妊娠期高血压病胎儿肺静脉血流参数评估左心舒张功能的价值

Value of fetal pulmonary venous blood flow parameters in the evaluation of left ventricular diastolic function in patients with hypertension disorder complicating pregnancy

目的探讨妊娠期高血压病(HDCP)胎儿肺静脉血流参数在左心舒张功能评估中的临床应用价值。方法选取我院收治的HDCP孕妇137例(病例组),其中HDCP 49例(A组)、轻度子痫前期46例(B组)、重度子痫前期42例(C组);另选同期健康孕妇40例(正常对照组)。各组胎儿均行超声心动图检查,比较其心房收缩期A峰流速、心室收缩期峰值流速、心室舒张期峰值流速、肺静脉搏动指数(PI)及肺静脉峰值流速指数(PVIV);分析病例组各血流参数的相关性。产后进一步将病例组新生儿分为窒息组26例和无窒息组111例,比较两亚组肺静脉血流参数的差异。结果病例组A峰流速低于正常对照组,PI和PVIV均高于正常对照组,差异均有统计学意义(均P<0.05);病例组A峰流速在A、B、C组呈降低趋势(P<0.05),PI和PVIV在A、B、C组呈升高趋势(P<0.05),组间两两比较差异均有统计学意义(均P<0.05)。Pearson相关分析显示,病例组A峰流速与PI和PVIV均呈负相关(r=-0.724、-0.639,均P<0.05)。产后窒息组A峰流速低于无窒息组,PI和PVIV均高于无窒息组,差异均有统计学意义(均P<0.05)。结论肺静脉血流参数可准确评估HDCP胎儿左室舒张功能,为临床干预提供可靠依据,具有较好的临床应用价值。

Objective To investigate the clinical application value of fetal pulmonary vein(PV)blood flow parameters in the assessment of left ventricular diastolic function in patients with hypertension disorder complicating pregnancy(HDCP).Methods A total of 137 cases(disease group)of HDCP admitted to our hospital were selected,including 49 cases of HDCP(group A),46 cases of mild preeclampsia(group B),42 cases of severe preeclampsia(group C),40 cases of healthy pregnant women(control group)were selected from our hospital during the same period.The PV blood flow parameters in each group were compared,including peak atrial systolic velocity,peak ventricular systolic velocity,peak ventricular diastolic velocity,pulmonary vein pulsation index(PI),peak pulmonary vein velocity index(PVIV)by ultrasound examination.After delivery,the fetus of case group were divided into asphyxia group(26 cases)and non-asphyxia group(111 cases),and the differences of PV blood flow parameters between the two subgroups were compared.Results The peak atrial systolic velocity of the disease group was lower than that of the control group,PI and PVIV were higher than those of the control group,the differences were statistically significant(all P<0.05).The peak atrial systolic velocity showed a decreasing trend in the group A,B and C(P<0.05),PI and PVIV showed an increasing trend in group A,B and C(P<0.05),there were significant difference between the two groups(all P<0.05).Pearson correlation analysis showed that the peak atrial systolic velocity of the disease group was negatively correlated with PI and PVIV(r=-0.724,-0.639,both P<0.05).The peak atrial systolic velocity of the asphyxia group was lower than that of the non-asphyxia group,PI and PVIV were higher than those of the non-asphyxia group(all P<0.05).Conclusion The detection of PV blood flow parameters can accurately assess the left ventricular diastolic function of HDCP fetus and provide basis for early clinical intervention,which have good clinical application value.