超声心动图评估利托君防治早产时对孕妇心脏结构及功能的影响

Effect of ritodrine on heart structure and function of pregnant women who after treatment for threat of preterm birth: A report based on echocardiographic assessment

目的:研究超声心动图评估利托君防治早产时对妊娠者心脏结构及功能可能产生的影响。方法:选取因有早产征象来本院就诊住院且无利托君应用禁忌证中晚期妊娠者共112例,首先根据妊娠者用药时间及妊娠数目不同分组:A组(首次应用利托君48 h,双胎妊娠)、B组(末次应用利托君,双胎妊娠)、C组(首次应用利托君48 h,单胎妊娠)、D组(末次应用利托君,单胎妊娠)4组;其次将单胎妊娠者按照用药时间及孕妇年龄不同分组:E组(首次应用利托君48 h,单胎适龄)、F组(末次应用利托君,单胎适龄)、G组(首次应用利托君48 h,单胎高龄)、H组(末次应用利托君,单胎高龄)4组。应用超声心动图对妊娠者进行检查,记录心脏各项参数(左房收缩末期前后径、左房收缩末期左右径、左室舒张末期内径、右房舒张末期内径、右室舒张末期内径、室间隔厚度、左心室后壁厚度、左心室射血分数、舒张早期最大峰值流速、舒张晚期最大峰值流速、收缩期主动脉瓣最大峰值流速、三尖瓣反流速度、心包积液)进行比较。结果:A组与B组心脏各项参数比较,差异无统计学意义(P>0.05);A组与C组比较,LAD1、LVD、EF间差异有统计学意义(P<0.05);C组与D组比较,仅E峰间差异有统计学意义(P<0.05);E组与G组比较,仅PE间差异有统计学意义(P<0.05);F组与H组比较,LVD、E峰、TRVmax之间差异有统计学意义(P<0.05);其余各项比较差异无统计学意义(P>0.05)。结论:应用利托君防治早产期间孕妇心脏结构及功能可能发生一定变化,超声心动图检查可以早期发现孕妇心脏结构、大小和功能变化。

Objective: To evaluate the possible effects of ritodrine on the heart structure and function of pregnant women who had threat of preterm birth by echocardiography. Methods:From September 2012 to December 2018, 112 women in the second and third trimester pregnancy with sign and symptom of preterm birth were included,and those with contraindication to ritodrine and other several diseases were excluded.Firstly they were divided into four groups according to the time of medication and number of fetuses.Group A: Ritodrine was first used 48 h in twin pregnancies;Group B: Ritodrine was last used in twin Pregnancy;Group C: Ritodrine was used 48 h for the first time in single Pregnancy.Group D:Ritodrine was used for the last time in single pregnancy. Secondly, singleton pregnancies were divided into four groups according to the time of medication and the age of pregnant women.Group E: Ritodrine was first used 48 h to singleton pregnancy with normal age.;Group F: Ritodrine was last used to singleton pregnant women with normal age;Group G: Ritodrine was first used 48 h to singleton pregnancy with older age;Group H: Ritodrine was last used to singleton pregnant women with older age.Ehocardiography were used to examine the hearts of pregnant women,and relevant parameters were filed,including LAD1, LAD2, LVD, RA, RVD, IVST, LVPWT, EF, E peak, A peak, AVmax,TRVmax,and PE.Results:Compareing the heart parameters between group A and group B,there were no significant difference(all P>0.05);there were significant differences among LAD1, LVD,and EF between group A and group C(P<0.05);there was significant difference in E peak between group C and group D(P<0.05);Compareing group E with group G,there was only significant difference in PE(P<0.05);Compareing with group H,LVD, E peak and TRVmax in group F,there was significant differences(P<0.05).Comparing the rest items,there was no significant difference(all P>0.05).Conclusion: The use of ritodrine for the treatment of preterm birth may bring effect on the heart structure and function of pregnant women,and echocardiography can early find and assess the changes of maternal heart structure and function.