心肌做功参数评估重度子痫前期孕妇子代新生儿期心肌损伤的前瞻性研究

Assessment of myocardial injury in neonates born to pregnant women withpregnancy complicated by severe preeclampsia by myocardial work indices: aprospective study

摘要:

目的 应用心肌做功参数评估重度子痫前期孕妇子代新生儿期心肌损伤。 方法 前瞻性收集2020年6月至2021年4月重度子痫前期孕妇分娩的早产儿25例作为重度子痫前期组，同时收集无严重妊娠期并发症孕妇分娩的早产儿25例作为对照组，分别于出生后24 h内、48~72 h及14~28 d应用超声心动图检查测量常规参数，应用二维斑点追踪成像技术通过心肌二维应变联合无创测得的左室收缩压构建无创性左室压力-应变环计算心肌做功参数。 结果 与对照组相比，重度子痫前期组在出生后24 h内左室整体做功指数和整体有用功降低（P<0.05）；在出生后48~72 h左室整体做功效率降低，左室整体无用功增加（P<0.05）；在出生后14~28 d左室整体做功效率仍降低（P<0.05）。 结论 重度子痫前期孕妇分娩的早产儿在新生儿期持续存在亚临床心肌损伤。

Abstract:

Objectives To evaluate myocardial injury in neonates born to pregnant women with pregnancy complicated by severe preeclampsia by myocardial work indices.Methods A prospective cohort study was performed on 25 preterm infants born to the pregnant women with severe preeclampsia from June 2020 to April 2021(severe preeclampsia group),and 25 preterm infants born to the pregnant women without severe complications in pregnancy were enrolled as the control group.Echocardiography was performed within 24 hours and at 48-72 hours and 14-28 days after birth to measure conventional parameters.Two-dimensional speckle-tracking echocardiography was performed to construct a noninvasive left ventricular pressure-strain loop based on two-dimensional myocardial strain and left ventricular systolic pressure noninvasively measured,so as to calculate myocardial work indices.Results Compared with the control group,the severe preeclampsia group had significant reductions in left ventricular global work index and global constructive work within 24 hours after birth(P<0.05),a significant reduction in left ventricular global work efficiency and a significant increase in global waste work at 48-72 hours after birth(P<0.05),and a significant reduction in left ventricular global work efficiency at 14-28 days after birth(P<0.05).Conclusions Subclinical myocardial injury persists in the neonatal period in preterm infants born to pregnant women with severe preeclampsia.