心肌做功指数评价产科抗磷脂综合征孕妇胎儿左心室功能

目的 观察心肌做功指数（MPI）评价产科抗磷脂综合征（OAPS）孕妇胎儿左心室（LV）功能的价值。方法 前瞻性纳入41例单胎妊娠OAPS孕妇包括16例典型OAPS （C-OAPS组）及25例非典型OAPS （NC-OAPS组）]及60名健康孕妇（对照组），比较3组胎儿二尖瓣口血流频谱E/A值、LV等容舒张时间（IRT）、等容收缩时间（ICT）、射血时间（ET）及MPI；采用受试者工作特征（ROC）曲线评估MPI预测孕妇不良妊娠结局的效能。结果 3组胎儿二尖瓣口血流频谱E/A值、LV IRT、LV ICT、LV ET及MPI差异均有统计学意义（P均<0.05）。两两比较，C-OAPS组、NC-OAPS组及对照组LV IRT及MPI依次降低、而二尖瓣口血流频谱E/A值及LV ET依次升高（P均<0.05）；C-OAPS组LV ICT高于对照组（P<0.05）。以MPI预测OAPS孕妇不良妊娠结局的敏感度、特异度及曲线下面积分别为90.00%、64.45%及0.798。结论 MPI可用于评价OAPS孕妇胎儿LV功能及预测不良妊娠结局。

Myocardial performance index for evaluating fetal left ventricular function in pregnant women with obstetric antiphospholipid syndrome

Objective To observe the value of myocardial performance index (MPI) for evaluating fetal left ventricular (LV) function in pregnant women with obstetric antiphospholipid syndrome (OAPS). Methods Totally of 41 singleton pregnancy women with OAPS (criteria-OAPS C-OAPS] group, n=16; non-criteria OAPS NC-OAPS] group, n=25) and 60 healthy singleton pregnancy women (control group) were prospectively enrolled. Mitral flow E velocities/A velocities, isovolumic relaxation time (IRT), isovolumic contraction time (ICT), ejection time (ET) and MPI of fetal LV were compared among 3 groups. Receiver operating characteristic (ROC) curve was drawn to evaluate the efficacy of MPI for predicting adverse pregnancy outcomes of pregnant woman. Results Significant differences of mitral flow E velocities/A velocities, IRT, ICT, ET and MPI of fetal LV were found among 3 groups (all P<0.05). Results of pairwise comparison showed that among C-OAPS group, NC-OAPS group and control group, IRT and MPI of LV decreased, whereas E/A and ET of LV increased in order (all P<0.05). ICT in C-OAPS group was higher than that in control group (P<0.05). The sensitivity, specificity and area under the curve of MPI for predicting adverse pregnancy outcomes of pregnant woman with OAPS was 90.00%, 64.45% and 0.798, respectively. Conclusion MPI could be used to evaluate fetal LV function in pregnant women with OAPS, also being helpful for predicting adverse pregnancy outcomes.