右心室Tei指数联合右心室缩短分数、下腔静脉相关参数评价妊娠期高血压疾病胎儿右心功能

Application of TDI Tei index combined with shortening fraction and inferior vena cava index in the evaluation of right ventricular function of fetuses in women with hypertensive disorder complicating pregnancy

目的综合右心室Tei指数、右心室缩短分数（ shortening fraction, SF）、下腔静脉相关参数3项指标评价妊娠期高血压疾病（hypertensive disorder complicating pregnancy, HDCP）胎儿右心功能的改变。方法选择孕龄为28～39＋6周孕妇175例为研究对象，其中HDCP患者59例作为疾病组，血压正常孕妇115例作为对照组，将所有病例再按照孕周分为28—31＋6周组、32—35＋6周组、36—39＋6周组。首先应用组织多普勒（TDI）技术分别测量胎儿右心室等容收缩时间（ICT）、等容舒张时间（IRT）及射血时间（ET），计算Tei指数；再分别测量胎儿右心室sF、下腔静脉相关参数，最后通过以上参数综合评价HDCP胎儿右心功能的改变。结果28—31＋6周组、32—35＋6周组、36～39＋6周组各疾病组胎儿右心室Tei指数、下腔静脉相关参数与对照组相比增高（P〈0．05），各疾病组胎儿右心室sF与对照组相比差异无统计学意义（P〉0．05）。结论。综合HDCP胎儿右心室Tei指数及右心室sF、下腔静脉相关参数3项指标，对临床诊断及治疗HDCP胎儿官内缺氧、心功能异常，降低围产儿死亡率意义重大。

Objective To investigate the changes of the right ventricular function of fetuses in women with hyperten- sive disorder complicating pregnancy （HDCP） using tissue doppler imaging （TDI） Tel index, right ventricular shortening fraction （SF） and inferior vena cava index. Methods A total of 175 pregnant women at the gestional age of 28 - 39 ＋6 weeks were enrolled, including 59 HDCP patients （a disease group） and 115 pregnant women with normal hypertension （a control group）. They were then divided into three groups according to their gestional weeks： 28 -31 ＋6 weeks, 32 - 35 ＋6 weeks and 36 - 39 ＋6 weeks. The isovolumic contraction time （ ICT）, isovolumie relaxation time （IRT） and ejection time （ET） of the right ventricle in each fetus were measured by TDI, while Tel index was calculated. Then, the right ventricular SF and inferior vena cava index were measured to evaluate the changes of the right ventricular function. Re- suits Compared with the control group, pregnant women at the gestional age of 28 -31 ＋6 weeks, 32 -35 ＋6 weeks and 36 -39 ＋6 weeks showed remarkable increases in TDI -Tei index and inferior vena cava index （P 〈 0.05 ）, while no sta- tistical difference was found in the right ventricular SF （P 〉 0.05）. Conclusions TDI - Tei index, shortening fraction and inferior vena cava index can be used in combination to diagnose and treat fetuses in HDCP patients.