三维斑点追踪成像技术评价子痫前期患者左心室收缩功能

目的 采用三维斑点追踪成像（3D-STI）技术检测子痫前期患者左心室收缩功能。方法 纳入轻度子痫前期患者73例（轻度组）、重度子痫前期患者64例（重度组）和年龄、孕周匹配的健康孕妇60例（对照组）。检测生化指标和常规超声参数，并运用3D-STI测量左心室收缩期整体纵向峰值应变（GLS）、整体径向峰值应变（GRS）、整体环向峰值应变（GCS）和整体面积峰值应变（GAS），计算面积应变不同步指数（ASDI）。并分析三维应变参数与生化指标及超声参数的相关性。结果 与对照组比较，重度组左心房前后径（LAD）增大，二尖瓣口舒张期流速比值（E/A）减低，Tei指数在对照组、轻度组、重度组依次增高（P均<0.05）。与对照组比较，轻度组|GLS|、|GAS|降低，ASDI增高，重度组|GLS|、|GRS|、|GCS|、|GAS|和ASDI差异均有统计学意义（P均<0.05）。与轻度组比较，重度组GLS、GAS明显降低，ASDI明显增高（P均<0.05）。|GLS|与Tei指数呈负相关（r=-0.471，P=0.036）；|GAS|与LVEF呈正相关（r=0.051，P=0.028），与Tei指数呈负相关（r=-0.612，P=0.017）；ASDI与心脏脂肪酸结合蛋白（H-FABP）呈负相关（r=-0.525，P=0.046），与Tei指数呈正相关（r=0.489，P=0.037）。结论 子痫前期患者左心室收缩功能明显受损，心肌应变能力下降，3D-STI技术可早期无创评价子痫前期患者左心室收缩功能变化。

Three-dimensional speckle tracking imaging technology in evaluation on systolic function of left ventricular in patients with preeclampsia

Objective To evaluate the systolic function in patients with preeclampsia using three-dimensional speckle tracking imaging (3D-STI) technology. Methods Totally 73 patients with mild preeclampsia (mild group), 64 patients with severe preeclampsia (severe group) and 60 healthy pregnant women with matched age and gestational weeks (control group) were enrolled in this study. All the biochemical indicators and conventional echocardiogram parameters were detected. The left ventricular global longitudinal systolic peak strain (GLS), global radial systolic peak strain (GRS), global circulation systolic peak strain (GCS) and global area systolic peak strain (GAS) were measured using 3D-STI, and the dyssynchronization index of area strain (ASDI) was calculated in all three groups. The correlation between sensitive three dimensional strain and biochemical indexes and echocardiogram parameters were analyzed. Results Compared with control group, the left atrial diameter (LAD) increased, E/A decreased in severe group, Tei index increased in turn at control group, mild group and severe group (all P<0.05). Compared with control group, the|GLS|and|GAS|reduced and ASDI was increased in mild group, the changes were more significant in severe group. The GRS and GCS were also appeared lower in severe group (all P<0.05). The correlation analysis showed a negative correlation between|GLS|and Tei index (r=-0.471, P=0.036), a positive correlation between|GAS|and LVEF (r=0.051, P=0.028), a negative correlation between|GAS|and Tei index (r=-0.612, P=0.017), a negative correlation between ASDI and H-FABP (r=-0.525, P=0.046), a positive correlation between ASDI and Tei index (r=0.489, P=0.037). Conclusion The myocardial strain capacity of left ventricular decrease and systolic function are significantly impaired in patients with preeclampsia. The 3D-STI technology can early noninvasively assess the change of left ventricular systolic function in patients with preeclampsia.