M型血流传播速度评价妊娠高血压孕妇的胎儿心室舒张功能的价值

Evaluation of fetal ventricular diastolic function of pregnant women with hypertensive disorder complicating pregnancy by color M-mode propagation velocity

目的应用M型血流传播速度(Vp)检测评价妊娠高血压孕妇的胎儿心室舒张功能。方法选取2016年8月至2017年12月在我院就诊的妊娠高血压综合征孕妇70例,包括妊娠高血压(GH组)34例、子痫前期轻度(M-PE组)24例、子痫前期重度(S-PE组)12例,正常血压孕妇为对照组60名,进行胎儿超声心动图检查,测量并比较各组间左、右心室舒张早期Vp值的差异性。结果 GH组胎儿左、右心室Vp值与健康对照组差异无统计学意义(P>0.05);子痫前期(M-PE组、S-PE组)胎儿左、右心室Vp值均分别低于健康对照组,差异有统计学意义(P<0.01);S-PE组胎儿左、右心室Vp值低于M-PE组,差异有统计学意义(P<0.01)。结论应用M型彩色多普勒测量Vp值,有助于及早发现妊娠高血压孕妇的胎儿心室舒张功能异常;子痫前期可引起胎儿心功能异常,导致心室Vp升高,并且严重程度越高,影响越大。

Objective To evaluate fetal ventricular diastolic function of pregnant women with hypertensive disorder complicating pregnancy by color M-mode propagation velocity(Vp). Methods Seventy hypertensive disorder complicating pregnant women(including 34 with gestational hypertension,24 with mild pre-eclampisa and 12 with severe preeclampsia) and 60 normotensive pregnant women(normal control group) between August 2016 and December 2017 were enrolled in this study. They all had fetal echocardiography examination and left and right ventricular Vp in early diastole were measured and compared among groups. Results Compared to the normal control group,there was none statistically significant difference in left and right ventricular Vp in gestational hypertension group(P > 0. 05). However,there were significant decreases for left and right ventricular Vp in mild pre-eclampisa group and severe pre-eclampisa group(P <0. 01 for both). Left and right ventricular Vp in severely pre-eclampsia group were significantly lower than those in mild pre-eclampisa group(P < 0. 01). Conclusion The application of color M-mode propagation velocity to measure ventricular Vp in early diastole is helpful for early detection of fetal abnormal ventricular diastolic function in pregnant women with hypertensive disorder complicating pregnancy. Pre-eclampsia can impair the ventricular diastolic function of the fetuses,which leads to the decrease of ventricular Vp. Meanwhile,the lower the Vp,the greater the severity.