应用多普勒超声评价11～14周胎儿心脏功能的价值  

Evaluating the cardiac function in 11-14 weeks' gestation by Doppler ultrasound

作　　者：钱敏[1,2] 孙燕[1] 吴青青[1] 马玉庆[1] 陈焰[1] 

机构地区：[1]首都医科大学附属北京妇产医院超声科,北京100026 [2]首都医科大学附属北京复兴医院超声影像科,北京100038

出　　处：《中国医学影像技术》2008年第2期209-212,共4页Chinese Journal of Medical Imaging Technology

基　　金：北京市科技新星计划资助(2005B07)

摘　　要：目的应用多普勒技术观察妊娠11+0～14+6周正常胎儿心脏的血流动力学状态,获得该孕周正常胎儿心脏的血流动力学参数。方法对230位正常妊娠孕妇在11+0～14+6周进行经腹超声检查,同时观察胎儿心脏血流动力学参数。结果二、三尖瓣的血流A峰高于E峰,三尖瓣E峰及A峰血流速度明显高于二尖瓣血流,二、三尖瓣血流速度与孕周之间无相关性,但E/A比值与孕周之间呈正相关;左右心室舒张时间和收缩时间与孕周之间呈正相关,左右心室等容舒张时间与孕周之间呈负相关,而等容收缩时间与孕周之间无明显相关性。TI指数反映心室的收缩功能,左右心室的TI指数与孕周之间呈负相关,左心室TI指数稍高于右心室,两者之间有统计学差异。结论妊娠13周以后,胎儿的心脏显示率较高,可进行心脏超声心动检查;在胎儿期右心功能稍高于左心功能,主要反映在三尖瓣流速高于二尖瓣,右心室等容收缩时间和收缩时间较左心室长等方面。当胎儿心脏血流动力学发生改变,则可能预示胎儿心脏功能异常或结构异常。Objective To observe the hemodynamic status of heart in normal fetuses between 11＋0 to 14＋6 weeks＇ gestation by Doppler ultrasound for obtaining the normative data of these gestational age. Methods There were 230 pregnant women had a general examination by transabdominal ultrasonography between 11＋0to 14＋6 gestational weeks, and observe the cardiac hemodynamic parameter. Results The A-wave maximum velocity is higher than E-wave maximum velocity both in blood flow of tricuspid and mitral valve. And E-wave and A-wave of tricuspid valve higher than mitral valve significantly. There is no correlation between weeks＇ gestation and the blood velocity of tricuspid and mitral valves. And there is a positive correlation between the E/A ratios and the gestational weeks. The diastolic and systolic time of left ventricular （LV） and right ventricular （RV） have a positive correlation with the weeks＇ gestation, and the isovolumic relaxation time （IRT） in LV and RV have a negative correlation with the gestational week, but the isovolumic contraction time （ICT） has no significant correlation with the weeks＇ gestation. The Tei index （TI） reflects the cardiac contract function. The TI of LV and RV have a negative correlateion with gestational weeks, and the TI of LV higher than RV, there is statistic difference significantly between them. Conclusion The fetal cardiac structure can be visualized significantly after 13 weeks＇ gestation, so we can do the echocardiography examination during this phase. The blood velocity of tricuspid faster than mitral, and the ICT and systolic time in RV longer than LV, so the RV function higher than LV. It could be used to indicate the fetal cardiac abnormal functions and structures malformation when the fetal cardiac hemodynamic is changed.

关 键 词：胎儿 血流动力学 早期妊娠 超声检查 多普勒 

分 类 号：R714.51[医药卫生—妇产科学] R445.1[医药卫生—临床医学]