标题:妊娠期高血压疾病患者左室舒张功能检测及新生儿结局评估
作者:雷燕,杨莉 渭南市妇幼保健院产科,陕西 渭南 714000
卷次:
2019年30卷22期
【摘要】 目的 探究妊娠期高血压疾病患者左室舒张功能检测结果及新生儿结局,为临床诊断和治疗提供参考依据。方法 选取2017年1月至2018年10月期间渭南市妇幼保健院产科接诊的妊娠期高血压患者156例设为研究组,其中妊娠期高血压41例(A组),轻度子痫前期50例(B组),重度子痫前期65例(C组),另选取同期收治的52例正常妊娠期孕妇为对照组。使用彩色多普勒超声检测所有受检者的舒张期二尖瓣血流频谱,测量其舒张晚期最大流速(A峰)和舒张早期最大流速(E峰),计算E/A比值、E峰减速时间(DT)。比较各组受检者的检测结果及新生儿结局。结果 A组、B组和C组患者的A峰值分别为(68.37±17.83) cm/s、(81.48±16.73) cm/s、(92.37±18.59) cm/s,明显高于对照组的(62.17±19.30) cm/s,DT值分别为(0.20±0.06) s、(0.28±0.09) s、(0.34±0.10) s,明显高于对照组的(0.13±0.01) s,差异均有统计学意义(P<0.05);A组、B组和C组患者E/A值分别为(1.12±0.18) cm/s、(1.08±0.20) cm/s、(0.74±0.11) cm/s,明显低于对照组的(1.47±0.23) cm/s,而C组患者的E峰值为(73.72±17.27) cm/s,明显低于对照组的(90.13±21.73) cm/s、A组的(102.31±21.36) cm/s和B组的(97.16±18.38) cm/s,差异均具有统计学意义(P<0.05);A组、B组和C组新生儿体质量分别为(3.23±1.32) kg、(3.08±1.15) kg、(2.92±1.02) kg,与对照组的(3.64±1.76) kg比较差异均无统计学意义(P>0.05);A组、B组和C组新生儿Apgar评分分别为(8.87±1.14)分、(8.01±1.11)分、(7.82±1.03)分,与对照组的(9.56±1.21)分比较差异均无统计学意义(P>0.05);研究组新生儿窒息、早产、胎儿窘迫、围生儿死亡的发生率明显高于对照组,差异均有统计学意义(P<0.05);C组、B组患者的不良妊娠结局发生率分别为32.31%、24.00%,明显高于A组的12.20%,差异均有统计学意义(P<0.05)。结论 应用超声心动图检测所有患者左室舒张功能,发现妊娠期高血压疾病患者左室舒张功能异常,且重度子痫前期患者的左室舒张功能异常现象较重,患者的新生儿不良结局发生率较高,需及早检测监控,保护新生儿健康。
【关键词】 高血压;妊娠期;左室舒张功能;超声心动图;子痫前期;新生儿结局
【中图分类号】 R714.24+6 【文献标识码】 A 【文章编号】 1003—6350(2019)22—2897—04
Detection of left ventricular diastolic function and evaluation of neonatal outcomes in 156 cases of gestationalhypertension.
LEI Yan, YANG Li. Department of Obstetrics, the Maternal and Child Health Hospital of Weinan City,Weinan 714000, Shaanxi, CHINA
【Abstract】 Objective To explore the results of left ventricular diastolic function test and neonatal outcomes inpatients with pregnancy-induced hypertension, and to provide reference for clinical practice. Methods A total of 156patients with pregnancy-induced hypertension admitted to the Maternal and Child Health Hospital of Weinan City fromJanuary 2017 to October 2018 were selected as the research subjects and divided into study group, including 41 patientswith pregnancy-induced hypertension (group A), 50 patients with mild pre-eclampsia (group B), and 65 patients with se-vere pre-eclampsia (group C). Another 52 normal pregnancy women admitted in the same period were selected as the con-trol group. The diastolic mitral flow spectrum of all women was measured by color Doppler ultrasonography. The maxi-mum late diastolic velocity (A peak) and early diastolic velocity (E peak) were measured. The E/A ratio and E peak decel-eration time (DT) were calculated. The test results and neonatal outcomes of each group were compared. Results The Apeak values of group A, group B, and group C were (68.37±17.83) cm/s, (81.48±16.73) cm/s, and (92.37±18.59) cm/s, re-spectively, which were significantly higher than (62.17 ± 19.30) cm/s in the control group (P<0.05). DT values were(0.20±0.06) s, (0.28±0.09) s, and (0.34±0.10) s, respectively, which were significantly higher than (0.13±0.01) s in thecontrol group (P<0.05). The E/A values of group A, group B, and group C were (1.12±0.18) cm/s, (1.08±0.20) cm/s, and(0.74±0.11) cm/s, respectively, which were significantly lower than (1.47±0.23) cm/s in the control group (P<0.05). TheE peak value was (73.72±17.27) cm/s in group C, significantly lower than (90.13±21.73) cm/s in control group, (102.31±21.36) cm/s in group A, and (97.16±18.38) cm/s in group B (P<0.05). The weights of newborns in group A, group B andgroup C were (3.23±1.32) kg, (3.08±1.15) kg, and (2.92±1.02) kg, which showed no significant difference as comparedwith (3.64±1.76) kg in the control group (P>0.05). The Apgar scores of the newborns were 8.87±1.14, 8.01±1.11, and7.82±1.03, respectively, which showed no significant difference as compared with 9.56±1.21 in the control group (P>0.05). The incidence of neonatal asphyxia, premature birth, fetal distress, and perinatal death in the study group wassignificantly higher than that in the control group (P<0.05). The incidence of adverse pregnancy outcomes in group Cand B was 32.31% and 24.00% respectively, which was significantly higher than that 12.20% i
下载PDF