速度向量成像技术定量参数评估妊娠期肝内胆汁淤积症孕妇胎儿心功能研究*

目的 探讨速度向量成像技术(VVI)定量参数评估妊娠期肝内胆汁淤积症(ICP)孕妇胎儿心功能的价值。方法 2016年5月～2018年5月我院收治的100例ICP孕妇(轻度ICP50例和重度ICP50例)胎儿和98例同孕周正常孕妇胎儿,均接受超声心动图检查,并将动态四腔心声像图导入速度向量成像技术(VVI)软件,获取左心室和右心室VVI定量参数,包括舒张期峰值速度(Vd)、收缩期峰值速度(Vs)、收缩期峰值应变(S)、舒张期峰值应变率(SRd)、收缩期峰值应变率(SRs),比较各组上述指标变化情况。结果 重度ICP胎儿左心室整体S为(-11.2±1.1)%,显著低于轻度ICP和对照组,SRd为(1.5±0.2)/s,显著低于轻度ICP和对照组,SRs为(-1.7±0.1)/s,显著低于轻度ICP和对照组;三组左心室整体Vd和Vs比较差异无统计学意义(P＞0.05);重度ICP胎儿右心室整体Vd为(1.3±0.3)cm/s,显著低于轻度ICP和对照组,S为(17.6±2.5)%,显著低于轻度ICP和对照组,SRd为(1.6±0.6)/s,显著低于轻度ICP和对照组,SRs为(-2.1±0.2)/s,显著低于轻度ICP和对照组;三组右心室整体Vs比较差异无统计学意义(P＞0.05)。结论 应用VVI定量参数Vd、S、SRd、SRs评估ICP孕妇胎儿心功能具有重要的作用,其临床意义还需要进一步探讨。

Evaluation of fetal cardiac functions by velocity vector imaging in pregnant women with intrahepatic cholestasis of pregnancy

Objective The aim of this study was to investigate the evaluation of fetal cardiac functions by velocity vector imaging(VVI)in pregnant women with intrahepatic cholestasis of pregnancy(ICP).Methods 100 ICP pregnant women(mild in 50 and severe in 50)and 98 healthy pregnant women and their fetuses were enrolled in our hospital between May 2016 and May 2018.All the fetuses were examined by echocardiography and the parameters were analyzed by velocity vector imaging(VVI),which included diastolic peak velocity(Vd),systolic peak velocity(Vs),peak systolic strain(S),diastolic peak strain rate(SRd)and peak systolic strain rate(SRs).Results The overall S of the left ventricle in fetuses from severe ICP group was(-11.2±1.1)%,significantly lower than[(-16.7±2.0)%,P<0.05]in from mild ICP group or[(-17.0±2.0)%,P<0.05]in from healthy control,the SRd was(1.5±0.2)/S,significantly lower than[(1.8±0.2)/S,P<0.05]in fetuses from mild ICP group or[(1.9±0.2)/S,P<0.05]in healthy group,and the SRs was(-1.7±0.1)/S,significantly lower than[(-2.0±0.1)/s,P<0.05]in from ICP mild group or[(-2.0±0.2)/s,P<0.05]in from healthy control;there was no significant difference in left ventricular Vd and Vs among the three groups(P>0.05);the overall Vd of right ventricle in fetuses from severe ICP group was(1.3±0.3)cm/s,significantly lower than[(1.8±0.3)cm/s,P<0.05]or[(1.8±0.3)cm/s,P<0.05],the S was(17.6±2.5)%,significantly lower than[(22.6±3.2)%,P<0.05]or[(23.1±3.8)%,P<0.05],the SRd was(1.6±0.6)/s,significantly lower than[(2.4±0.7)/s,P<0.05]or[(2.5±0.7)/s,P<0.05],and the SRs was(-2.1±0.2)/s,significantly lower than[(-2.7±0.3)/s,P<0.05]or[(-2.7±0.3)/s,P<0.05]in from mild ICP group or healthy control group;there was no significant difference in the overall Vs of right ventricle among the three groups(P>0.05).Conclusion The early evaluation of fetal cardiac functions by VVI parameters might be beneficial in clinical practice.