多普勒测定孕妇左心室舒张功能与年龄、心率及胎龄变化的关系

目的运用多普勒及组织多普勒技术测定正常孕妇左心室舒张功能变化,探讨孕妇年龄、胎龄、心率与心功能的关系,为孕产妇早期心功能判断提供帮助。方法选取2009年4月至2010年4月产前检查704例孕妇,年龄19~41岁,平均年龄26.43岁。对所有孕妇进行超声心动图检查,常规检测各项数据,然后分别测定二尖瓣血流频谱及二尖瓣环部组织多普勒频谱。分析孕妇不同年龄、心率及胎龄与左心室舒张功能不全的关系。结果出现血流多普勒异常43例(6.1%),组织多普勒异常152例(21.6%)。随年龄增长、胎龄增长及心率增快,组织多普勒和血流多普勒异常也增多,并且组织多普勒改变比血流多普勒更加明显。结论孕妇怀孕的生理过程相当于心脏功能的负荷试验,使正常衰老过程或病理状态下才出现的舒张功能改变提早出现。并且与孕妇的年龄、胎龄、心率增加有关,这种负荷试验出现的心脏舒张功能异常改变,对孕妇分娩时心功能估计及产后心脏情况评价有积极意义。

Study on relationship among diastolic function of left ventricular,age,heart rate,and gestational age by Doppler in pregnancy women

Objective To determine the left ventricular diastolic function by common Doppler and tissue Doppler imaging in pregnant women,and investigate its relationship among age,gestational age and heart rate.Methods The 704 pregnant women checked with echocardiography from April 2009 to April 2010 were enrolled,aged 19-41 years old,mean age 26.43 years old.All of them were checked in routine data firstly,then recorded the frequency spectrum of blood flow under mitral valve(E/A) and tissue in mitral ring(Em/Am).The frequency spectrum of E/A ≤ 1 and Em/Am ≤ 1 were defined as diastolic dysfunction,and the relationship among diastolic dysfunction,maternal age,gestational age and heart rate were investigated.Results The abnormality rate was 6.1 %(43/704) maternal age assessed by flow frequency spectrum,and 21.6 %(152/704) assessed by tissue frequency spectrum.The rate of abnormality increased with maternal age,gestational age and heart rate growth.Conclusion It is demonstrated that pregnancy physiological process is equivalent to the stress test in heart function,and that made change of diastolic function,which should occur in normal aging process or under pathological condition,appear earlier.The dysfunction is related with maternal age,gestational age and heart rate,and which will be helpful to assess the left ventricular function of pregnancy women in partum and postpartum period.