超声速度矢量成像联合NT-proBNP评估重度子痫前期患者左心室功能的变化

Evaluation of left ventricular function changes of patients with severe preeclampsia by ultrasound velocity vector imaging combined with amino terminal brain natriuretic peptide precursor

目的:探讨超声速度矢量成像速度矢量成像(VVI)、血氨基末端脑钠肽前体(NT-proBNP)检测重度子痫前期患者左心室功能变化。方法:选取2019年1月-2020年3月本院重度子痫前期患者57例(病例组)、正常孕妇64例(正常组),应用超声心动图以及VVI技术检测左心室相关参数左心房内径(LAD)、室间隔厚度(IVSD)、舒张末期左心室内径(LVD)、左心室射血分数(EF)、舒张早期最大心脏血流速度(E)/舒张晚期最大心脏血流速度(A)、E/舒张早期组织运动速度(e′)、左心室收缩期整体长轴应变(S)、应变率(SRs)、舒张期整体长轴应变率(SRd);检测血浆NT-proBNP浓度,记录两组不良妊娠结局。结果:病例组收缩压以及舒张压均高于正常组(P<0.05);病例组LAD、IVSD、LVD以及E/e′均高于正常组,EF、E/A低于正常组,VVI测量指标S(-13.67±5.39)%、SRs(-0.72±0.29/s)以及SRd(0.76±0.24/s)均低于正常组(-23.36%±5.87%、-0.72±0.29/s、1.47±0.53/s),NT-proBNP(2.11±0.43 pg/ml)高于正常组(1.57±0.32 pg/ml)(均P<0.05);病例组VVI测量指标与血液NT-proBNP水平均呈负相关性(P<0.05);病例组胎儿生长受限、早产以及胎盘早剥发生率均高于正常组(P<0.05)。结论:重度子痫前期患者VVI测量指标、血液NT-proBNP水平均发生异常,且两项检测指标存在相关性。

Objective:To explore the evaluation of left ventricular function changes of patients with severe preeclampsia by ultrasound velocity vector imaging(VVI)combined with amino terminal brain natriuretic peptide precursor(NT proBNP).Methods:57 pregnant women with severe preeclampsia(in study group)and 64 normal pregnant women(in control group)were selected in this study from January 2019 to March 2020.Echocardiography and VVI technique were used to detected the values of the left ventricular related parameters of the women in the two groups,which included left atrium inner diameter(LAD),ventricular septal thickness(IVSD),end diastolic left ventricular diameter(LVD),left ventricular ejection fraction(EF),early diastolic maximum cardiac blood flow velocity(E)/late diastolic maximum cardiac blood flow velocity(A),E/early diastolic tissue movement velocity(e),left ventricular systolic overall long axis strain(S),strain rate(SRs),and diastolic overall longaxis strain rate(SRd).The plasma NT proBNP level of the women in the two groups was tested,and the adverse pregnancy outcomes of the women in the two groups were recorded.Results:The systolic and diastolic blood pressure values,and the valuesof LAD,IVSD,LVD,and E/e'of the women in the study group were significantly higher than those of the women in the control group(P<0.05).While the values of EF and E/A of the women in the study group were significantly lower than those of the women in the control group.The measure values of VVI indictors,such as S(13.67±5.39)%,SRs(0.72±0.29/S),and SRd(0.76±0.24/S),of the women in the study group were significantly lower than those(23.36%±5.87%,0.72±0.29/S,1.47±0.53/s)of the women in the control group,and the NT proBNP(2.11±0.43 pg/ml)value of the women in the study group was significantly higher than that(1.57±0.32 pg/ml)of the women in the control group(P<0.05).The measurement values of VVI of the women in the study group were negatively correlated with their blood NT proBNP level(P<0.05).The incidences of fetal growth restriction,preterm delivery,and placental abruption of the women in the study group were significantly higher than those of the women in the control group(P<0.05).Conclusion:The measurement value of VVI and blood NT proBNP level of the women with severe PE are abnormal,and there is correlation between the measurement value of VVI and the blood NT proBNP level.