子痫前期孕妇超声心动图改变与N端脑利纳肽前体水平的临床分析

Clinical analysis of changes in echocardiography and myocardial enzymes in pregnant women with hypertensive disorder complicating pregnancy

目的探讨子痫前期孕妇超声心动图改变与N端脑利纳肽前体(NT-proBNP)水平的相关性及临床意义。方法将2016年2月至2018年7月松岗人民医院妇产科诊治的65例子痫前期孕妇分为轻度子痫前期组(35例)、重度子痫前期组(30例),同期选取该院健康妊娠孕妇35例为对照组。比较各组孕妇超声心动图及NT-proBNP的差异,分析妊娠结局。结果重度子痫前期组左心房收缩末期内径(LADs)、左室舒张末期内径(LVDd)、左室收缩末期内径(LVDs)、二尖瓣口舒张早期速度峰值(E)及其与收缩期二尖瓣环室间隔部运动速度峰值(Ea)的比值(E/Ea)及NT-proBNP均明显高于轻度子痫前期组及对照组,轻度子痫前期组高于对照组,差异均有统计学意义(P<0.05);重度子痫前期组Ea值、左室射血分数(LVEF)明显低于轻度子痫前期组及对照组,轻度子痫前期组低于对照组,差异均有统计学意义(P<0.05)。子痫前期孕妇超声心动图指标LADs、LVDd、LVDs、E、E/Ea与NT-proBNP均呈显著正相关(r=0.566,0.615,0.602,0.537,0.685,P<0.05),LVEF及Ea均与NT-proBNP均呈显著负相关(r=-0.586,-0.583,P<0.05)。重度子痫前期组胎儿生长受限(FGR)、早产及胎盘早剥的比例均明显高于轻度子痫前期组及对照组,差异有统计学意义(P<0.05)。结论子痫前期孕妇超声心动图指标与血清NT-proBNP水平均会发生变化,且呈一定的相关性,并对妊娠结局有不利影响。

Objective To investigate the changes and clinical significance of echocardiography and myocardial zymogram in pregnant women with gestational hypertension.Methods From February 2016 to July 2018,65 pregnant women with preeclampsia were divided into mild preeclampsia group(35 cases)and severe preeclampsia group(30 cases),35 normal pregnant women were selected as the control group.The differences of echocardiography and NT-proBNP betweenthem were analyzed.Results LADs,LVDd,LVDs,E peak,E/Ea ratio and NT-proBNP in severe preeclampsia group were significantly higher than those in mild preeclampsia group and control group,those in mild preeclampsia group were higher than the control group,the difference had statistically significant(P<0.05).LVEF was significantly lower in mild pre-eclampsia group and control group,mild pre-eclampsia group was lower than the control group,the difference had statistically significant(P<0.05).LADs,LVDd,LVDs,E,E/Ea were positively correlated with NT-proBNP(r=0.566,0.615,0.602,0.537,0.685,P<0.05),LVEF and Ea were negatively correlated with NT-proBNP(r=-0.586,-0.583,P<0.05).The proportion of FGR,premature delivery and placental abruption in severe preeclampsia group were significantly higher than the mild preeclampsia group and control group(P<0.05).Conclusion NT-proBNP and echocardiography in pregnant women with preeclampsia will change and have adverse effects on the outcome of pregnancy.