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目的:探索孕产妇心脏安全性评估的新指标。方法:39名孕妇志愿纳入该研究。基于数字心音信号处理技术,测量、计算和分析孕妇的舒张期时限对收缩期时限的比值(D/S),把D/S比值分为5级:Ⅰ级≥1.5;Ⅱ级:1.49~1.40;Ⅲ级:1.39~1.30;Ⅳ级:1.29~1.20;Ⅴ级:<1.2。用该指标来评估舒张期心脏自身供血时间是否充足,并观察和记录在关注期间内出现的产科事件。结果:舒张期时限对收缩期时限的比值随孕周增加而变小;<32孕周组的D/S为1.39±0.40,32~39孕周组的D/S为1.25±0.44,各组间D/S值比较无统计学差异(P>0.05)。D/S比值≥1.5者9例,而D/S比值<1.5者30例。这是一个不利于孕妇心脏健康的变化。其中有1例D/S非常低(0.59)的孕妇,D/S比值在Ⅴ级,在剖宫产手术准备中死亡。结论:在孕妇保健工作中应该对D/S比值给予充分的重视,应当关注孕期D/S比值降低程度与孕妇和胎儿预后的关系以及产后D/S恢复至≥1.5的速度和程度。该项研究所用的方法客观、简单、费用低、快速并且安全。
Objective: To explore new indicators of cardiac safety assessment in pregnant women. Methods: 39 pregnant women were included in the study. Based on the digital heart sound signal processing technique, the ratio of D / S to diastolic time limit (D / S) was measured, calculated and analyzed. The D / S ratio was divided into five grades: Ⅰ grade ≥1.5; Ⅱ grade: 1.49-1.40 Grade Ⅲ: 1.39-1.30; Grade Ⅳ: 1.29-1.20; Grade V: <1.2. Use this indicator to assess the adequacy of diastolic heart autologous blood supply and to observe and record the obstetric events that occurred during the period of interest. Results: The ratio of diastolic time to systolic time became smaller with gestational weeks increasing. The D / S of <32 gestational weeks group was 1.39 ± 0.40, and the D / S of 25 ~ 39 weeks gestation groups was 1.25 ± 0.44. Between the D / S value was no significant difference (P> 0.05). D / S ratio ≥ 1.5 in 9 cases, while the D / S ratio of 1.5 in 30 cases. This is a change that is detrimental to the heart health of pregnant women. Among them, 1 pregnant woman with very low D / S (0.59), D / S ratio at grade V, died during cesarean section. Conclusion: The D / S ratio should be paid more attention in the health care of pregnant women. The relationship between the D / S ratio of pregnant women and the prognosis of pregnant women and fetuses should be paid attention to, and the speed and degree of postpartum D / S recovery to ≥1.5. The methodology used in this study is objective, simple, inexpensive, fast and safe.