摘要: |
目的 探讨子痫前期孕妇颈总动脉应变改变及其与血管弹性相关性。方法 选择2011 年 2月 至 2012年1 月来我院门诊产检的子痫前期孕妇30名作为病例组,年龄及孕周匹配的正常妊娠组35名作为对照组。应用Esaote公司Mylab Twice彩色多普勒超声诊断仪,采用内中膜厚度定量技术获得受试者左侧颈总动脉内中膜厚度(intima-media thickness,IMT);采用血管弹性技术获得血管弹性指标,包括颈总动脉扩张系数,血管僵硬度(β),脉搏波传播速度( pulse wave velocity,PWV) ,动脉增强压( augmented pressure,AP);采用X-strain技术获得血管应变指标,包括血管内膜环向应变及应变率(EN-CS、EN-CSR),血管外膜环向应变及应变率(EP-CS、EP-CSR),径向应变及应变率(RAD-S、RAD-SR)。比较正常及子痫前期孕妇颈总动脉应变的差异,并分析血管应变与血管IMT及血管弹性指标的相关性。选取组间统计学差异在P<0.01水平的应变及弹性超声指标绘制ROC曲线。结果 子痫前期孕妇环向应变EN-CS、环向应变率EN-CSR及径向应变率RAD-SR较正常对照组显著减低(P<0.01),余应变指标两组间无显著差异。子痫前期孕妇内、外膜环向应变、应变率及径向应变及应变率均与PWV、β、IMT呈负相关,与DC、AP呈正相关。颈动脉应变指标EN-CS、EN-CSR、RAD-SR及PWV对诊断子痫前期病情均具有显著判断价值,ROC曲线下面积分别为0.74 (P<0.01)、0.75 (P<0.01)、0.84 (P<0.01)、0.68 (P=0.02)。结论 子痫前期孕妇颈总动脉血管环向应变及纵向应变率减低,并与血管弹性指标显著相关。应变及应变率特别适合于子痫前期孕妇的病情判断,优于传统的弹性指标。 |
关键词: 子痫前期 颈总动脉 应变 弹性 |
DOI: |
投稿时间:2021-03-17修订日期:2021-03-17 |
基金项目:陕西省科技计划项目基金(2011K15-02-05) |
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Ultrasonographic study on strain of common carotid artery and its correlation with vascular elasticity in pregnant women with preeclampsia |
xuedan,yuanlijun,duanyunyou,zhangyuxin,majing,houna,xingchangyang |
(Department of Ultrasound Diagnostics,Tangdu Hospital, Air Force Medical University) |
Abstract: |
Objective To investigate the strain change of common carotid artery and its correlation with vascular elasticity in pregnant women with preeclampsia. Methods Thirty pregnant women with preeclampsia who came to our outpatient department for obstetric examination from February 2011 to January 2012 were selected as the case group, thirty-five normal pregnant women matched for age and gestational age were selected as the control group. Used the Esaote MyLab Twice Color Doppler Ultrasonography Instrument ;the thickness of the left common carotid artery intima-media thickness was measured by the QualityIntima-Media Thickness; the indexes of vascular elasticity were obtained by Quantitative Artery Stiffness, including the distention coefficient,stiffness parameter β, pulse wave velocity and augmented pressure; the X-strain technique was used to obtain the vascular strain index, including the intimal circumferential strain and strain rate, circumferential strain and strain rate of vascular adventitia, radial strain and strain rate. To compare the difference of common carotid artery strain between normal and preeclampsia pregnant women, the correlation between vascular strain and vascular intima-media thickness and vascular elasticity indexes was analyzed. The strain and elastic ultrasonic indexes with significant statistical differences between the groups were selected to draw ROC curves.Results The circumferential strain, circumferential strain rate and radial strain rate in pregnant women with preeclampsia were significantly lower than those in normal control group(P<0.01), there was no significant difference in residual strain index between the two groups. The circumferential strain, strain rate, radial strain and strain rate of the inner and outer membrane of women with preeclampsia were negatively correlated with pulse wave velocity, stiffness parameter β and intima-media thickness, and positively correlated with distention coefficient and augmented pressure. The carotid strain indexes EN-CS, EN-CSR, RAD-SR and PWV have significant value in the diagnosis of preeclampsia, the areas under the ROC curve are respectively 0.74 (P<0.01)、0.75 (P<0.01)、0.84 (P<0.01)、0.68 (P=0.02).Coclusion The circumferential strain and longitudinal strain rate of the common carotid artery in women with preeclampsia were decreased and significantly correlated with vascular elasticity. Strain and strain rate are especially suitable for the diagnosis of preeclampsia pregnant women, which are better than the traditional elastic indexes. |
Key words: Preeclampsia Common carotid artery Strain Elastic |