斑点追踪超声心动图对重度子痫前期患者左心室心肌分层应变分析
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延安市人民医院,延安市人民医院

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Left ventricular myocardial layer-specific analysis in patients with Severe preeclampsia using speckle tracking echocardiography.
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    摘要:

    目的 探讨分层应变技术评估无症状和左心室射血分数保留的晚发型重度子痫前期(LO-SPE)患者的左心室收缩功能早期损害的价值。方法 选择51例LO-SPE患者(LO-SPE组),同期选择年龄和孕龄匹配的正常孕妇的52例(晚孕健康对照组)以及非孕健康妇女50例(非孕健康对照组)。采用纵向分层应变技术测量所有受试者左心室纵向心内膜应变(GLSendo)、左心室纵向中层应变(GLSmid)以及左心室纵向心外膜应变(GLSepi),并获取晚孕受试者产后3月的应变数据。结果 与非孕健康对照组比较,晚孕健康对照组GLSendo、GLSmid以及GLSepi均减低(P<0.005),产后显著恢复并达到健康对照组水平(P>0.005);与晚孕健康对照组以及非孕健康对照组比较,LO-SPE组GLSendo、GLSmid以及GLSepi均减低(P<0.005),产后GLSendo和GLSmid均有显著恢复(P<0.005)并达到健康对照组水平(P>0.005),GLSendo于产后虽有显著恢复(P<0.005)但未达到非孕健康对照组水平(P<0.005)。结论 分层应变评估LO-SPE患者的左心室早期心肌损害具有重要价值。该新技术可能帮助我们识别高风险患者并早期干预,以防止进一步损害和确保围产期安全。

    Abstract:

    Objectives The aim of this study was to explore the value of layer-specific strain on assessing the early damage of the left ventricular (LV) systolic function in asymptomatic and left ventricular ejection fraction (LVEF) well-preserved patients with late-onset severe preeclampsia (LO-SPE) . Methods A total of 51 patients with LO-SPE(LO-SPE group), 54 age-,gestational age-matched normal pregnancy woman(NP group) and 50 age-matched non-pregnant women as control group were included. Longitudinal strains of the endocardium, myocardium, and epicardium (GLSendo, GLSmyo, and GLSepi ) were obtained by a software enabling the analysis of strains in three myocardial layers.Date from women in late pregnancy and 3 months after delivery.Results GLSendo, GLSmyo, and GLSepi were significantly reduce in NP group compared with control group(P<0.005),and subsequently returned postpartum to values comparable to the control(P>0.005). GLSendo, GLSmyo, and GLSepi were significantly reduce in LO-SPE group compared with NP group and control, and returned to above baseline values after delivery(P<0.005), and all strain index except GLSendo returned to normal level comparable to the control (P<0.005). Conclusions Layer-specific evaluation of the left ventricle has great value in evaluating early impairment of LV in patients with LO-SPE. And this relatively novel technique may made it possible to help us identify patients at high-risk , thus early intervention to preventing further damage and ensure perinatal safety.

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谢彩霞,拓胜军.斑点追踪超声心动图对重度子痫前期患者左心室心肌分层应变分析[J].临床超声医学杂志,2018,20(3):

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  • 收稿日期:2017-02-22
  • 最后修改日期:2017-02-22
  • 录用日期:2017-03-31
  • 在线发布日期: 2018-03-23
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