| 摘要: |
| 目的：利用三维斑点追踪技术(3D-STE)及实时三维超声心动图,通过与适龄孕妇对比分析,研究高龄孕妇在早孕、中孕、晚孕期左室心肌应变能力、左室形态及功能的变化特点,试图及早发现高龄孕妇的亚临床心肌损伤,为临床及时干预提供可靠的影像学依据。方法：选取2020年2月至2021年3月于我院产检的高龄(妊娠年龄≥ 35岁)单胎孕妇40例,匹配同期适龄(妊娠年龄25-29 岁)单胎孕妇35例,分别于早孕(妊娠第 12～14 周)、中孕(妊娠第 24～27 周)、晚孕(妊娠第 36～39 周)期采集超声心动图数据,对比两组受试者不同孕期常规超声心动图参数以及三维应变指标。结果：同组间、不同孕周相比较：适龄组,与早孕、中孕期相比,晚孕期结构、功能指标左房内径(LAD)、左室舒张末容积(LVEDV)、每搏输出量(SV)、心输出量(CO)增大,差异有统计学意义(P<0.05)；高龄组,与早孕期相比,中孕及晚孕期结构、功能指标LAD、LVEDV、SV、CO增大,差异有统计学意义(P<0.05)； 左室收缩末容积(LVESV)、室间隔舒张末厚度(IVSd)、左室后壁舒张末厚度(LVPWd)、左室射血分数(LVEF)于两组各孕周均无显著变化,差异无统计学意义(P>0.05)；两组间、同孕周比较三维应变参数,高龄组左室整体纵向率(GLS)、左室整体环向应变率(GCS)均低于适龄组,差异有统计学意义(P<0.05)。结论：高龄孕妇在妊娠期间,心脏结构、功能变化发生较适龄孕妇早,且可观察到心肌应变指标下降,运用三维斑点追踪技术可更早发现高龄孕妇的心肌结构、功能障碍,是监测高龄孕妇孕期心功能变化的可靠手段。 |
| 关键词: 超声心动图 三维斑点追踪 高龄孕妇 左心功能 |
| DOI： |
| 投稿时间：2022-07-08修订日期：2022-08-11 |
| 基金项目:云南省教育厅科学研究基金资助(三维斑点追踪技术监测高龄孕产妇左心功能的运用价值),(项目编号：2020Y0135) |
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| Application value of three-dimensional speckle tracking technology in monitoring left ventricular function of pregnant women of advanced maternal age Song Rui, Ding Yunchuan |
| songrui,dingyunchuan,liujuan,chenzhuo,wangqinghui,chenjian |
| () |
| Abstract: |
| Objective: Using three-dimensional speckle tracking technology and real-time three-dimensional echocardiography, comparative analysis the change of left ventricular myocardial strain capacity, left ventricular structure and function in different gestational weeks of appropriate age pregnant women and advanced-age women. It is hoped to provide reliable imaging evidence for the early detection of subclinical myocardial injury in advanced maternal age pregnant women. Methods: Select 40 advanced maternal age (pregnancy age ≥ 35 years) singleton pregnant women from February 2020 to March 2021 in our hospital, and match 35 singleton pregnant women of appropriate age (pregnancy age 25-29 years) in the same period. Echocardiographic data were collected during early pregnancy (12 to 14 weeks of gestation), second trimester (24 to 27 weeks of gestation), and third trimester (36 to 39 weeks of gestation), and the two groups of patients were compared with conventional echocardiographic parameters and three-dimensional strain index during different pregnancy periods. Results: In the age-appropriate group, compared with the early and second trimesters, the structural and functional indexes LAD, LVEDV, SV and CO increased during the third trimester (P<0.05); In the advanced maternal age group, compared with the first trimester, the structure and function indexes LAD, LVEDV, SV, CO increased in the second and third trimesters (P<0.05); There was no significant change in LVESV, IVSd, LVPWd, LVEF, at each gestational week of the two groups (P>0.05); comparing the three-dimensional strain parameters between the two groups at the same gestational week, the global longitudinal strain and global circumferential strain of the advanced maternal age group (P<0.05). Conclusion: During pregnancy, the changes in cardiac structure and function of advanced maternal age pregnant women occur earlier than those of appropriate age, and the myocardial strain index can be observed to decrease. The use of three-dimensional speckle tracking technology can detect the myocardial structure and dysfunction of advanced maternal age pregnant women earlier and is a reliable method for advanced maternal age pregnant women to monitor changes in cardiac function. |
| Key words: echocardiography three-dimensional speckle tracking technology pregnant women of advanced maternal age left ventricular function |
