4DSLAQ技术在早期定量评估妊娠期高血压患者左心房容积及功能变化的临床应用
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重庆市渝北区人民医院

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重庆市科卫联合医学科研项目,编号:2024MSXM082


Clinical application of 4D LAQ in early quantitative evaluation of left atrial volume and function in patients with hypertensive disorder of pregnancy
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    摘要:

    目的 探讨四维自动左心房定量(4DSLAQ)技术在早期定量评估妊娠期高血压(HDP)患者左心房容积及功能变化的临床应用价值。方法 选取2021年4月~2024年4月重庆市渝北区人民医院收治的100例HDP患者纳入HDP组,按病情严重分型标准将入组患者为低危组59例和中高危组41例,另选取50例同期产检的健康孕妇为对照组,均于妊娠28w接受4DSLAQ检查。比较HDP组和对照组一般资料和4DSLAQ左心房容积参数和应变参数;比较不同病情严重程度HDP患者一般资料及4DSLAQ左心房容积参数和应变参数;Logistic回归分析4DSLAQ参数评估HDP患者病情严重程度的价值;受试者操作特征曲线(receiver operating characteristic curve, ROC)分析4DSLAQ左心房容积参数和应变参数对HDP患者病情严重程度的评估价值。结果 HDP组LAVmax、LAVmin、LAVpreA、LAVImax、LAEV、LAScd绝对值和LAScd-c绝对值均显著高于对照组,LAEF、LAEI、LApEF、LASr和LASr-c均显著低于对照组(P<0.05);中高危组BMI、收缩压、舒张压和LAVmax、LAVmin、LAVpreA、LAVImax、LAEV、LAScd绝对值、LAScd-c绝对值均显著高于低危组,LAEF、LAEI、LApEF、LASr和LASr-c均显著低于低危组(P<0.05);Logistic回归分析显示,LAVImax、LAScd-c绝对值升高和LASr降低可以评估HDP患者病情严重程度(P<0.05);LAVImax、LASr和LAScd-c绝对值联合检查评估HDP患者病情严重程度的AUC为0.901,敏感度为90.24%(P<0.05)。结论 4DSLAQ左心房四维参数可早期定量评估HDP患者左心房容积及功能变化,其中LAVImax、LASr和LAScd-c绝对值检测对在评估患者病情严重程度中具有较好的应用价值,可在临床推广应用。

    Abstract:

    Objective To explore clinical application value of 4-dimensional automatic left atrial quantification (4D LAQ) in early quantitative evaluation of left atrial volume and function in patients with hypertensive disorder of pregnancy (HDP). Methods A total of 100 patients with HDP admitted to Yubei District People"s Hospital, Chongqing, were enrolled as HDP group between April 2021 and April 2024. According to disease severity, they were divided into low-risk group (59 cases) and medium-high risk group (41 cases). A total of 50 healthy pregnant women undergoing prenatal examination during the same period were enrolled as control group. All underwent 4D LAQ examination at 28w of gestation. The general data, left atrial volume parameters and strain parameters of 4D LAQ were compared between HDP group and control group, and among patients with different severity of HDP. The evaluation value of 4D LAQ parameters for disease severity in HDP patients was analyzed by Logistic regression analysis, and evaluation value of left atrial volume parameters and strain parameters for disease severity was analyzed by receiver operating characteristic (ROC) curves. Results LAVmax, LAVmin, LAVpreA, LAVImax, LAEV, absolute values of LAScd and LAScd-c in HDP group were significantly higher than those in control group, while LAEF, LAEI, LApEF, LASr and LASr-c were significantly lower than those in control group (P<0.05). BMI, systolic blood pressure, diastolic blood pressure, LAVmax, LAVmin, LAVpreA, LAVImax, LAEV, absolute values of LAScd and LAScd-c in medium-high risk group were significantly higher than those in low-risk group, while LAEF, LAEI, LApEF, LASr and LASr-c were significantly lower than those in low-risk group (P<0.05). Logistic regression analysis showed that increased LAVImax, absolute value of LAScd-c and decreased LASr were of evaluation value for disease severity in HDP patients (P<0.05). AUC and sensitivity of LAVImax combined with LASr and absolute value of LAScd-c for evaluating disease severity were 0.901 and 90.24% (P<0.05). Conclusion 4D LAQ left atrial parameters can be applied in early quantitative evaluation of changes in left atrial volume and function in HDP patients. The application value of LAVImax, LASr and absolute value of LAScd-c is good in evaluating disease severity.

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曾令玲,胡劼.4DSLAQ技术在早期定量评估妊娠期高血压患者左心房容积及功能变化的临床应用[J].临床超声医学杂志,2025,27(6):

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  • 收稿日期:2025-01-11
  • 最后修改日期:2025-02-21
  • 录用日期:2025-03-31
  • 在线发布日期: 2025-06-30
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