彩色多普勒超声监测正常妊娠和胎儿生长迟缓孕妇及胎儿血液循环的变化  

Color Doppler Monitoring the Utero placental fetal Circulation Variety of Normal Pregnancy and Intrauterine Growth Retardation

作　　者：许建平[1] 闻良珍[1] 马庭元[1] 张友耿[1] 张青萍[1] 高淑英[1] 

机构地区：[1]同济医科大学附属同济医院妇产科

出　　处：《中华妇产科杂志》1998年第4期209-212,共4页Chinese Journal of Obstetrics and Gynecology

基　　金：国家自然科学基金

摘　　要：目的应用彩色多普勒超声监测子宫胎盘胎儿血液循环（ＵＰＦＣ）。方法测定１５０例中、晚期妊娠妇女［其中正常８９例、胎儿生长迟缓（ＩＵＧＲ）５８例、妊娠合并慢性肾功能不良及ＩＵＧＲ３例］的脐动脉、脐静脉及子宫动脉的时间平均血流速度（ＴＡＶ）和血流量（Ｑ）等血流动力学变化，并监测母血雌三醇（Ｅ３）、胎盘泌乳素（ＨＰＬ）、血栓素Ｂ２（ＴＸＢ２）和６ｋｅｔｏＰＧＦ１α（６ＫＰ）水平。结果正常孕妇随孕龄增长，胎盘功能增强，ＵＰＦＣ日渐丰富。ＩＵＧＲ者ＵＰＦＣ则明显障碍，在孕２０周时脐动、静脉及子宫动脉的ＴＡＶ、Ｑ皆显著降低，其发生率占９２５３％。ＩＵＧＲ母血Ｅ３、ＨＰＬ及６ＫＰ显著下降，ＴＸＢ２／６ＫＰ比值升高。结论彩色多普勒超声可直接测定ＵＰＦＣ，能在早期准确诊断ＩＵＧＲ、判断病情，估计预后。Objective To study the utero placental fetal circulation (UPFC) in normal pregnancy and intrauterine growth retardation (IUGR) cases. Methods Color doppler ultrasound was used to detect UPFC in 150 second and third trimester pregnant women, of which 89 cases were normal pregnancy and 58 cases were IUGR. 3 cases were IUGR with chronic renal failure. Hemodynamical value of the umbilical artery (UmA), umbilical vein (UmV) and uterine artery (UtA) were examined directly. The indices included time average velocity (TAV), pulsatility index (PI), resistance index (RI), systolic /diastolic (S/D) ratio, blood flow volume (Q). The maternal serum estriol (E 3), human placental lactogen (HPL) and plasma thromboxane B 2 (TXB 2)/ 6 keto PGF1α (6 KP) were measured simultaneously. Results The result shows that in normal prgnancy group UPFC is abundant gradually with increasing gastational age. In IUGR group 92.53% of cases showed that TAV and Q of UmA, UmV markedly decreased and PI, RI and S/D ratio of UmA elevated at 20 weeks of gestation. There were significant difference between the two groups. maternal serum E 3, HPL level in IUGR group were significantly lower than that of the normal pregnancy group, 6 KP level reduced, and TXB 2/6 KP ratio significantly increased. Conclusion Using color doppler ultrasound examining hemodynamical changes of UmA, UmV and UtA could observe UPFC function directly. It is one of the best method to early diagnose and predict the prognosis of IUGR.

关 键 词：胎儿 生长迟缓 血液动力学 彩色多普勒 

分 类 号：R714.431[医药卫生—妇产科学] R445.1[医药卫生—临床医学]