医学影像学杂志

目的探讨重度子痫前期(severe preeclampsia,SPE)与正常孕妇心脏形态及功能的差异。方法回顾分析37例重度子痫前期患者及31例正常妊娠孕妇的经胸超声心动图(TTE)及临床资料,比较两组心脏形态、心功能指数的差异。结果与正常妊娠比较,SPE组收缩末期左心房内径(LAD)、舒张末期左心室内径(LVDD)及室间隔厚度(IVSTD)明显增大(P<0.05);舒张末期右心室内径(RVDD)、收缩末期右心房内径(RAD)两组无明显差异(P>0.05)。SPE组舒张末期收缩功能参数LVFS(左心室短轴缩短率)、LVEF(左心室射血分数)较正常妊娠下降(P<0.05),舒张功能参数E/A比值显著下降(P<0.01),其中21例E/A<1。两组心输出量(CO)无显著差异(P>0.05)。SPE组心包积液发病率较正常妊娠明显升高(χ²=7.67,P<0.01)。结论 SPE患者心脏形态改变以左心增大、IVSTD增厚为主,心脏舒张功能及收缩功能均下降。

Objective To explore differences of cardiac morphology and cardiac function between severe preeclampsia and normal pregnant women.Methods We retrospectively analyzed transthoracic echocardiography(TTE) and clinical data of37 cases of severe preeclampsia and 31 cases of normal pregnancy,and compared the cardiac morphology and cardiac function index of two groups.Results Compared with normal pregnancy group in SPE group,end-systolic left atrial diameter(LAD),left ventricular end-diastolic internal diameter(LVDD) and interventricular septum thickness(IVS) were significantly increased(P <0.05);Right ventricular end-diastolic internal diameter(RVDD) and end-systolic right atrial diameter(RAD) in two groups had no significant difference(P >0.05).Moreover,compared with normal pregnancy,end-diastolic systolic function parameters LVFS(left ventricular fractional shortening) and LVEF(left ventricular ejection fraction) in two groups were decreased(P <0.05).Diastolic function parameter E/A was significantly decreased(P <0.01);CO had no significant difference in two groups(P >0.05).In SPE group,the incidence of pericardial effusion was significantly higher than normal pregnancy(χ²=7.67,P <0.01).Conclusion Cardiac morphology changes in SPE patients were mainly left ventricular increasing and IVSTD thickening,and both diastolic function and systolic function decreased.