摘要
背景目前临床研究主要侧重于妊娠期高血压(PIH)对母婴结局的影响,而有关PIH所致母体心脏结构或功能改变对母婴结局影响的研究报道相对少见。目的探究PIH患者左心结构改变及其与新生儿生长发育的相关性。方法选取2016年2月-2019年3月陕西省人民医院收治的PIH患者120例作为研究组,另选取同期114例产检健康孕妇作为对照组。研究组患者明确诊断后给予常规治疗,比较两组孕妇治疗前及研究组患者治疗前、终止妊娠即刻左心结构指标[包括室间隔厚度(IVS)、左心房内径(LA)、左心室后壁厚度(LVPW)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]和心功能指标[包括左心室短轴缩短率(LVFS)、左心室射血分数(LVEF)],两组孕妇围产结局及新生儿生长发育指标;PIH患者终止妊娠即刻左心结构指标与新生儿生长发育指标的相关性分析采用Pearson相关分析。结果(1)研究组患者治疗前IVS、LA及LVPW大于对照组(P<0.05);两组孕妇治疗前LVESD、LVEDD、LVFS及LVEF比较,差异无统计学意义(P>0.05)。研究组患者终止妊娠即刻IVS、LA及LVPW小于治疗前(P<0.05);但研究组患者治疗前及终止妊娠即刻LVESD、LVEDD、LVFS及LVEF比较,差异无统计学意义(P>0.05)。(2)两组孕妇终止妊娠方式比较,差异无统计学意义(P>0.05);研究组患者终止妊娠孕周小于对照组(P<0.05)。(3)研究组新生儿出生时Apgar评分、出生体质量低于对照组,头围、身长小于对照组(P<0.05)。(4)Pearson相关分析结果显示,PIH患者终止妊娠即刻IVS与新生儿出生体质量呈负相关(r=-0.615,P=0.007),终止妊娠即刻LA与新生儿出生时Apgar评分呈负相关(r=-0.563,P=0.009)。结论PIH患者存在左心结构改变,且其左心结构改变与新生儿出生体质量及窒息程度有关。
Background Clinical researches mainly focus on the impact of pregnancy-induced hypertension(PIH)on maternal and infant outcomes at present,however reports about the impact of changes of maternal cardiac structure or function caused by PIH on maternal and infant outcomes is relatively rare.Objective To explore the changes of left cardiac structure and its correlation with growth and development of neonates in patients with PIH.Methods A total of 120 patients with PIH were selected as study group in Shaanxi Provincial People’s Hospital from February 2016 to March 2019,meanwhile a total of 114 healthy pregnant women admitted to this hospital for antenatal care were selected as control group.Patients in study group received conventional treatment after making a definite diagnosis,index of left cardiac structure(including I VS,LA,LVPW,LVESD and LVEDD)and cardiac function(including LVFS and LVEF)before treatment,perinatal outcome,growth and development indicators of neonates were compared between control group and study group,meanwhile index of left cardiac structure and cardiac function before treatment and immediately after ending pregnancy were compared in study group;Pearson correlation analysis was used to analyze the correlations of index of left cardiac structure immediately after ending pregnancy with growth and development indicators of neonates in patients with PIH.Results(1)I VS,LA and LVPW in study group were statistically significantly greater than those in control group before treatment(P<0.05),but there was no statistically significant difference in LVESD,LVEDD,LVFS or LVEF between the two groups(P>0.05).IVS,LA and LVPW immediately after ending pregnancy in study group were statistically significantly lower than those before treatment(P<0.05),but there was no statistically significant difference in LVESD,LVEDD,LVFS or LVEF(P>0.05).(2)There was no statistically significant difference in methods of ending pregnancy between the two groups(P>0.05),while gestational weeks to the end of pregnancy in study group was statistically significantly shorter than that in control group(P<0.05).(3)Apgar score,birth weight,head circumference and body length of neonates in study group were statistically significantly lower than those in control group(P<0.05).(4)Pearson correlation analysis results showed that,IVS immediately after ending pregnancy was negatively correlated with birth weight of neonates in patients with PIH(r=-0.615,P=0.007),meanwhile LA immediately after ending pregnancy was negatively correlated with Apgar score of neonates(r=-0.563,P=0.009).Conclusion There are changes of left cardiac structure in patients with PIH,moreover the changes of left cardiac structure are significantly correlated with the birth weight and asphyxia degree of asphyxia degree.
作者
邓小艳
李艳川
DENG Xiaoyan;LI Yanchuan(Department of Obstetrics,Shaanxi Provincial People's Hospital,Xi'an 710068,China)
出处
《实用心脑肺血管病杂志》
2019年第11期44-48,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
高血压
妊娠性
左心结构
新生儿
生长发育
Hypertension,pregnancy-induced
Left cardiac structure
Neonate
Growth and development
