中文摘要：

目的 探讨速度向量成像技术检测妊娠高血压综合征（PIH）胎儿左、右心室心肌节段功能的临床意义.资料与方法 采集81例PIH胎儿,包括妊娠高血压组（GH组）24例、轻度子痫前期组（MPE组）25例、重度子痫前期组（SPE组）32例,以及136例正常胎儿（对照组）的心脏四腔观超声心动图,测量左、右心室各节段收缩期峰值运动速度（Vs）、舒张期峰值运动速度（Vd）、峰值应变（S）、收缩期峰值应变率（SRs）和舒张期峰值应变率（SRd）.结果 217例胎儿中成功采集图像192例.PIH各组左、右心室壁Vs和Vd均由基底段至心尖段逐渐减低（P＜0.01）,S、SRs和SRd在基底段、中间段和心尖段差异无统计学意义（P＞0.05）.GH组左、右心室壁Vs、Vd、S、SRs和SRd与对照组相应节段心肌比较,差异无统计学意义（P＞0.05）：MPE组右心室壁S、SRs和SRd较对照组降低（P＜0.05）；SPE组左、右心室壁S、SRs和SRd较对照组、GH组和MPE组均降低（P＜0.05）,右心室壁Vd较对照组及GH组降低（P＜0.05）.结论 速度向量成像技术可以检测PIH胎儿左、右心室心肌节段功能的变化,PIH对子痫前期胎儿左、右心室功能均有影响,以右心功能损害首先发生.

英文摘要：

Purpose To investigate the clinical value of velocity vector imaging inthe assessment of regional left ventricular and right ventricular longitudinal myocardialfunction in fetuses with pregnancy-induced hypertension （PIH）. Materials and MethodsDigital dynamic four-chamber views of 81 fetuses with PIH and 136 normal fetuses werecollected and analyzed by using velocity vector imaging technique. Fetuses in PIH weredivided into gestational hypertension （GH, n=24）, mild preeclampsia （MPE, n=25） andsevere preeclampsia （SPE, n=32）. The regional tissue systolic peak velocity （Vs）, diastolicpeak velocity （Vd）, peak strain （S）, systolic peak strain rate （SRs） and diastolic peak strainrate （SRd） of interventricular septum, right free wall and left lateral wall were measuredrespectively. Results 192 out of 217 cases were collected successfully. Both Vs and Vdgradually decreased from the basal segment to the apical segment in the left ventricle（LV） and right ventricle （RV） （P〈0.01）, whereas S, SRs and SRd were stable among allsegments in each group （differences without statistic significance, P〉0.05）. Vs, Vd, S,SRs and SRd in LV and RV in GH did not change significantly compared with those innormal fetuses （differences without statistic significance, P〉0.05）. S, SRs and SRd in RVwere significantly lower in MPE than those in normal fetuses （P〈0.05）. S, SRs and SRdin LV and RV were significantly lower in SPE than those in normal fetuses, GH and MPE（P〈0.05）, and Vd in RV was significantly lower in SPE than that in normal fetuses and GH（P〈0.05）. Conclusion The fetal regional left ventricular and right ventricular longitudinalmyocardial function could be evaluated with velocity vector imaging. Both left ventricularfunction and right ventricular function would be impaired in fetuses with preeclampsia, yetthe deterioration of right ventricular function was earlier than that of LV.