| 摘要: |
| 目的 应用组织多普勒联合时间-空间相关成像技术对孕晚期子痫前期孕妇胎儿的心功能进行评价，旨在发现胎儿长期暴露于高血压的宫内环境中，胎儿心脏的收缩、舒张和整体功能的是否受损。方法 应用组织多普勒联合时间-空间相关成像技术对晚孕期正常妊娠孕妇115例，PE孕妇121例（其中MPE孕妇61例，SPE孕妇60例），按照孕28～31+6 w、32～35+6 w、36～40 w三个时间段进行连续胎儿心脏功能评估。结果 孕晚期三个孕周时间段中，SPE、MPE两组二、三尖瓣环Sa、Ea/Aa均小于正常妊娠组（P＜0.05），PE两组间比较无统计学差异；孕晚期三个孕周时间段中，SPE、MPE两组左心Tei指数均大于正常妊娠组（P＜0.05），PE两组间在孕36~40 w，SPE组大于MPE组（P＜0.05）；孕晚期三个孕周时间段中，PE两组右心Tei指数均大于正常妊娠组，SPE组大于MPE组（P＜0.05）；孕晚期三个时间段中SPE、MPE两组LVSF、RVSF均小于正常妊娠组（P＜0.05），PE组间在孕36～40 w，SPE组小于MPE组（P＜0.05）。结论 通过TDI联合STIC-M技术发现孕晚期SPE、MPE两组胎儿的心脏收缩、舒张和整体功能减低，主要的表现为左、右心功能指标Ea/Aa、Sa、SF的降低和Tei指数增高。孕妇血压升高的程度和胎儿心功能的变化有关，孕妇血压越高，胎儿暴露于高血压的宫内环境中，对心功能的影响程度越大。 |
| 关键词: 组织多普勒成像技术 时间-空间成像技术 子痫前期 胎儿心功能 |
| DOI： |
| 投稿时间：2022-04-09修订日期：2022-11-17 |
| 基金项目:北京市科学委员会首都临床特色应用研究与成果推广项目（Z171100001017139） |
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| Evaluation of fetal cardiac function in third trimester preeclampsia by combined tissue Doppler imaging and spatio-temporal image correlation |
| Ge Tingting,,zhao xu,chen wen jiao |
| () |
| Abstract: |
| Objective To apply combined tissue Doppler imaging and spatio-temporal image correlation to evaluate fetal cardiac function in pregnant women with preeclampsia in late pregnancy with the aim of detecting whether the systolic, diastolic and overall function of the fetal heart is impaired by prolonged exposure of the fetus to a hypertensive intrauterine environment. Methods A combined tissue Doppler imaging (TDI) and spatio-temporal image correlation (STIC) was applied to evaluate the continuous fetal cardiac function in 115 pregnant women with normal pregnancy and 121 pregnant women with PE in late pregnancy (including 61 pregnant women with MPE and 60 pregnant women with SPE) according to three time periods from 28 to 31+6 w, 32 to 35+6 w, and 36 to 40 w of gestation. Result In the three gestational week time periods in late pregnancy, the Sa and Ea/Aa of the mitral and tricuspid annulus in both SPE and MPE groups were smaller than those in the normal pregnancy group (P<0.05), and there was no statistical difference between the two PE groups; in the three gestational week time periods in late pregnancy, the LV-Tei in both SPE and MPE groups was larger than that in the normal pregnancy group (P<0.05), and between the two PE groups in 36-40 w of gestation, the SPE group was larger than that in the MPE group (P<0.05); in the three gestational weeks of late pregnancy, RV-Tei was greater in both PE groups than in the normal pregnancy group, and in the SPE group than in the MPE group (P<0.05); in the three gestational weeks of late pregnancy, LVSF and RVSF were smaller in both SPE and MPE groups than in the normal pregnancy group (P<0.05), and between the PE groups, in the 36-40 w gestation, the SPE group was smaller than the MPE group (P<0.05). Conclusion The TDI combined with STIC-M technique revealed that the systolic, diastolic and overall cardiac functions of fetuses in the two groups of SPE and MPE were reduced in late pregnancy, mainly manifested by the reduction of left and right cardiac function indices Ea/Aa, Sa, SF and the increase of Tei index. The higher the maternal blood pressure and the changes in fetal cardiac function, the greater the maternal blood pressure and the greater the exposure of the fetus to the hypertensive intrauterine environment, the greater the impact on cardiac function. |
| Key words: Tissue Doppler imaging Spatio-temporal image correlation Preeclampsia Fetal cardiac function |
