组织多普勒成像和超声二维斑点追踪技术对妊娠高血压综合征患者左心室舒张功能的评估

To evaluate the left ventricular diastolic function in the patients with Pregnancy induced hypertension by Doppler Tissue Imaging and two-dimensional speckle tracking imaging

目的:应用组织多普勒成像技术(DTI)和超声二维斑点追踪显像技术(STI)等方法评估妊娠高血压综合征患者的左心室舒张功能,研究DTI和STI技术对妊高症患者左心室舒张功能的临床应用价值。方法:根据舒张早期和舒张晚期二尖瓣口血流峰值速度比值(E/A)将32例妊高症患者分为两组:妊高症1组(B组)(13例)E/A<1,和妊高症2组(C组)(19例)E/A≥1,正常妊娠对照组(A组)35例。应用STI评价二尖瓣环运动:用二尖瓣环位移(TMAD)软件描绘二尖瓣环间隔部和二尖瓣环左室侧壁2个点相对于心尖部的运动曲线,测量2个点相对于心尖运动的舒张早期和舒张晚期位移和速度,记录舒张早期二尖瓣环间隔部速度(ESV)、二尖瓣环间隔部位移(ESD)、二尖瓣环左室侧壁速度(ELV)、二尖瓣环左室侧壁位移(ELD),舒张晚期二尖瓣环间隔部速度(ASV)、二尖瓣环间隔部位移(ASD)、二尖瓣环左室侧壁速度(ALV)、二尖瓣环左室侧壁位移(ALD)等参数,并进行比较。应用DTI分析二尖瓣环的舒张早期运动速度峰值(Ve)、舒张晚期运动速度峰值(Va)及二者的比值Ve/Va,并计算各点处的平均值。结果:妊高症1组和2组ESD、ESV均较正常对照组减低(P<0.05),ASD、ASV、ALD和ALV均比对照组增高(P<0.05),妊高症1组和2组的Ve、Ve/Va与正常妊娠对照组相比均有明显下降(P<0.05)。而妊高症1组和2组之间比较差异无统计学意义(P>0.05)。结论:组织多普勒成像和超声二维斑点追踪技术均可以较准确全面地评定妊高症患者左室舒张功能。

Objective To evaluate the left ventricular diastolic function in the patients with Pregnancy induced hypertension by Doppler Tissue Imaging(DTI) and two-dimensional speckle tracking imaging(STI). Methods Thirty-two patients with Pregnancy induced hypertension were divided into two guoups according to mitral valve peak flow velocity E/A ratio: group1, E/A < 1(n=19);group 2, E/A ≥ 1(n=13);thirty-five normal pregnancy volunteers. Thenthe septal and lateral mitral annular movement curves were traced with the TMAD software, and the early diastolic septal mitralannular displacement and velocity(ESD and ESV), early diastolic lateral mitral annular displacement and velocity(ELD and ELV), later diastolic that is atrial systolic septal mitral annular displacement and velocity(ASD and ASV), later systolic lateralmitral annular displacement and velocity(ALD and ALV) were measured. The above parameters were compared in three groups.Mitral annular velocity in early diastole(Ve) and late diastole(Va) by DTI were measured.Results ESD and ESV in hypertensive patients both group 1 and group 2 were lower than normal pregnancy(P < 0.05). ASD、ASV、ALD and ALV in hypertensive patients both group 1 and group 2 were higher than normal pregnancy(P < 0.05).Vp,Ve,Ve/Va in hypertensive patients both group 1 and group 2 were lower than normal pregnancy(P < 0.05). While there were no significant differences between group 1 and group 2(P > 0.05). Conclusions STI and DTI can evaluate the left ventricular diastolic function in the patients with Pregnancy induced hypertension more reliably.