Tei指数在重度子痫前期胎儿右心功能评价中的应用

Application of Tei index in the evaluation of the influence of severe preeclampsia on fetal right cardiac function

目的：探讨重度子痫前期对胎儿右心功能的影响,评价其临床治疗意义。方法选择2010年6月~2014年6月四川省宜宾市第二人民医院（以下简称“我院”）重度子痫前期孕晚期（孕龄〉28周）患者16例为研究组；同时选取孕28＋周健康孕妇50例作为对照组。比较分析两胎儿右心室Tei指数、等容收缩时间（ICT）、等容舒张时间（IRT）、右室射血时间（RVET）。给予研究组孕妇镇静、解痉、降压、利尿等治疗,比较分析治疗前及治疗后48、72 h胎儿右心室Tei指数。结果研究组右心室Tei指数[（0.58±0.07）比（0.43±0.03）]、ICT[（52.15±9.11）比（38.12±7.83）ms]、IRT [（46.94±8.19）比（35.01±6.67）ms]均明显高于对照组,差异均有高度统计学意义（P 〈0.01）；右室射血时间（RVET）与对照组比较有所降低[（168.15±9.78）比（173.41±5.31）ms],但差异无统计学意义（P〉0.05）。研究组16例患者中,3例治疗后48 h内终止妊娠,2例治疗后右心室Tei指数无明显变化,余11例经治疗后48 h,胎儿右心室Tei指数为（0.46±;0.05）,较治疗前（0.49±0.06）降低,差异有统计学意义（P〈0.05）。治疗后72 h胎儿右心室Tei指数为（0.44±0.03）,较治疗前及治疗后48 h降低,且与治疗前比较,差异有统计学意义（P〈0.05）。结论重度子痫前期胎儿右心功能整体受损,治疗后胎儿右心室Tei指数虽有所降低,但仍明显高于正常水平,提示短时间恢复重度子痫前期胎儿右心功能存在较大困难。

Objective To discuss the influence of severe preeclampsia on the right cardiac function of fetus, and evaluate the clinical significance. Methods 16 cases of later pregnancy （〉28 weeks） with severe preeclampsia from June 2010 to June 2014 in the Second People＆#39;s Hospital of Yibin City （“our hospital” for short） were selected as study group, and 50 healthy with gestational age of 28＋ weeks in our hospital at the same period were selected as control group. Fetal right ventricular Tei index, ICT, IRT, RVET of two groups were compared and analyzed. Pregnant women of the study group were given the treatment of calm, spasmolysis, decompression, diuresis therapy, fetal right ventricular Tei inde before and 48、72 h after treatment of the study group were compared. Results Compared with the control group, fetal right ventricular Tei index [（0.58±0.07） vs （0.43±0.03）], ICT [（52.15±9.11） vs （38.12±7.83） ms], IRT [（46.94±8.19） vs （35.01±6.67） ms] of the study group were significantly higher than those of the control group （P〈0.01）. The RVET of fetus in study group was shorter than that of the control group [（168.15±9.78） vs （173.41±5.31）ms], but there was no statistically significant difference （P〉0.05）. Among 16 cases of the study group, 3 cases end the pregnancy 48 h after treatment, fetal right ventricular of 2 cases did not change after treatment, fetal right ventricular of other 11 cases 48 h after treatment was （0.46±0.05）, decreased compared with before treatment （0.49±0.06）, the difference was statistically significant （P〈 0.05）. 72 h after treatment, the fetal right ventricular was （0.44±0.03）, decreased compared with before treatment and 48 h after treatment, and compared with before treatment, the difference was statistically significant （P〈0.05）. Conclusion Right ventricular function of SPE fetal is impaired, fetal right ventricular Tei index is reduced to some extent after the treatment, but still significantly higher than the normal level. It is difficult to recover the severe preeclampsia fetal right ventricular function in a short time.