标题：子痫前期孕妇超声心动图改变与血清NT-proBNP水平变化的临床意义

      作者：车亚玲 1，李璠 2，惠彩玲 1    1.西安市中心医院妇产科，陕西 西安 710003；2.西北工业大学医院超声诊断科，陕西 西安 710072

      卷次： 2019年30卷14期

      【摘要】 目的 探讨子痫前期孕妇超声心动图改变与血清N端脑利纳肽前体(NT-proBNP)水平的变化及其临床意义。方法 选择2015年10月至2018年10月西安市中心医院妇产科收治的65例子痫前期患者(观察组)为研究对象，其中轻度子痫29例(轻度组)、重度子痫36例(重度组)，并选择同期50例正常孕妇为对照组。所有患者均行超声心功图检测左室舒张末内径(LVIDd)、左室收缩末内径(LVIDs)、右房内径(RVDd)、左室射血分数(LVEF)，并检测血清心肌酶[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]、NT-proBNP水平。比较两组间上述指标的差异，并分析血清NT-ProBNP水平与LVEF的相关性。结果 观察组患者的LVIDs为(30.28±5.62) mm，明显高于对照组的(26.35±3.51) mm，LVEF为(64.25±5.69)%，明显低于对照组的(68.25±6.85)%，差异均有统计学意义(P<0.05)，而观察组和对照组的LVIDd [(48.52±5.02) mm vs (47.16±4.25) mm]、RVDd [(20.31±3.69) mm vs (19.77±2.61) mm]比较差异均无统计学意义(P>0.05)；观察组和对照组患者的CK [(156.52±35.25) U/L vs (82.21±20.07) U/L]、CK-MB [(12.35±6.59) U/L vs (8.02±4.61) U/L]、LDH [(253.26±30.25) U/L vs (135.13±12.54) U/L]、NT-ProBNP [(142.02±12.35) pg/mL vs(86.25±6.97) pg/mL]水平比较，观察组均明显高于对照组，差异均有统计学意义(P<0.05)；轻度组患者的LVIDs为(28.15±4.57) mm，明显低于重度组的(31.21±5.98) mm，LVEF为(66.23±6.25)%，明显大于重度组的(63.02±4.39)%，NT-ProBNP水平为(130.51±9.68) pg/mL，明显低于重度组的(143.25±13.01) pg/mL，差异均有统计学意义(P<0.05)；Pearson相关性分析结果显示，血清NT-ProBNP水平与LVEF呈高度负相关(r=-0.761，P<0.05)。结论 超声心动图和血清NT-ProBNP检测有助于早期发现子痫前期孕妇心功能损伤。
      【关键词】 子痫前期；超声心动图；N端脑利纳肽前体；妊娠；高血压；子痫
      【中图分类号】 R714.24+5 【文献标识码】 A 【文章编号】 1003—6350（2019）14—1827—03

Clinical significance of echocardiographic changes and N-terminal pro-brain natriuretic peptide level inpregnant women with preeclampsia.
CHE Ya-ling 1, LI Fan 2, HUI Cai-ling 1. 1. Department of Obstetrics andGynecology, Xi'an Central Hospital, Xi'an 710003, Shaanxi, CHINA; 2. Department of Ultrasound Diagnosis, NorthwesternPolytechnical University, Xi'an 710072, Shaanxi, CHINA
【Abstract】 Objective To investigate the echocardiographic changes of pregnant women with preeclampsia andthe changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) level and its clinical significance. Methods A to-tal of 65 pregnant women with preeclampsia (the observation group), who admitted to Department of Obstetrics and Gy-necology of Xi'an Central Hospital from Oct. 2015 to Oct. 2018, were selected as the research object, including 29 casesof mild eclampsia (mild group), 36 cases of severe eclampsia (severe group), and 50 normal pregnant women in the sameperiod were selected as the control group. The left ventricular end-diastolic diameter (LVIDd), left ventricular end-systol-ic diameter (LVIDs), right atrial diameter (RVDd), left ventricular ejection fraction (LVEF) were measured by echocar-diography in all patients, and the levels of serum myocardial enzymes (creatine kinase [CK], creatine kinase isoenzyme[CK-MB], lactate dehydrogenase [LDH]), NT-proBNP were measured. The differences of the above indicators betweengroups were compared. The correlation between serum NT-ProBNP level and LVEF was analyzed. Results The LVIDsin the observation group were (30.28±5.62) mm, which was significantly higher than (26.35±3.51) mm in the controlgroup (P<0.05); the LVEF was (64.25±5.69)%, which was significantly lower than (68.25±6.85)% of the control group(P<0.05). There was no significant difference in LVIDd and RVDd between the observation group and the control group(P>0.05): (48.52±5.02) mm vs (47.16±4.25) mm, (20.31±3.69) mm vs (19.77±2.61) mm. The levels of CK, CK-MB,LDH, NT-ProBNP in the observation group were (156.52±35.25) U/L, (12.35±6.59) U/L, (253.26±30.25) U/L, (142.02±12.35) pg/mL, respectively, which were significantly higher than corresponding (82.21±20.07) U/L, (8.02±4.61) U/L,(135.13±12.54) U/L, (86.25±6.97) pg/mL in the control group (all P<0.05). LVIDs in the mild group were significantlylower than those in the severe group (P<0.05): (28.15±4.57) mm vs (31.21±5.98) mm, and LVEF in the mild group wassignificantly higher than that in the severe group (P<0.05): (66.23±6.25)% vs (63.02±4.39)%. The level of NT-ProBNP