三维斑点追踪成像技术评价子痫前期患者左心室收缩功能

发布时间：2018-04-29 10:14

本文选题：超声心动描记术 + 先兆子痫　；参考：《中国医学影像技术》2017年03期

【摘要】：目的采用三维斑点追踪成像(3D-STI)技术检测子痫前期患者左心室收缩功能。方法纳入轻度子痫前期患者73例(轻度组)、重度子痫前期患者64例(重度组)和年龄、孕周匹配的健康孕妇60例(对照组)。检测生化指标和常规超声参数,并运用3D-STI测量左心室收缩期整体纵向峰值应变(GLS)、整体径向峰值应变(GRS)、整体环向峰值应变(GCS)和整体面积峰值应变(GAS),计算面积应变不同步指数(ASDI)。并分析三维应变参数与生化指标及超声参数的相关性。结果与对照组比较,重度组左心房前后径(LAD)增大,二尖瓣口舒张期流速比值(E/A)减低,Tei指数在对照组、轻度组、重度组依次增高(P均0.05)。与对照组比较,轻度组|GLS|、|GAS|降低,ASDI增高,重度组|GLS|、|GRS|、|GCS|、|GAS|和ASDI差异均有统计学意义(P均0.05)。与轻度组比较,重度组GLS、GAS明显降低,ASDI明显增高(P均0.05)。|GLS|与Tei指数呈负相关(r=-0.471,P=0.036);|GAS|与LVEF呈正相关(r=0.051,P=0.028),与Tei指数呈负相关(r=-0.612,P=0.017);ASDI与心脏脂肪酸结合蛋白(H-FABP)呈负相关(r=-0.525,P=0.046),与Tei指数呈正相关(r=0.489,P=0.037)。结论子痫前期患者左心室收缩功能明显受损,心肌应变能力下降,3D-STI技术可早期无创评价子痫前期患者左心室收缩功能变化。
[Abstract]:Objective to detect left ventricular systolic function in patients with preeclampsia by three-dimensional dot-tracking imaging (3D-STI). Methods 73 patients with mild preeclampsia (mild group), 64 patients with severe preeclampsia (severe group) and 60 healthy pregnant women with age and gestational week matched (control group) were included. Biochemical parameters and conventional ultrasound parameters were measured. The global longitudinal peak strain (GLSN), global radial peak strain (GRSs), global circumferential peak strain (GCSs) and global area peak strain (GASA) were measured by 3D-STI. The correlation of three-dimensional strain parameters with biochemical and ultrasonic parameters was analyzed. Results compared with the control group, the left atrial anterior and posterior diameter (lad) in the severe group was increased, and the mitral orifice diastolic velocity ratio (E / A) was decreased in the control group (P < 0.05). Compared with the control group, GLS, GAS in the mild group was lower than that in the control group, and the GLS, GRS, GCS, GAS and ASDI in the severe group were significantly higher than those in the control group (P < 0.05). Compared with mild group, GLS in severe group was significantly lower than that in mild group (P < 0.05). There was a negative correlation between GLS and Tei index, a negative correlation between GAS and LVEF, a positive correlation between GAS and LVEF, and a negative correlation between GAS and Tei index. There was a negative correlation between GAS and heart fatty acid binding protein H-FABP0.046, and a positive correlation with Tei index. Conclusion left ventricular systolic function is significantly impaired in preeclampsia patients. The 3D-STI technique can be used to evaluate the left ventricular systolic function in preeclampsia patients.
【作者单位】：湖北省科技学院临床医学院超声诊断教研室;咸宁市中心医院神经外科;
【分类号】：R445.1;R714.244

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