摘要
目的应用超声心动图评估双胎妊娠并发症孕妇左心结构和功能随孕周增长的变化规律。方法选取经我院定期产前检查诊断的双胎妊娠并发症孕妇20例(病例组)和正常双胎妊娠孕妇50例(对照组),均于妊娠早中期(孕11～14周)、妊娠中期(孕21～26周)及妊娠晚期(孕28～34周)行常规产前超声检查和成人超声心动图检查,对病例组孕妇的左心结构和功能进行纵向研究,并与对照组各相关参数进行比较。结果两组孕妇左房舒张末期内径均随孕周增加而增大,其中病例组左房收缩末期内径在妊娠中晚期显著增加,两组比较差异有统计学意义(P<0.05);两组二尖瓣舒张早期血流峰值速度与二尖瓣环舒张早期运动峰值速度比值(E/e’)均随孕周增长而升高,但病例组心输出量、心脏指数、心率及左室射血分数(LVEF)随孕周增加无明显变化;与对照组比较,病例组妊娠早中期LVEF低,妊娠中期Tei指数高,差异均有统计学意义(均P<0.05)。结论双胎妊娠并发症孕妇左房舒张、收缩末期内径随孕周增大而增加,心输出量、心脏指数、心率随孕周增大未出现正常适应性改变,妊娠早中期即表现为左室收缩末期内径增高、LVEF降低,妊娠中期心脏整体功能较差。
Objective To investigate the maternal left cardiac morphology and function in complicated twin pregnancies by echocardiography.Methods A total of 20 complicated twin pregnancies who were diagnosed by regular prenatal examinations were obtained as study group,and 50 normal twin pregnancies were selected as control group. These cases underwent serial fetal ultrasound examinations and maternal echocardiography at 11~14 weeks,21~26 weeks and 28~34 weeks of gestation.Left cardiac morphologic and functional parameters were assessed longitudinally in complicated twin pregnancies who developed pre-eclampsia and fetal growth restriction,and compared with normal twin pregnancies.Results Maternal left atrial end-diastolic dimensions showed significant increase throughout the pregnancy period in both two groups.Left atrial end-systolic dimensions showed significant increase in study group,especially at second and third trimester(P<0.05).Peak velocity of early diastolic period / peak velocity of early diastolic filling(E/e’) showed significant increase throughout the pregnancy period in both groups,but cardiac output(CO),cardiac index(CI),heart rate(HR)and left ventricular ejection fractions(LVEF)remained stable throughout the pregnancy period in study group.Compared with control group,LVEF was lower at 11~14 weeks,and Tei index was higher at 21~26 weeks in study group(both P<0.05). Conclusion Left atrial end-systolic and end-diastolic dimensions showed significant increase in complicated twin pregnancies,but CO,CI and HR does not show the profound adaptable changes.Left ventricular end-systolic dimensions is higher and LVEF is lower at early second-trimester,and global cardiac function is poor at second trimester.
作者
李晓菲
王莉
马玉庆
孙丽娟
张丽娜
安园园
邓笛
王晶晶
吴青青
LI Xiaofei;WANG Li;MA Yuqing;SUN Lijuan;ZHANG Lina;AN Yuanyuan;DENG Di;WANG Jingjing;WU Qingqing(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)
出处
《临床超声医学杂志》
CSCD
2019年第2期89-93,共5页
Journal of Clinical Ultrasound in Medicine
基金
国家重点研发计划项目(2016YFC1000104)
北京市医院管理局"登峰"计划专项(DFL20151302)
首都医科大学附属北京妇产医院院内课题(201207)
关键词
超声心动描记术
妊娠并发症
双胎
心脏结构
左
心功能
左
Echocardiography
Pregnancy complication,twin
Cardiac morphology,left
Cardiac function,left
