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目的探讨应用组织追踪法(TT)测定左心室壁收缩期位移,以此评价妊娠高血压(PIH)先兆子痫孕妇左心室收缩功能。方法 20例PIH先兆子痫孕妇(PIH组),年龄24~36岁,平均年龄30.63岁;21例正常孕妇(对照组),年龄29~34岁,平均年龄30.14岁。获取标准心尖位左心室长轴切面、两腔切面及四腔切面,应用TT对20例PIH组和21例对照组妊娠妇女心脏不同节段即左心室侧壁、后间隔、前壁、下壁、前间隔、后壁的基底段及中间段的位移曲线,测量左心室射血分数(LVEF)、左心室心肌质量指数(LVMI)、二尖瓣口血流舒张早期峰值流速(E)、舒张末期峰值流速(A)、E/A比值、肺静脉心房收缩期反向血流充盈峰(AR),肱动脉收缩压及舒张压,对所获指标进行定量分析。结果与对照组相比,PIH组LVEF和反映左心舒张功能的E峰、肺静脉S波、D波及Ar波明显减低(P<0.05,0.05,0.01,0.01,0.01),同时二尖瓣舒张末期充盈峰(A)、LVM和LVMI则显著增加(P<0.01)。PIH组左心室前壁、前间隔、后间隔各位点的收缩期位移低于对照组(P<0.01);左心室侧壁、下壁、后壁各位点收缩期位移在两组之间比较,差异无统计学意义(P>0.05)。结论 TT可无创、敏感、客观地评价PIH先兆子痫孕妇左心室收缩功能。
Objective To evaluate the left ventricular systolic function in pregnancy induced hypertension (PIH) preeclampsia by using tissue tracking (TT) to measure the left ventricular wall systolic displacement. Methods Twenty pregnant women with PIH preeclampsia (PIH group), aged from 24 to 36 years, with an average age of 30.63 years and 21 normal pregnant women (control group), aged from 29 to 34 years with a mean age of 30.14 years. Obtain standard apical left ventricular long axis section, two-chamber section and four-chamber section, the application of TT on 20 cases of PIH group and 21 cases of control group, different sections of the heart of women with left ventricular left ventricular wall, posterior septum, anterior wall, inferior wall (LVEF), left ventricular mass index (LVMI), mitral peak early diastolic velocity (E) and diastolic The final peak flow velocity (A), E / A ratio, pulmonary venous atrial contraction reverse flow filling peak (AR), brachial artery systolic pressure and diastolic pressure, quantitative analysis of the indicators obtained. Results Compared with the control group, LVEF in PIH group and E peak in pulmonary function, S wave in pulmonary vein, D wave and Ar wave in PIH group were significantly decreased (P <0.05,0.05,0.01,0.01,0.01), meanwhile mitral end diastolic phase Filling peak (A), LVM and LVMI were significantly increased (P <0.01). The systolic displacement of the anterior wall, anterior septum and posterior septum of the PIH group was lower than that of the control group (P <0.01). The systolic displacement of the left ventricular wall, inferior wall and posterior wall was compared between the two groups. The difference was not statistically significant (P> 0.05). Conclusion TT can be noninvasive, sensitive and objective evaluation of left ventricular systolic function in pregnant women with PIH preeclampsia.