多普勒超声评价妊娠期高血压疾病胎儿心功能的研究

Investigation of Doppler ultrasonography on evaluation of fetal cardiac function in gestational hypertension

目的探讨多普勒超声对妊娠期高血压疾病孕妇胎儿心功能评价的临床价值。方法将研究对象分为两组:30例妊娠期高血压孕妇为观察组,30例健康孕妇为对照组。多普勒超声观测胎儿二尖瓣环、三尖瓣环舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)、收缩期运动速度(Sa),计算舒张早期/舒张晚期灌注血流峰速比值(E/A)及舒张早期/舒张晚期心肌运动速度(Em/Am);同时检测两组孕妇胎儿心脏结构以及射血分数。结果两组胎儿三尖瓣环Ea、Aa及Sa均大于二尖瓣环运动(P<0.05);观察组胎儿的二尖瓣环、三尖瓣环Ea、Aa及Sa均低于对照组(P<0.05);两组差异有统计学意义。两组胎儿在LVDs、LVDd、IVSd比较中,差异无统计学意义(P>0.05);在RVDs、RVDd、IVSs、LVEF等指标比较中,观察组胎儿数值明显高于对照组,有明显的差异有统计学意义(P<0.05)。结论多普勒超声能检出胎儿二尖瓣环、三尖瓣环运动速度差异及心脏结构、心功能改变情况,在评价妊娠期高血压疾病对胎儿心脏功能的影响方面具有一定的临床价值。

Objective To investigate the clinical value of Doppler ultrasound in evaluating fetal heart function in pregnant women with gestational hypertension. Methods The subjects was divided into two groups: 30 pregnant women with gestational hypertension as observation group and 30 healthy pregnant women as control group. The fetal mitral annulus and tricuspid annulus were observed and the velocity of early diastolic motor(Ea), late diastolic motor(Aa), systolic motor(Sa) were measured by tissue Doppler ultrasound, the peak velocity of mitral orifice forward flow was measured by Doppler ultrasound and the E/A ration was calculated, myocardial velocity was measured by tissue doppler and the value of early diastolic/late diastolic myocardial motion(Em/Am) was calculated;at the same time the fetal cardiac structure and left entricular ejection fraction of the two groups were detected. Results The tricuspid annulus Ea, Aa and Sa of the two groups were larger than those of mitral annulus(P<0.05). The value of mitral annulus and tricuspid annulus Ea, Aa and Sa in the observation group were lower than the control group, there was no statistical difference(P<0.05);There was no significant differences in the LVDs, LVDd, and IVSd between the two groups(P>0.05). In the comparison of RVDs, RVDd, IVSs, LVEF and other indicators, the value of the observation group was significantly higher than that of the control group, with statistically differences(P<0.05). Conclusion Doppler ultrasonography can detect the difference of fetal mitral annulus and tricuspid annulus velocity and the changes of cardiac structure and cardiac functio, which has certein clinical value in evaluating the effect of gestational hypertension on fetal cardiac function.