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目的探讨二维斑点追踪技术评估妊娠期高血压疾病孕妇左心功能的效果及干预措施。方法选取2012年10月-2014年10月在该院孕检的孕妇1 591例作为研究对象,均行妊娠期高血压疾病筛查,根据筛查结果将患者分为B1组和B2组,其中1 510例非妊娠期高血压疾病孕妇作为A组,81例妊娠期高血压疾病孕妇作为B组,均行二维斑点追踪技术检查,评估两组孕妇左心功能,用Echo Pac-120软件分析得到所有心肌节段圆周应变、径向应变、纵向应变。对比分析两组患者基本资料,了解妊娠期高血压疾病发生的危险因素;根据患者自愿原则将妊娠期高血压疾病患者分为两组,B1组49例予以孕期保健,B2组32例予以常规健康教育,了解两组妊娠结局。结果 B组左室等容舒张时间显著高于A组(P<0.05);B组扭转角度峰值、等容舒张末期扭转角度、收缩末期扭转角度、解旋减半时间均显著高于A组,解旋率显著低于A组(均P<0.05);B组心肌阶段圆周应变、纵向应变、径向应变峰值均显著低于A组(P<0.05)。B组≤20岁或>36岁、小学及以下学历、BMI>24 kg/m~2、初产妇、基础收缩压≥120 mm Hg出现几率均显著高于A组(P<0.05);B1组产妇产后出血、产妇死亡、新生儿窒息、新生儿围产期死亡率均显著低于B2组(P<0.05)。结论二维斑点追踪技术可评估妊娠期高血压疾病孕妇左室扭转运动,临床应注重对妊娠期高血压疾病孕妇的孕期保健,改善妊娠预后。
Objective To explore the effect and intervention of two-dimensional speckle tracking in evaluating left ventricular function in pregnant women with hypertensive disorder complicating pregnancy. Methods A total of 1 591 pregnant women undergoing pregnancy test in our hospital from October 2012 to October 2014 were enrolled in this study. All patients were divided into B1 and B2 groups according to the result of screening. A total of 1 510 pregnant women with non-pregnancy-induced hypertension were enrolled as group A and 81 pregnant women with gestational hypertension as group B. Their left ventricular function was assessed by two-dimensional speckle tracking. The Echo Pac-120 software was used to analyze the left ventricular function All myocardial segment circumferential strain, radial strain, longitudinal strain. According to the voluntary principle of patients, the patients with gestational hypertension were divided into two groups, 49 cases in group B1 were given prenatal care, and the other 32 cases in group B2 were given routine health care Education, understand the two groups of pregnancy outcomes. Results The left ventricular isovolumic relaxation time in group B was significantly higher than that in group A (P <0.05). In group B, the peak torsion angle, isokinetic end-diastolic torsion angle, end-systolic torsion angle and half rotation time were significantly higher than those in group A, (P <0.05). The peak values of circumferential strain, longitudinal strain and radial strain in group B were significantly lower than those in group A (P <0.05). The incidence of primiparous and basic systolic blood pressure ≥120 mm Hg in group B was significantly higher than that in group A (P <0.05); group B1 Postpartum hemorrhage, maternal death, neonatal asphyxia and neonatal perinatal mortality were significantly lower than those in the B2 group (P <0.05). Conclusions Two-dimensional speckle tracking can assess left ventricular torsional motion in pregnant women with hypertensive disorder complicating pregnancy. Clinical care should focus on pregnant women’s health during pregnancy and improve prognosis of pregnancy.