组织多普勒Tei指数在妊娠高血压疾病胎儿左心功能评价的应用研究

Application of tissue Doppler Tei index in the evaluation of fetal left ventricular function in pregnancy-induced hypertension

目的:通过胎儿左心组织多普勒Tei指数评估妊娠高血压疾病胎儿左心功能。方法:将130例妊娠高血压疾病孕妇分为子痫前期轻度组84例及子痫前期重度组46例,另选取130例孕龄匹配的正常孕妇为对照组,应用组织多普勒技术测量胎儿左心室等容收缩时间(ICT)、等容舒张时间(IRT)及射血时间(ET),计算Tei指数。同时获取胎儿脐动脉及孕妇子宫动脉频谱并观察其形态。结果:子痫前期轻度组Tei指数与对照组比较,差异无统计学意义(P>0.05);子痫前期重度组Tei指数与对照组及子痫前期轻度组比较,差异均有统计学意义(P<0.05);比较子痫前期轻度及重度组患者脐动脉异常(舒张期血流缺失或反向血流)的发生率,差异有统计学意义(χ~2=11.33,P<0.01);比较子痫前期轻度及重度组孕妇子宫动脉舒张早期切迹的发生率,差异有统计学意义(χ~2=8.20,P<0.01)。结论:左心组织多普勒Tei指数能够准确判断妊娠高血压疾病胎儿左心整体功能改变,为临床提供客观诊疗依据。

Objective:To evaluate fetal left ventricular function in patients with pregnancy-induced hypertension by using the tissue Doppler Tei index.Methods:One hundred and thirty pregnant women with hypertension were enrolled,including 84 cases of mild preeclampsia and 46 cases of severe preeclampsia.One hundred and thirty pregnant women with matching gestational age were selected as the control group.Tissue Doppler parameters were measured including isovolumetric time(ICT),isovolumetric relaxation time(IRT)and ejection time(ET),and the Tei index was calculated.Both fetal umbilical arteries spectrum and pregnant women’s uterine arteries spectrum were acquired.Results:There was no significant difference in the Tei index between the mild preeclampsia group and the the control group(P>0.05).There was significant difference in Tei index between severe preeclampsia group and control group and mild preeclampsia group(P<0.05).There was significant difference in the incidence of umbilical artery abnormalities beweeen mild preeclampsia group and severe preeclampsia group(χ~2=11.33,P<0.01).There was significant difference in the incidence of early diastolic notch of uterine arteries in pregnant women between mild and severe preeclampsia groups(χ~2=8.20,P<0.01).Conclusion:By measuring the tissue Doppler Tei index of fetal left ventricular during pregnancy-induced hypertension,the fetal left ventricular function can be estimated,which can provide clinical diagnosis and treatment basis.