摘要
目的 探讨心肌做功指数(MPI)评价胆汁淤积症(ICP)孕妇胎儿心功能的临床价值。资料与方法 回顾性选取2016年1月—2021年5月在首都医科大学附属北京妇产医院临床确诊ICP孕妇胎儿24例(ICP组)和正常孕妇胎儿53例(对照组),比较两组胎儿左心室MPI、二尖瓣E/A比值的差异。采用受试者工作特征曲线分析MPI对不良结局的预测价值,不良结局定为胎儿窘迫、早产、新生儿转ICU、新生儿低血糖等任意一个。结果 与对照组比较,ICP组左心室MPI显著升高(0.55±0.03比0.45±0.04;t=9.530,P<0.001);ICP组二尖瓣E/A值显著降低(0.58±0.13比0.77±0.11;t=-0.7481,P<0.001)。ICP组胎儿左心室MPI预测不良结局的受试者工作特征曲线下面积为0.856(95%CI 0.771~0.941,P<0.01),最佳截断值为0.50,敏感度为100%,特异度为67.2%。结论 ICP孕妇胎儿左心室心功能降低,左心室MPI对预测不良结局具有一定的临床价值。
Purpose To evaluate the clinical value of myocardial performance index(MPI) in evaluating fetal cardiac function in women with intrahepatic cholestasis of pregnancy(ICP). Materials and Methods Twenty-four singleton pregnant women with ICP of gestation and 53 healthy women with normal pregnancies were retrospectively enrolled in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2016 to May 2021. The left ventricular modified myocardial performance index(LV-Mod-MPI) and E wave/A wave peak velocities(E/A) ratios were compared between the two groups via Doppler echocardiography. Adverse perinatal outcome was defined as fetal distress, premature birth, admission to the neonatal ICU and neonatal hypoglycemia. The receiver operating characteristic curve of MPI was performed to evaluate the prognostic value of adverse pregnancy outcomes. Results The LV-Mod-MPI of ICP group was significantly higher than that of control group(0.55±0.03 vs. 0.45±0.04;t=9.530, P<0.001), and MV E/A ratio of ICP group was significantly lower than that of control group(0.58±0.13 vs. 0.77±0.11;t=-0.7481, P<0.001). The area under the curve of LV-Mod-MPI of ICP group in predicting the adverse outcome was 0.856(95% CI 0.771-0.941, P<0.01), and the optimal cut-off level was 0.50, the sensitivity and specificity were 100% and 67.2%, respectively. Conclusion The significant decreases of left ventricular function can be found in women with ICP, and the LV-Mod-MPI has certain clinical value in predicting adverse outcome.
作者
张娜
吴青青
孙丽娟
张丽娜
韩吉晶
李贞
ZHANG Na;WU Qingqing;SUN Lijuan;ZHANG Lina;HAN Jijing;LI Zhen(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第3期250-253,267,共5页
Chinese Journal of Medical Imaging
基金
北京市科学技术委员会首都市民健康培育项目(Z161100000116089)。
关键词
胆汁淤积症
心肌做功指数
孕妇
胎儿
新生儿
Intrahepatic cholestasis
Myocardial performance index
Pregnancy
Fetus
Neonatus
