胎儿大脑中动脉血流速度与胎儿地中海贫血的相关性研究  

Study on the Association of Fetal Thalassemia with Middle Cerebral Artery Blood Flow Velocity

作　　者：马燕[1] 温静[2] 李敏清[3] 余健[4] 李智贤[1] 廖新红[1] 叶桂宏[1] 

机构地区：[1]广西医科大学第一附属医院超声科,南宁市530021 [2]杭州市中医院超声科 [3]广西医科大学第一附属医院妇产科,南宁市530021 [4]广西医科大学第三附属医院妇产科

出　　处：《中国超声医学杂志》2008年第4期361-364,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西科学基金资助项目(桂科自No0640111)

摘　　要：目的研究胎儿大脑中动脉(MCA)血流速度与胎儿地中海贫血(地贫)的关系。方法对146例孕19～30周有胎儿地贫风险的单胎孕妇行二维及多普勒超声检查,测量胎儿MCA收缩期峰值血流速度(PSV),并行羊膜腔穿刺或脐血穿刺术进行地贫基因诊断,行脐血穿刺术者做胎儿血红蛋白(Hb)测定。MCA-PSV和Hb均用中位数的倍数(MOM)表示。各地贫组胎儿共109例,对照组37例。结果各组胎儿MCA-PSV随着孕龄的增加而递增。重型α地贫胎儿(HbBarts胎儿水肿综合征)MCA-PSV明显高于其他组胎儿,差异有统计学意义(P<0.001),其他各组胎儿MCA-PSV两两比较差异无统计学意义(P>0.05)。5例α地贫胎儿脐血Hb均<0.55MOM。结论超声多普勒测量胎儿MCA-PSV可作为预测胎儿重型α地贫的一种非侵入性方法,提示MCA-PSV是预测胎儿贫血的可靠参数。Objective To investigate the association between the middle cerebral artery （MCA） blood flow velocity and fetal thalassemia. Methods Totally 146 singleton pregnancies at risk due to fetal thalassemia, at 19-30 weeks＇ gestation, underwent two-dimensional ultrasound and Doppler imaging. The MCA peak systolic velocity （ PSV ） were measured. All fetuses were detected thalassemia genotypes by amniocentesis or cordocentesis. Hemoglobin determination was performed after cordocentesis. There were 109 thalassemia fetuses and 37 normal fetuses in this study. Results MCA-PSV was increased along with gestational age increasing in all fetuses. The group of fetuses with hemoglobin Bart＇s hydrops fetalis syndrome had significantly higher MCA-PSV compared to the other groups （P〈0. 001）.There were no statistical significant difference in the MCA-PSV between the other groups （P〉0. 05）. Hemoglobin concentration in 5 cases with α-thalassemia was〈0. 55 multiples of the median （MoM）. Conclusions Middle cerebral artery peak systolic velocity on Doppler ultrasound can be used to be a noninvasive tool to predict hemoglobin Bart＇s hydrops fetalis syndrome. Middle cerebral artery peak systolic velocity may be an accurate parameter for the prediction of fetal anemia.

关 键 词：大脑中动脉 地中海贫血 胎儿 超声 多普勒 

分 类 号：R714.5[医药卫生—妇产科学]