目的：探讨二维斑点追踪成像（ STI）技术对妊娠高血压不同孕期孕妇心功能改变的评价价值。方法2014年1月—2015年1月于唐山市协和医院选取妊娠高血压（ PIH）孕妇48例（ PIH组），正常孕妇45例（正常妊娠组），健康未孕女性45例（健康对照组），应用STI软件对图像进行分析，记录3组整体扭转角度峰值（ Ptw）、心底水平旋转角度峰值（ Prot-MV）、心底水平旋转角度达峰绝对时间（ Pti-MV）、达峰时间百分比（ Perc-Pti-MV）、心尖水平旋转角度峰值（Prot-AP）、心尖水平旋转角达峰绝对时间（Pti-AP）及达峰时间百分比（Perc-Pti-AP）。结果 Pti-MV在PIH组及正常妊娠组孕早期、中期水平低于健康对照组（ t ＝8 e．963、9．142， P ＜0．05），而在PIH组妊娠晚期时高于正常妊娠组孕晚期（ t ＝10．236， P ＜0．05）；Prot-AP、Perc-Pti-MV、Perc-Pti-AP、Ptw在PIH组及正常妊娠组孕早、中、晚期水平均高于健康对照组（ t Prot-AP ＝7．855、8．023、9．141、10．022；t Perc-Pti-MV ＝8．002、10．963、9．445、9．856；t Perc-Pti-AP ＝11．263、8．022、9．102、8．012；t Ptw ＝10．232、11．011、9．126、11．452， P ＜0．05），其中Prot-AP在PIH组孕早、中、晚期水平均高于正常妊娠组同一时期（ P ＜0．05），Perc-Pti-MV在PIH组妊娠中期、晚期及正常妊娠组晚期是其水平高于孕早期（P ＜0．05），Ptw在PIH组晚期水平高于妊娠组晚期（ P ＜0．05），并高于PIH组孕早期（ P ＜0．05）。 Ptw与BSA、Pro-AP呈正相关（ r ＝0．295、0．342， P ＜0．05），而与孕妇身高、LVEDV、LVEF、Pro-MV无相关性（ P ＞0．05）。结论通过早期应用STI技术可观测到PIH患者左心室旋转及扭转运动，有助于对PIH患者早期心功能的评价。%Objective To evaluate the value of two-dimensional speckle tracking imaging (STI) in evaluating the cardiac function of pregnant women with different pregnancy induced hypertension.Methods From Jan 2014 to Jan 2015 in Tangshan Union Hospital,selected pregnant women with pregnancy induced hypertension (PIH, n =48 ) , normal pregnant women(n =45), healthy nonpregnant women(n =45).STI software were used for image analysis, recorded the three groups of integral torsion angle peak (Ptw) , heart horizontal angle of rotation (prot-MV) , heart horizontal rotation angle of the peak time (Pti-MV) , peak time percentage (perc-Pti-MV) , apical horizontal rotation angle peak (Prot-AP) , apical level reached the peak time (Pti-AP) and peak time percentage (Perc-Pti-AP) .Results Pti-MV in PIH group and normal pregnancy group in early and middle pregnancy were lower than the control group (t =8.963, t =9.142, P <0.05), and PIH group in late pregnancy was higher than the normal pregnancy group in late pregnancy (t =10.236, P <0.05);Prot-AP, Perc-Pti-MV, Perc-Pti-AP,Ptw were higher in PIH group and normal pregnancy group trimester level than the control group (t Prot-AP =7.855,8.023,9.141,10.022;t Perc-Pti-MV =8.002,10.963,9.445,9.856;t Perc-Pti-AP =11.263,8.022,9.102,8.012;t Ptw =10.232,11.011,9.126,11.452, P <0.05), the Prot-AP in PIH group from early pregnancy to the advanced pregnancy were higher than those in normal pregnancy group during the same period (P <0.05), Perc-Pti-MV in PIH in the middle and late pregnancy group and normal pregnancy group’s late pregnancywere higher than the level of the early pregnancy (P <0.05), Ptw in advanced level of PIH group was higher than that of the late pregnancy in pregnancy group (P <0.05), and higher than the PIH group’s early pregnancy (P <0.05).Ptw were positive correlated with BSA, Pro-AP(r =0.295,0.342, P <0 .05),and with no correlation with maternal height, LVEDV, LVEF, Pro-MV (P >0.05).Conclusion By early applica-tion of STI technology, the left ventricular rotation and torsion motion of PIH patients can be observed, which is helpful for the evaluation of early cardiac function in patients with PIH.
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