摘要
目的探讨超声心动图结合血N-端脑利钠肽前体(NT-proBNP)评价妊娠期高血压疾病不同构型左心室功能变化的临床价值。方法将77例妊娠期高血压疾病患者根据Ganau分型法分为4个亚组:正常构型组25例、向心性重构组23例、向心性肥厚组15例和离心性肥厚组13例,另选取26例血压正常孕妇作为对照组。各组孕妇均进行超声心动图检查,测量左心室形态参数[包括相对室壁厚度(RWT)、左心室质量指数(LVMI)]和功能参数[包括左心室射血分数(LVEF)、二尖瓣瓣口舒张早期E波峰值流速(E)、二尖瓣瓣口舒张晚期A波峰值流速(A)及E/A、收缩期二尖瓣环左心室侧壁、室间隔处心肌运动峰值速度(Sa1、Sa2)及舒张早期二尖瓣环左心室侧壁、室间隔处心肌运动峰值速度(Ea1、Ea2),并计算Sa1、Sa2的平均值(Sam)和E/Ea1、E/Ea2的平均值(E/Eam)]。同时检测血浆NT-proBNP浓度。结果与对照组比较,向心性肥厚组及离心性肥厚组LVMI增大,E/Eam增大,NT-proBNP升高,Sam降低,差异均有统计学意义(均P<0.05)。相关分析显示:LVMI、E/Eam与自然对数转换后的NT-proBNP(Ln NT-proBNP)呈正相关(r=0.74、0.58,均P<0.05),Sam与Ln NT-proBNP呈负相关(r=-0.71,P<0.05)。多元线性逐步回归分析显示:E/Eam、Sam、LVMI为Ln NT-proBNP独立影响因素。结论通过超声心动图测量E/Eam、Sam及LVMI是评价妊娠期高血压疾病早期左心室功能异常准确而灵敏的指标。
Objective To explore the echocardiography and plasma N-terminal brain natriuretic peptide precursor(NT-proBNP)level in evaluation of left ventricular function in gestational hypertension patients with different ventricle geometric patterns.Methods Seventy-seven patients with gestational hypertension and 26 normotensive pregnant women(control group)were enrolled in the study.According to Ganau categories,the patients were divided into normal pattern group(25 cases),concentric remodeling group(23 cases),concentric hypertrophy group(16 cases)and eccentric hypertrophy group(13 cases).The parameters of left ventricular morphology and functions were measured by echocardiography,including relative wall thickness(RWT),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF),mitral valve diastolic early E wave peak velocity(E),diastolic late A wave peak velocity(A),E/A,systolic myocardial motion peak velocity of left ventrical lateral wall and ventricular septum in the mitral annulus(Sa1,Sa2),early diastolic myocardial motion peak velocity of left ventrical lateral wall and ventricular septum in the mitral annulus(Ea1 and Ea2).The mean of Sa1,Sa2(Sam),and E/Ea1,E/Ea2(E/Eam)were calculated.And plasma NT-proBNP concentration were detected.Results Compared with the control group,LVMI,E/Eam,NT-proBNP in concentric hypertrophy group and eccentric hypertrophy group were significantly increased,and the Sam significantly decreased(P<0.05).Correlation analysis showed that LVMI,E/Eam were positively correlated with the natural logarithmic transformation of NT-proBNP(Ln NT-proBNP)(r=0.74,0.58,P<0.05);Sam were negatively correlated with Ln NT-proBNP(r=-0.71,P<0.05).Multiple linear stepwise regression analysis showed that E/Eam,Sam,LVMI were independent influencing factors of Ln NT-proBNP.Conclusion E/Eam,Sam and LVMI measured by echocardiography are accurately and sensitive indexes for evaluation of left ventricular early dysfunction in patients with gestational hypertension.
作者
寿列军
解左平
金社红
谭乳燕
谢乐燕
袁华
SHOU Liejun;XIE Zuoping;JIN Shehong;TAN Ruyan;XIE Leyan;YUAN Hua(Department of Diagnostic Ultrasound,Shaoxing Women&Children's Hospital,Shaoxing 312000,China)
出处
《浙江医学》
CAS
2021年第2期161-166,共6页
Zhejiang Medical Journal
基金
浙江省公益性技术应用研究计划项目(2015C33296)
绍兴市公益性技术应用研究计划项目(2014B70060)。
关键词
超声心动图
N-端脑利钠肽前体
妊娠期高血压疾病
左心室功能
Echocardiography
N-terminal brain natriuretic peptide precursor
Hypertensive disorder complicating pregnancy
Ventricular function
Left
