妊娠高血压疾病胎儿肺静脉血流参数在左心舒张功能评估中的临床价值

目的 探讨妊娠期高血压疾病(HDCP)胎儿肺静脉(PV)血流参数在左心舒张功能评估中的价值。方法 选择我院产科2017年7月至2018年11月收治的HDCP患者137例(疾病组),其中妊娠高血压49例(A组),轻度子痫前期46例(B组),重度子痫前期42例(C组),选择同期于我院产检的健康孕妇40例(对照组)。对各组胎儿进行心脏超声检查,比较各组胎儿PV血流参数,包括心房收缩期峰值流速(A)、心室收缩期峰值流速(S)、心室舒张期峰值流速(D),肺静脉搏动指数(PI)、肺静脉峰值流速指数(PVIV),分析疾病组各血流参数的相关性。并比较疾病组是否发生新生儿窒息胎儿的PV血流参数。结果 疾病组A峰流速低于对照组,PI、PVIV值高于对照组,差异均有统计学意义(P＜0.05)；

Clinical Value of Fetal Pulmonary Venous Blood Flow Parameters in Assessment of Left Ventricular Diastolic Function in Pregnancy Induced by Gestational HypertensionChen Wanming1,Liu Changzhu1,Ma Xiaoyan2

Objective To investigate the value of fetal pulmonary vein (PV) blood flow parameters in the assessment of left ventricular diastolic function in pregnancy induced by gestational hypertension (HDCP). Methods 137 cases (disease group) of HDCP admitted to our hospital from July, 2017 to November, 2018 were selected, including 49 cases of pregnancy hypertension (group A), 46 cases of mild preeclampsia (group B), 42 cases of severe preeclampsia (Group C), 40 cases of healthy pregnant women (control group) were selected from our hospital during the same period. The blood flow parameters of PV in each group were compared, including peak atrial systolic velocity (A), peak ventricular systolic velocity (S), peak ventricular diastolic velocity (D), pulmonary vein pulsation index (PI), peak pulmonary vein velocity index (PVIV) after ultrasound examination. The PV blood flow parameters of asphyxiated fetus of the disease group were compared. Results The peak flow rate of A of the disease group was lower than that of the control group, and the values of PI and PVIV were higher than those of the control group, the differences were statistically significant(P < 0.05); The peak velocity of AA decreased of the group A, B and C (P < 0.05), PI and PVIV increased of the group A, B and C (P < 0.05), and there was significant difference between the two groups (P < 0.05); Pearson correlation analysis showed that the peak velocity of A of the disease group was negatively correlated with PI and PVIV (r = -0.724, - 0.639, P < 0.05); 26 cases of neonatal asphyxia occurred of the disease group after birth There was no asphyxia in the other 111 cases (no asphyxia group). The peak velocity of A of the asphyxia group was lower than that of the non asphyxia group (P < 0.05), and the values of PI and PVIV were higher than that of the non asphyxia group (P < 0.05). Conclusion The detection of PV blood flow parameters can early understand left ventricular diastolic function of HDCP fetus and provide basis for early clinical intervention.