with HDCP（ HDCP group）,fetal artery spectrum was measured,then the results were compared with those of control group（ normal pregnant women）. Results： There was no statistically significant difference in age,gestational age and heart rate between the two groups（ P〈0. 05）. Compared with control group,MAP,TPR,LVM,LVEDV and LVESV in HDCP group increased,LVSV and PFR in HDCP group decreased,there were statistically significant differences（ P〈0. 05）; LVCO,LVEF and PER decreased slightly（ P〈0. 05）,PI,RI and S / D of umbilical blood flow increased（ P〈0. 05）. In HDCP group,LVCO was negatively correlated with MAP and TPR（ P〈0. 01）,while LVCO was positively correlated with heart rate,LVM,LVEDV,LVSV,LVEF and PER（ P〈0. 01）,there was a significant positive correlation between PER and LVEF（ P〈0. 01）. In HDCP group,PI,RI and S / D were significantly positively correlated with MAP,TPR,LVM and LVESV（ P〈0. 01）,while PI,RI and S / D were significantly negatively correlated with LVSV and PFR（ P〈0. 01）. Conclusion： Left ventricular function parameters detected by FV3 DE combined with fetal umbilical blood flow spectrum can be used for early evaluation of left ventricular function of pregnant women with HDCP and intrauterine fetal status.