早发型重度子痫前期患者心脏构型和功能及其与脑钠肽浓度的相关性研究

Correlation between Cardiac Characteristics of Structure and Function and Plasma Brain Natriuretic Peptide Concentration in Early Onset Severe Preeclampsia

目的:研究早发型重度子痫前期患者心脏构型和心脏功能及其与血浆脑钠肽(BNP)水平的相关性。方法:对早发型重度子痫前期患者(研究组)30例、正常晚期妊娠孕妇(对照组)30例应用彩色多普勒超声测定并比较两组心脏构型及功能指标:左室舒张末期室间隔厚度(IVST)、左室后壁厚度(LVP-WT)、左室内径(LVD)、左房收缩末期内径(LAD)、左室射血分数(EF)、心输出量(CO)、心脏指数(CI);舒张早期最大流速(E峰)、舒张晚期最大流速(A峰)、E/A比值;用ELISA法测定两组血浆BNP浓度,并分析其与心脏构型及左心室功能的相关性。结果:研究组LAD、IVST、LVP-WT及LVD均显著高于对照组,差异有统计学意义(P<0.05);研究组EF、CO、CI、E、A、E/A与对照组比较,差异有统计学意义(P<0.05)。研究组血BNP浓度与对照组比较,差异有统计学意义(P<0.05)。研究组EF及E/A与BNP浓度呈负相关(r=-0.49,P<0.05;r=-0.38,P<0.05);对照组EF与BNP浓度呈正相关(r=0.45,P<0.05)。结论:早发型重度子痫前期患者彩超检查提示心脏结构异常、心脏功能受损,孕妇血浆BNP浓度水平能在一定程度上反应孕妇心脏功能状态。

Objective：To assess the correlation between cardiac characteristics of structure and function and plasma level of plasma brain natriuretic peptide（BNP） in patients with early onset severe preeclampsia（ EOSP）. Methods-Color Doppler ultrasonography was used to assess the cardiac characteristics of structure and function, including left atrial end systolic diameter（LAD） ,interventrieular septum thickness（IVST） ,left ventrieular posterior wall thickness（ LVP-WT）, left ventricular diastolic diameter （ LVD ）, ejection fraction （ EF）, cardiac output （ CO ）, cardiac index（CI） ,diastolic function indexes E peak,A peak and E/A ratio. The plasma BNP level was tested by enzyme-linked immunosorbent assay （ELISA） among 30 pregnant women with EOSP, 30 normal pregnant women, And we assessed the relationship between the left ventricular diastolic function and plasma level of plasma brain natriuretic peptide（BNP）. Results.The parameters such as LAD, IVST, LVP-WT,and LVD of the EOSP patients were significantly lower than those of the normal pregnant women （ P 〈 0.05）. The parameters such as EF,CO,CI,and diastolic function indexes E peak,A peak and E/A ratio of the EOSP patients were significantly higher than those of the normal pregnant women （ P 〈 0. 05）. The BNP concentration of EOSP women was signifi- cantly higher than that of the normal pregnant women（ P 〈0.05）. The BNP of early onset preeclampsia patients was negative correlated with E/A and EF （ r = - 0.49, P 〈 0. 05; r = - 0.38, P 〈 0.05 ）. There was a significant positive correlation between EF and BNP concentration in the control group （ r = 0. 45, P 〈 0.05 ）. Conclusions： Color Doppler ultrasound examination could reveal abnormal cardiac structure, cardiac function damage in patients with EOSP. The plasma BNP level of pregnant women could also reflect the cardiac function.