超声心动图联合血清血管紧张素转换酶水平可作为评估妊娠期高血压患者心功能的潜在生物学指标

Echocardiography combined with serum angiotensin-converting enzyme levels can be used as a potential biological indicator to evaluate cardiac function in hypertensive patients during pregnancy

目的研究超声心动图联合血清血管紧张素转换酶(ACE)对妊娠期高血压(HIP)的诊断价值及与心功能的相关性。方法纳入2021年3月~2024年3月在我院诊治的50例HIP患者作为研究组,另选取同期在我院接受健康体检的50例健康体检者视为对照组。比较研究组与对照组HIP患者的超声心动图结果、血清ACE水平及心功能指标;采用Pearson分析超声心动图、血清ACE与心功能指标的相关性;采用ROC曲线分析超声心动图、血清ACE单独及联合诊断HIP的诊断价值。结果研究组ACE水平高于对照组(P<0.05);研究组舒张早期充盈峰速度/舒张晚期充盈峰速度(E/A)和舒张早期快速充盈分数(RFF)低于对照组(P<0.05),左心室射血分数(LVEF)、肌钙蛋白T(c Tn T)及血浆脑钠肽(BNP)水平高于对照组(P<0.05);Pearson分析结果显示,HIP患者E/A、RFF与c Tn T、BNP呈负相关(P<0.05),LVEF、ACE与c Tn T、BNP呈正相关(P<0.05);ROC曲线分析显示,ACE诊断妊娠期高血压的AUC值为0.619,E/A、RFF、LVEF及四者联合诊断妊娠期高血压的AUC值分别为0.700、0.706、0.793、0.880。结论超声心动图联合血清ACE水平可作为评估HIP患者心功能的潜在生物学指标。

Objective To investigate the value of echocardiography combined with serum angiotensin-converting enzyme(ACE)in the diagnosis of gestational hypertension(HIP)and its correlation with cardiac function.Methods Fifty patients with HIP who were treated in our hospital from March 2021 to March 2024 were included as the study group,and another 50 healthy subjects who underwent physical examination in our hospital during the same period were selected as the control group.The echocardiographic results,serum ACE levels and cardiac function indexes of HIP patients in the study group and the control group were determined.The correlation between echocardiography,serum ACE and cardiac function index was analyzed by Pearson.ROC curve analysis of echocardiography,serum ACE alone and combined diagnostic value of HIP.Results The level of early diastolic filling peak velocity/late diastolic filling peak velocity(E/A)and early diastolic rapid filling fraction(RFF)in the study group were lower than those in the control group(P<0.05),left ventricular ejection fraction(LVEF),ACE level,troponin T(cTnT)level and plasma brain natriuretic peptide(BNP)level were higher than those of control group(P<0.05);Pearson analysis showed that E/A and RFF in HIP patients were negatively correlated with cTnT and BNP(P<0.05),while LVEF and ACE were positively correlated with cTnT and BNP(P<0.05).ROC curve analysis showed that the AUC value of ACE in diagnosis of gestational hypertension was 0.619,and the AUC value of E/A,RFF,LVEF and the combination of the four patients in diagnosis of gestational hypertension was 0.700,0.706,0.793,0.880,respectively.Conclusion Echocardiography combined with serum ACE level can be used as a potential biological index to evaluate cardiac function in HIP patients.