超声心动图指标与血清心肌酶水平改变对妊娠期高血压的评估价值

摘要

To explore relationship among disease severity , serum myocardial enzyme levels and echocar‐diographic indexes in patients with gestational hypertension (GH).Methods : A total of 101 GH inpatients treated in our department of gynecology from 2015 to 2018 were divided into severe group (severe preeclampsia and eclampsia patients , n＝46 ) and mild group (mild preeclampsia patients , n＝ 55 ) , and another 60 normal pregnant women were simultaneously selected as normal control group .Heart indexes , serum levels of creatine kinase isoenzyme MB (CK‐MB) and creatine kinase (CK ) were measured and compared among three groups .Results : Compared with normal control group , there were significant rise in LVESd , LVEDd , right ventricular diameter (RVD) , end‐di‐astolic interventricular septal thickness (IVSTd ) and left ventricular posterior wall thickness (LVPWT ) in mild group and severe group , and above indexes of severe group were significantly higher than those of mild group , P＜0.01 all.Compared with normal control group , there was significant rise in transmitral late diastolic peak flow ve‐locity (A) , and significant reductions in LVEF , cardiac output (CO) , cardiac index (CI) , transmitral early dias‐tolic peak flow velocity (E) and E／A in mild group and severe group ;compared with mild group , there was signifi‐cant rise in A , and significant reductions in LVEF , CO , CI , E and E／A in severe group , P＜0. 01 all .Compared with normal control group , there were significant rise in serum levels of CK‐MB [ (6.2 ± 2.5) IU／L vs.(9.4 ± 3.2) IU／L vs.(15. 3 ± 5. 7) IU／L] and CK [(41.8 ± 7.9) IU／L vs.(61.7 ± 12. 5) IU／L vs.(88. 7 ± 20. 4) IU／L] in mild group and severe group , and those of severe group were significantly higher than those of mild group , P＝0.001 all.Conclusion : Echocardiography and myocardial enzyme examination in GH patients help to understand functional state and structure of heart , which possess important significance for early identification and treatment .%目的 探讨妊娠期高血压(GH)患者病情严重程度与血清心肌酶水平、超声心动图指标的关系.方法 我院2015～2018年妇产科收住院的GH患者101例患者被分为重症组(子痫前期重度以及子痫患者,46例)和轻症组(子痫前期轻度患者,55例) ,同期选择正常妊娠孕妇60例作为正常对照组.检测比较三组的各项心脏指标以及血清肌酸激酶同工酶(CK‐MB) 、肌酸激酶(CK)水平.结果 与正常对照组比较,轻症组、重症组的LVESd 、LVEDd 、右室内径(RVD) 、舒张末期室间隔厚度(IVSTd) 、左室后壁厚度(LVPWT)均显著增加,且重症组上述指标均显著高于轻症组,P均＜0.01 .与正常对照组比较,轻症组、重症组二尖瓣舒张晚期最大流速(A)显著增大,LVEF 、心输出量(CO) 、心脏指数(CI) 、二尖瓣舒张早期最大流速(E) 、E／A均显著减小;与轻症组比较,重症组 A增大更显著,LVEF 、CO 、CI 、E 、E／A减小更显著,P均＜0. 01 .与正常对照组比较,轻症组、重症组血清CK‐MB[(6.2 ± 2.5 )IU／L比(9.4 ± 3.2)IU／L比(15.3 ± 5.7)IU／L]和CK[(41.8 ± 7.9)IU／L比(61. 7 ± 12.5)IU／L比(88.7 ± 20.4)IU／L]水平均显著升高,且重症组的显著高于轻症组的,P均＝0.001 .结论 妊娠期高血压病人进行超声心动图及心肌酶检查,有助于了解心脏的功能状态及结构,对早期及治疗有重大意义.