二维超声斑点追踪成像技术评价正常妊娠胎儿心脏功能的临床研究

目的利用二维超声斑点追踪成像技术评价正常妊娠胎儿心脏功能。方法纳入我院常规产检的正常单胎妊娠孕妇50例,分别在24、32周和37周获得胎儿心尖四腔心二维图像。测量左室及右室的整体纵向应变(GLS)和收缩期应变率(GLSr)、舒张早期应变率(GLEr)、舒张晚期应变率(GLAr)。结果LVGLS、LVGLSr、RVGLEr及RVGLAr在三个不同孕周没有统计学差异,LVGLEr 32周及37周无差异,两组均与24周有统计学差异,LVGLAr随孕周增加而减低(P<0.05)。RVGLS随孕龄增加减低,三组间差异有统计学意义(P<0.05),第37周RVGLSr与24周比较呈减低。24周时LVGLEr/GLAr<1,32周及37周LVGLEr/GLAr>1,37周及32周分别与24周比较间存在统计学差异(P<0.05)。结论二维斑点追踪技术可以敏感评价胎儿心脏的功能。胎儿期心脏应变及应变率的变化反映了胎儿心脏成熟的过程,对其的研究可以更好的理解正常的生理变化。

Two-dimensional Speckle Tracking Echocardiography in Evaluation on Fetal Heart Function in Patients With Normal Pregnancy

Objective To evaluat the fetal heart function in normal pregnancy using two-dimensional Ultrasonic Speckle tracking Imaging.Methods 50pregnant women were recruited for fetal two-dimensional speckle-tracking echocardiography.The following parameters were according to apical four-chamber views at 24th week,32th week and 37th week′s postnatal age:global longitudinal left ventricular strain and strain rate,global longitudinal right ventricular strain and strain rate.Results There was no significant difference in LVGLS,LVGLSr,RVGLEr and RVGLAr at different weeks.Although there was no difference in LVGLEr at 32th week and37th week,they were significant higher than that in the 24th week.LVGLAr decreased with the increase of gestational weeks.RVGLS decreased with the increase of gestational age,and there was significant difference among the three groups(P<0.05).At the 37th week,the RVGLSr was lower than that at the 24th week.LVGLEr/GLAr<1at 24th week,LVGLEr/GLAr>1at 32th and 37th week,and there were significant differences between 37th week and 32th week and 24th week,respectively.Conclusions Two-dimensional speckle tracking technique can be used to evaluate the function of fetal heart.The changes of fetal heart strain and strain rate reflect the process of fetal heart maturation,and the study of fetal heart strain and strain rate can better understand the normal physiological changes.