三维斑点追踪技术与血清学指标评估子痫前期患者左心功能损伤的应用价值

目的 探讨三维斑点追踪(3D-STI)技术与血清学指标评估子痫前期患者左心功能损伤的临床应用价值.方法 选取我院收治的143例子痫前期孕妇,根据其是否合并左心功能损伤分为子痫前期组82例和合并组61例,另选同期体检正常的妊娠期孕妇40例为对照组,各组均行常规超声和3D-STI检查,并检测血清Ca+、内皮素、心脏型脂肪酸...

Application value of three-dimensional speckle tracing and serum markers in left heart injury in patients with preeclampsia

Objective To explore the clinical application value of three-dimensional speckle tracing(3D-STI)and serum indexes in left heart imjury in patients with preeclampsia.Methods A total of 143 pregnant women with preeclampsia admitted to our hospital were selected,they were divided into preeclampsia group(n=82)and combined group(n=61)according to the combination of left cardiac function injury or not.At the same time,normal pregnant women were choosed as control group(n=40).Conventional ultrasound and 3D-STI were performed on all patients,and serum Ca+,endothelin(ET),heart-type fatty acid binding protein(H-FABP)and N-terminal B-type brain natriuretic peptide precursor(NT-proBNP)levels were meascered.The results were compared and analyzed.Pearson analysis was used for correlation analysis among left ventricular ejection fraction(LVEF),Tei index and 3D-STI parameters and serological indexes.Receiver operating characteristic(ROC)curve was drawn for evaluating the diagnostic efficacy of each index in predicting left heart injury in patient with preeclampsia,and the area under curve(AUC)was calculated.Results There were significant differences of ultrasound parameters including LVEF,Tei index,global longitudinal strain(GLS),global area strain(GAS)of left ventricular,serological indicators Ca+,ET,H-FABP and NT-proBNP(all P<0.05).In addition,GLS and GAS in the combined group were significantly lower than those in the preeclampsia group and the control group(all P<0.05).Tei index and GLS in the preeclampsia group were significantly lower than those in the control group(both P<0.05).Ca+in the preeclampsia group and the combined group was significantly lower than that in the control group,while ET,H-FABP and NT-proBNP were significantly higher than those in the control group(all P<0.05).ET,H-FABP and NT-proBNP in the combined group were significantly higher than those in the preeclampsia group(all P<0.05).LVEF was positively correlated with GLS,GAS and Ca+(all P<0.05),and negatively correlatedwithET,H-FABPandNT-proBNP(allP<0.05).Teiindexwasnegatively correlated with GLS,GAS and Ca+(all P<0.05),and positively correlated with ET,H-FABP and NT-proBNP(all P<0.05).ROC curve analysis showed that the cutoff values of GLS,ET,H-FABP,NT-proBNP were 15.585%,77.775μg/L,21.9μg/L,341.725μg/L,respectively.The AUC were 0.627,0.643,0.774,0.627,the sensitivity were 0.639,0.885,0.787,0.984,and the specificity were 0.622,0.451,0.634,0.305,respectively.The AUC of combined diagnosis was 0.819,the sensitivity was 0.738 and the specificity was 0.768,and the AUC of combined diagnosis was significantly higher than that of GLS,ET,H-FABP and NT-proBNP alone(all P<0.05).Conclusion The combination of 3D-STI and serological indicators can improve the prediction effect of left heart injury in patients with preeclampsia in clinic,which has higher application value.