摘要
目的分析正常胎儿及先天性心脏病(CHD)胎儿右心室Tei指数与静脉导管频谱参数的变化特点,探讨其在不同CHD胎儿右心功能评价中的意义,并分析二者的相关性。方法 136例中、晚孕单胎孕妇根据超声诊断结果,将其中105例正常胎儿作为对照组(A组),另31例产前超声诊断为CHD的胎儿根据胎儿右心功能状态分为右心后负荷增加为主的B组(15例)和右心前负荷增加为主的C组(16例),超声检测各组胎儿的右心室Tei指数以及静脉导管的频谱参数,包括胎儿静脉导管心室收缩期血流速度(Vs)、心室舒张期血流速度(Vd)、心房收缩期血流速度(Va),计算阻力指数(RI)和静脉峰值流速指数(PVIV)。结果 A组、B组、C组胎儿右心室Tei指数分别为0.30±0.07、0.38±0.04、0.40±0.05,组间比较差异无统计学意义(P>0.05)。B组胎儿的Va与A组比较显著降低(P<0.05),Vs、Vd与A组比较差异均无统计学意义(P>0.05)。C组胎儿的Vs、Vd与A组比较均显著升高(P<0.05),而Va与A组比较差异无统计学意义(P>0.05)。B组胎儿静脉导管的RI、PVIV与A组比较均显著升高(P<0.05);C组胎儿静脉导管的RI、PVIV与A组比较差异无统计学意义(P>0.05)。A组、B组、C组胎儿的右心室Tei指数与静脉导管RI均无显著相关性(r=0.102、0.076、-0.108,P>0.05)。A组、B组、C组胎儿的右心室Tei指数与静脉导管PVIV均无显著相关性(r=-0.164、0.181、0.044,P>0.05)。结论静脉导管频谱可以评估CHD胎儿右心负荷的改变,Tei指数可能不受胎儿心脏前后负荷的影响,静脉导管频谱指数不能取代心室Tei指数的应用。
Objective To analyze the changes of Tei index and ductus venosus spectral parameters of right ventricular of normal fetus and fetus with congenital heart disease, clarify their significance in assessment of fight heart function in fetus with congenital heart disease and analyze the correlation between these two parameters. Methods One hundred and thirty-six at the middle and late gestation periods of single fetal pregnant women who performed antenatal examination were enrolled. Ac- cording to the ultrasonic diagnosis results, 105 normal fetuses were divided into control group （group A） ;the other 31 cases di- agnosed as congenital heart disease were divided into right ventrieular postload increasing group（ group B, 15 cases） and right ventricular preload increasing group（ group C, 16 cases） according to right heart function. All cases received ultrasonic detect of fetal right ventricular Tei index and venous catheter spectrum parameters, including fetal ventricular systolic flow velocity （ Vs）, ventricular diastolic flow velocity （Vd） and atrial systolic blood flow velocity （Va） ; the resistance index （ RI ） and the peak velocity index for veins （PVIV） were calculated. Results Tei index of right ventricular in group A, group B and group C were 0.30 ± 0. 07,0.38 ± 0. 04 and 0.40 ± 0.05, respectively, and there was no statistic difference among the groups （ P 〉 0. 05 ）. The Va in group B was significantly lower than that in group A （ P 〈 0. 05 ） ; there was no significant difference of Vs and Vd between the group A and group B （ P 〉 0.05 ）. Vs and Vd increased significantly in group C compared with group A （ P 〈 0. 05 ） ; but no significant difference of Va was found between the group A and group C （ P 〉 0.05 ）. The RI and PVIV in group B were significantly higher than those in group A （P 〈 0.05 ） ;but there was no statistic difference between group C and group A（ P 〉 0.05 ）. There was no obviously correlation between Tel index of right ventricle and RI of venous catheter among group A, group B and group C （r = 0. 102,0. 076, -0. 108, P 〉 0. 05 ）. There was no obviously correlation between Tei index of right ventricle and PVIV of venous catheter among group A, group B and group C （ r = - 0. 164,0. 181,0. 044, P 〉 0.05 ）. Conclusion The ductus venosus spectrum can evaluate the load changes of right heart fetus with congenital heart disease ; the characteristics of Tei index may not be influenced by pre and post-load of fetal heart and Tei index shows no correlation with parameters of ductus venosus in assessment of fetal cardiac function.
出处
《新乡医学院学报》
CAS
2015年第8期752-755,共4页
Journal of Xinxiang Medical University
