分层应变对子痫前期孕妇左室收缩功能的评估价值及其与N端脑钠肽前体的相关性

Evaluation Value of Layer-Specific Strain on Left Ventricular Longitudinal Systolic Function in Preeclampsia Pregnant Women and Its Correlation with N-Terminal Pro-brain Natriuretic Peptide

目的探讨二维分层应变对子痫前期患者左室纵向收缩功能早期改变的评估价值及其与N端脑钠肽前体(NT-proBNP)的相关性。方法选取2021年1月至2022年10月于洛阳市中心医院围产门诊就诊及住院治疗的子痫前期患者40例(子痫前期组),同期健康孕妇35例(正常组)纳入研究,所有受检者左室射血分数(LVEF)≥50%,超声测量、图像分析获得左室心肌内膜层纵向应变(LS-endo)、心肌中层纵向应变(LS-mid)、心肌外膜层纵向应变(LS-epi)、左室整体纵向平均应变(GLS-Avg),并检测NT-proBNP水平,将结果进行比较分析。结果两组分层应变均为从心内膜层到心外膜层逐渐递减趋势(P<0.05);与正常组比较,子痫前期组LS-endo、LS-mid、LS-epi及GLS-Avg减低均有统计学意义(P<0.05);子痫前期组NT-proBNP水平高于正常组,差异有统计学意义(P<0.05);LS-endo、LS-mid、LS-epi、GLS-Avg与NT-proBNP均呈负相关(P<0.05)。结论LVEF正常的子痫前期患者早期即存在左心室病变,而二维分层应变可以早期识别其左室各层心肌力学参数改变,且这种改变与其NT-proBNP水平有一定的相关性,具有较好的临床应用价值。

Objective To investigate the clinical value of layer-specific strain in evaluation the early changes of left ventricular longitudinal systolic function in patients with preeclampsia and their correlation with N-terminal pro-brain natriuretic peptide(NT-proBNP).Methods From January 2021 to October 2022,40 patients with preeclampsia(preeclampsia group)who were hospitalized or in the Perinatal Clinic of Luoyang Central Hospital and 35 healthy pregnant women(normal group)were selected for the study.Left ventricular ejection fraction(LVEF)of all subjects was≥50%.Longitudinal strains of the endocardium(LS-endo),longitudinal strains of the myocardium(LS-mid),longitudinal strains of the epicardium(LS-epi),global longitudinal average strain(GLS-Avg)were obtained by ultrasonic measurement and image analysis,NT-proBNP level was detected,and results were compared and analyzed.Results The layer-specific strain decreased gradually from endocardium to epicardium in both groups(P<0.05).Compared with control group,the LS-endo,LS-mid,LS-epi and GLS-Avg of group preeclampsi declined were statistically significant(P<0.05).NT-proBNP levels in preeclampsia group were higher than the control group,the difference had statistically significant(P<0.05).LS-endo,LS-mid,LS-epi,GLS-Avg were negatively correlated with NT-proBNP(P<0.05).Conclusion The preeclampsia patients with normal LVEF have left ventricular disease at an early stage,and two-layer-specific strain can identify the changes of myocardial mechanical parameters of each layer of the left ventricle at an early stage,and this change has a certain correlation with the NT-proBNP level,which has good clinical application value.