心肌做功指数评价产科抗磷脂综合征孕妇胎儿左心室功能

Myocardial performance index for evaluating fetal left ventricular function in pregnant women with obstetric antiphospholipid syndrome

目的观察心肌做功指数(MPI)评价产科抗磷脂综合征(OAPS)孕妇胎儿左心室(LV)功能的价值。方法前瞻性纳入41例单胎妊娠OAPS孕妇[包括16例典型OAPS(C-OAPS组)及25例非典型OAPS(NC-OAPS组)]及60名健康孕妇(对照组),比较3组胎儿二尖瓣口血流频谱E/A值、LV等容舒张时间(IRT)、等容收缩时间(ICT)、射血时间(ET)及MPI;采用受试者工作特征(ROC)曲线评估MPI预测孕妇不良妊娠结局的效能。结果3组胎儿二尖瓣口血流频谱E/A值、LV IRT、LV ICT、LV ET及MPI差异均有统计学意义(P均<0.05)。两两比较,C-OAPS组、NC-OAPS组及对照组LV IRT及MPI依次降低、而二尖瓣口血流频谱E/A值及LV ET依次升高(P均<0.05);C-OAPS组LV ICT高于对照组(P<0.05)。以MPI预测OAPS孕妇不良妊娠结局的敏感度、特异度及曲线下面积分别为90.00%、64.45%及0.798。结论MPI可用于评价OAPS孕妇胎儿LV功能及预测不良妊娠结局。

Objective To observe the value of myocardial performance index(MPI)for evaluating fetal left ventricular(LV)function in pregnant women with obstetric antiphospholipid syndrome(OAPS).Methods Totally of 41 singleton pregnancy women with OAPS(criteria-OAPS[C-OAPS]group,n=16;non-criteria OAPS[NC-OAPS]group,n=25)and 60 healthy singleton pregnancy women(control group)were prospectively enrolled.Mitral flow E velocities/A velocities,isovolumic relaxation time(IRT),isovolumic contraction time(ICT),ejection time(ET)and MPI of fetal LV were compared among 3 groups.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of MPI for predicting adverse pregnancy outcomes of pregnant woman.Results Significant differences of mitral flow E velocities/A velocities,IRT,ICT,ET and MPI of fetal LV were found among 3 groups(all P<0.05).Results of pairwise comparison showed that among C-OAPS group,NC-OAPS group and control group,IRT and MPI of LV decreased,whereas E/A and ET of LV increased in order(all P<0.05).ICT in C-OAPS group was higher than that in control group(P<0.05).The sensitivity,specificity and area under the curve of MPI for predicting adverse pregnancy outcomes of pregnant woman with OAPS was 90.00%,64.45%and 0.798,respectively.Conclusion MPI could be used to evaluate fetal LV function in pregnant women with OAPS,also being helpful for predicting adverse pregnancy outcomes.