正常妊娠期间母体左室收缩功能及血流动力学的变化

The Maternal LV Contractility Function and the Hemodynamic Changing During the Course of Gestation

目的 :探讨妊娠母体左室收缩功能及血流动力学变化 ,了解其特殊时期的生理状态。方法 :对142例正常妊娠母体用无创超声心动技术及II导心电图 ,参照Weyman氏方法用录像带慢回放 ,测量各项指标。同时测量身高、体质量、测量血压 ,并与未妊娠的健康志愿者作对照 (对照组 )。结果 :妊娠期血压无明显变化 ,心输出量(CO)、心率孕早期增加 ,随孕期逐渐增加 ,至孕末期分别增至最大和最快 ,每搏输出量 (SV)孕早期无明显提高 ,孕中期开始升高并维持。总外周阻力 (TPR)随孕期逐渐递减 ,对照组、孕早、孕中和孕晚期TPR[dynes/(sec·cm -5)]分别为1044 85±318 95、992 95±174 51、926 24±170 98和853 15±187 40(P<0.01)。结论 :正常妊娠期间为高流低阻血流动力学状态。早期CO的升高是由于心率的增快 ,随后才是心率和SV共同增高的结果。孕中期左心室的收缩功能略有增强。

Objective:Maternal cardiovascular adaptation to pregnancy involves enormous changes.The purpose of the study is to demonstrate the maternal cardiovascular hemodynamic,structural and functional changes during the course of gestation by echocardiography.Methods:142healthy pregnant women were studˉied by echocardiography in left lateral decubitus position,synchronously recording EKG.Results:CO and HR increased in early pregnancy,peaked in the last weeks of pregnancy.Strike volume began to increase until midpregnancy,and remained elevated afterward.TPR decreased during all three trimesters of pregnancy,which were1044.85±318.95,992.95±174.51,926.24±170.98and853.15±187.40dynes/(sec·cm -5 )(P<0.01).Conclusions:CO increases in early pregnancy,initially as a result of increased HR,followed by an inˉcreased stroke volume.There is a high-flow,low-resistance hemodynamic state during normal pregnancy.The LV contractility seems to be increased during midpregnancy,but remains in the normal range.