运用四维自动左房定量分析技术评估子痫前期患者左房结构和功能的临床价值

Evaluation of left atrial structure and function in patients with preeclampsia by four-dimensional automatic left atrial quantitative analysis technique clinical research

目的:探讨运用四维自动左房定量分析技术(4D AUTO LAQ)评估子痫前期(PE)患者左房结构和功能的价值。方法:选取2022年7月—2023年3月于西安市第三医院就诊的PE患者46例(PE组),同时选取43名健康单胎孕妇作为对照组。测量两组常规超声心动图参数,同时采集实时四维动态图像,将数据导入EchoPAC工作站进行脱机分析。结果:(1)一般临床资料:PE组体重指数、体重、收缩压(SBP)、舒张压(DBP)、均高于对照组,差异有统计学意义(P<0.05);(2)常规超声参数:PE组左房内径(LAD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVDd)、左室射血分数(LVEF)、二尖瓣舒张早期流速(E)与二尖瓣环舒张早期流速(e')之比(E/e')大于对照组,e'小于对照组,差异有统计学意义(P<0.05);(3)左房结构参数:PE组左房结构参数均大于对照组,差异有统计学意义(P<0.05);(4)左房应变参数:PE组左房储蓄期纵向应变(LASr)、左房管道期纵向应变(LAScd)、左房储蓄期圆周应变(LASr-c)、左房管道期圆周应变(LAScd-c)低于对照组,差异有统计学意义(P<0.05)。ROC曲线显示,当LASr截断值为32.5,LASr评估PE患者左房功能变化的效能最佳。Pearson相关分析显示,SBP、E/e'、左房最大容积(LAVmax)与LASr呈显著负相关。结论:4D AUTOLAQ技术可早期定量评估PE患者左房结构和功能。

Objective Exploring the value of using 4D AUTO LAQ to evaluate left atrial structure and function in patients with preeclampsia(PE).Methods 46 PE patients who visited Xi'an Third Hospital from July 2022 to March 2023(PE group)were selected,and 43 healthy singleton pregnant women were selected as the control group.Measure conventional parameter echocardiography parameters,collect real-time four-dimensional dynamic images,and import the data into the EchoPAC workstation for offline analysis.Results(1)General clinical data:the BMI,body weight,systolic blood pressure(SBP)and diastolic blood pressure(DBP)in PE group were all higher than those of the control group,and the difference was statistically significant(P<0.05);(2)Routine ultrasound parameters:left atrium diameter(LAD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end diastolic diameter(LVDd),left ventricular ejection fraction(LVEF),E/e'in PE group were higher than those of the control group,and e'was lower than the control group,with statistical significance(P<0.05);(3)Structural parameters of left atrium:the structural parameters of the left atrium in the PE group were all higher than those of the control group,and the difference was statistically significant(P<0.05);(4)Left atrial strain parameters:LASr,LAScd,LASr-c and LAScd-c in PE group were all lower than those of the control group,with statistical significance(P<0.05).ROC curve shows that when the cut off value of LASr is 32.5,the efficacy of LASr in evaluating the changes of left atrial function in PE patients is the best.Pearson correlation showed that SBP,E/e',LAVmax were negatively correlated with LASr.Conclusion 4D AUTO LAQ can evaluate the structure and function of left atrium in PE patients at an early stage.