三维斑点追踪技术对重度子痫前期患者左心室收缩功能的评价

Evaluating left ventricular systolic function of patients with severe preeclampsia using three-dimensional speckle-tracking echocardiography

目的采用三维斑点追踪技术评估重度子痫前期(SPE)患者的左心室收缩功能。方法选择2015年8月至2016年10月在延安市人民医院就诊的48例SPE患者,其中早发型重度(EOSPE)17例,晚发型重度(LOSPE)31例,同期选择年龄和孕期匹配的正常孕妇的54例作为对照。采用三维斑点追踪技术测量所有孕妇左心室纵向应变(GLS)、左心室径向应变(GRS)、左心室圆周应变(GCS)及左心室面积应变(GAS)。结果与对照组比较,EOSPE组GLS、GCS以及GAS均显著减低(t值分别为3.682、2.415、2.118,均P<0.05),与对照组比较,LOSPE组GLS显著减低(t=2.418,P=0.007),GCS显著增加(t=2.607,P=0.019)。结论重度子痫前期患者的左心室收缩功能显著减低,其中早发型重度子痫前期表现出更差的心功能,三维斑点追踪技术是评价重度子痫前期亚临床心肌损伤的实用工具。

Objective To evaluate the left ventricular（ LV） systolic function of patients with severe preeclampsia（ SPE） using threedimensional speckle-tracking echocardiography（ 3D-STE）. Methods A total of 48 patients with SPE including 17 early-onset SPE（ EOSPE） and 31 late-onset SPE（ LOSPE） were selected,and at the same period 54 normal pregnant women matched with age and gestational stage were chosen in control group. Global longitudinal strain（ GLS）,global radial strain（ GRS）,global circumferential strain（ GCS） and global endocardial area strain（ GAS） of left ventricular of all pregnant women were measured using 3D-STE. Results Compared with the control group,GLS,GCS and GAS in EOSPE group were significantly lower（ t value was 3. 682,2. 415 and 2. 118,respectively,all P 0. 05）,and GLS in LOSPE group was significantly lower（ t = 2. 418,P = 0. 007） but GCS was significantly higher（ t = 2. 607,P = 0. 019）. Conclusion Systolic function of left ventricular in patients with SPE is degraded significantly,and patients with EOSPE show worse cardiac function. Three-dimensional speckle-tracking technique is practical in evaluating subclinical myocardial injury in SPE.