超声心动图预测胎羊炎症反应综合征的研究  

Assessment to SIRS in the Ovine Fetus by Echocardiography

作　　者：唐力[1] 吕国荣[1] 李伯义[1] 胡诗音[1] 吴秀明[1] 

机构地区：[1]福建医科大学附属第二医院超声科,福建省泉州市362000

出　　处：《中国超声医学杂志》2009年第6期546-548,共3页Chinese Journal of Ultrasound in Medicine

基　　金：福建省自然科学基金（No.2007J0076）;福建医大重点学科建设基金（No.C0540002）

摘　　要：目的采用超声心动图检测胎羊炎症反应综合征（SIRS）血流动力学变化,探讨其与TNFα-、IL-6之间的相关性。方法17只晚孕期山羊分成对照组与实验组,实验组行超声引导下脐静脉穿刺术和羊膜腔穿刺术,注射内毒素（LPS）并分别于注药前后不同时间点检测胎羊血流动力学,取胎羊血检测TNF-α、IL-6含量,评价血流动力学参数与TNF-α、IL-6的相关性。结果实验组给LPS后TNF-α、IL-6、脐动脉（UmA）、肾动脉（RA）、静脉导管（DV）、大脑中动脉（MCA）搏动指数（PI）、左心室及右心室（LV及RV）射血分数（EF）、LV及RV Tei指数、三尖瓣及二尖瓣（TV及MV）E/A值随时间显著变化（P〈0.05）,与对照组比较差异有统计学意义（P〈0.05）;胎羊各种血流动力学参数除LV EF、RV EF外均与胎羊血TNF-α及IL-6水平具有相关性（P〈0.01）。结论外周血流频谱中DV PI与胎羊血TNF-α、IL-6水平的相关性最强;心功能指标中Tei指数与胎羊血TNF-α、IL-6水平的相关性最强。因此,DV PI与Tei指数可作为预测胎儿SIRS简单而有效的参考指标。Objective To study the changes of fetal hemodynamic in ovine fetus to systemic inflammatory re： sponse syndrome （SIRS） and evaluate the relationship between hemodynamie and TNF-α and IL-6. Methods 17 late- gestation fetal sheep underwent cordoeentesis or amniocentesis under ultrasound guidance. Echocardiography were performed in different time. Fetal blood samples were collected to measure for TNF-α and IL-6. Results After LPS ad- ministration, the fetal plasma TNF-α, IL-6 level and fetal UreA PI, RA PI, DV PI, MCA PI, LV, RV EF, LV, RV Tel indices, TV, MV E/A ratio significantly changed with time （P〈0.05）, and still significantly increased as compared with the control animals （P〈0.05） . There were significantly correlation between fetal hemodynamic values and TNF-α, IL-6 （P〈0. 01） . Conclusions DV PI, Tel index and TNF-α, IL-6 level exhibits the strongest relation in the peripheral vessels or in the cardiac function values, respectively. Therefore, DV PI and Tel index might be easy and useful quantitative parameters for assessing fetal SIRS.

关 键 词：超声心动图检查 血流动力学 胎羊 炎症反应综合征 

分 类 号：R842[医药卫生—航空、航天与航海医学] R364.5[医药卫生—临床医学]