应用多普勒组织显像评价腹主动脉壁运动预测妊娠期高血压疾病的临床应用价值探讨

目的 探讨应用多普勒组织显像(DTI)评价腹主动脉壁运动预测妊娠期高血压疾病的临床应用价值.方法 对112例孕龄20～40周正常孕妇的腹主动脉前壁进行DTI检查,结合同步心电图描记,测量电-机械时间(EMT)、射血前期时间(PEP),同时测量患者身高和体重,计算脉搏波时间(PWT,PWT=EMT-PEP)和相对脉搏波速度(RPWV).临床随访记录孕中、晚期妊娠期高血压疾病发病例数及时间.结果112例正常孕妇中,中、晚期发生妊娠期高血压疾病11例.妊娠期高血压疾病患者的频谱图第一峰(E峰)、第二峰(S_1峰),第三峰(S_2峰)、第四峰(D峰)峰值均明显低于无妊娠期高血压疾病患者[分别为(2.02±0.39)cm/s比(2.32±0.45)cm/s、(6.08±0.87)cm/s比(7.12±1.11)cm/s、(2.22±0.65)cm/s比(2.83±0.81)cm/s、(3.26±0.54)cm/s比(3.86±0.72)cm/s,P<0.01];EMT缩短[(120.87±11.34)ms比(134.32±10.62)ms,P<0.05];PEP延长[(92.36±9.04)ms比(83.11±8.95)ms,P<0.05];PWT缩短[(31±11)ms比(45±13)ms,P<0.01];RPWV增快[(102.28±20.69)m/s比(75.37±18.74)m/s,P<0.01].结论 妊娠期高血压疾病早期腹主动脉壁的运动就已经发生改变,DTI评价腹主动脉壁运动可以作为一种早期发现妊娠期高血压疾病患者的敏感、准确、易于推广的方法 .

Study on abdominal aortic wall motion using Doppler tissue imaging in predicting pregnancy-induced hypertension

Objective To explore the clinical value of Doppler tissue imaging (DTI) in evaluating abdominal aortic wall motion to predict pregnancy-induced hypertension (PIH).Methods The velocities of anterior abdominal aortic wall motion in 112 pregnant women with normal 20-40 weeks' pregnancy were detected by DTI and combined with simultaneous electrocardiography.Electromechanical time (EMT), left ventricular pre-ejection period (PEP), patients' height and weight were measured and recorded respectively.Pulsed wave time (PWT, PWT = EMT-PEP) and relative pulse wave velocity (RPWV) were calculated and analyzed.Medium and late stage PIH eases and time were recorded in clinical follow-up.Results PIH group were 11 cases, non-PIH group were 101 cases.E, S_1, S_2, D peak value in PIH group were significantly lower than those in non-PIH group [(2.02 ± 0.39 ) cm/s vs (2.32 ± 0.45 ) cm/s, (6.08 ± 0.87 ) cm/s vs(7.12 ±1.11 ) cm/s, (2.22 ± 0.65 ) cm/s vs( 2.83 ± 0.81 ) cm/s, (3.26 ± 0.54) cm/s vs( 3.86 ± 0.72 ) cm/s, P < 0.01]; EMT shortening[(120.87 ± 11.34) ms vs (134.32 ± 10.62) ms,P<0.05];PEP longer[(92.36±9.04) ms vs(83.11±8.95) ms,P< 0.05];PWT shortening[(31 ± 11) ms vs(45 ± 13) ms,P<0.01]; RPWV faster [( 1 02.28 ± 20.69) m/s vs (75.37 ± 18.74) m/s, P < 0.01].Conclusions Abdominal aortic wall motion has already changed in early stage of PIH.DTI is a valuable method to evaluate the abdominal aorta wall motion for early detection of PIH with high sensitivity, high accuracy and access to promote.