超声多普勒测量大脑中动脉收缩峰期血流速度预测胎儿α地中海贫血  

Study of middle cerebral artery peak systolic velocity by Doppler ultrasonography in predicting fetal α-thalassemia

作　　者：马燕[1] 龙凤[1] 李智贤[1] 廖新红[1] 李敏清[2] 叶桂宏[1] 

机构地区：[1]广西医科大学第一附属医院超声科,广西南宁530021 [2]广西医科大学产前诊断中心

出　　处：《中国妇幼保健》2010年第2期254-257,共4页Maternal and Child Health Care of China

基　　金：广西科学基金资助项目(桂科自No.0640111);国家"十一.五"科技支撑计划项目(No.2007BAI07A17-11)

摘　　要：目的:探讨应用超声多普勒技术测量胎儿大脑中动脉收缩峰期血流速度(middle cerebral artery peak systolic velocity,MCA-PSV)预测胎儿α地中海贫血的价值。方法:对129例具有α地贫风险的胎儿和正常对照组44例胎儿行二维及多普勒超声检查,测量胎儿MCA-PSV并对有地贫风险的胎儿行羊膜腔穿刺或脐血穿刺术进行α地贫基因诊断。MCA-PSV用中位数的倍数(multiples of the median,MOM)表示。结果:重型α地贫胎儿MCA-PSV明显高于中间型α地贫、轻型α地贫和正常胎儿,差异有统计学意义(P<0.001)。MCA-PSV预测胎儿重型α地贫的最佳临界点为1.29MOM,MCA-PSV>1.29MOM预测胎儿重型α地贫的灵敏度、特异度分别为81.25%、93.62%;重型α地贫胎儿MCA-PSV异常增高最早于孕16周出现。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,预测胎儿重型α地贫的灵敏度、特异度较高,可减少不必要的侵入性操作。Objective： To investigate the value of the middle cerebral artery peak systolic velocity （ MCA - PSV） by color Doppler ultrasonography in predicting fetal α - thalassemia. Methods： 129 pregnancies at risk due to fetal α- thalassemia and 44 pregnancies of the normal control were performed with two - dimensional ultrasound and Doppler imaging. The MCA - PSV was measured. All fetuses of with risk of α - thalassemia were detected α - thalassemia genotypes by amniocentesis or cordocentesis. MCA - PSV was expressed as multiples of the median （MOM） . Results： MCA - PSV in the group of fetuses with Hemoglobin Bart＇s Hydrops Fetalis Syndrome was significantly higher than the fetuses with Hemoglobin H disease , α - thalassemia Trait and the normal fetuses （ P 〈0. 001 ） . The best cut - off point of MCA - PSV was 1.29 MOM. The sensitivity and the specificity of MCA - PSV 〉 1.29 MOM in prediction of Hemoglobin Bart＇s Hydrops Fetalis Syndrome were 81. 25% and 93.62% respectively. The earliest time for MCA - PSV to predict Hemoglobin Bart＇s Hydrops Fetalis Syndrome was 16 gestational weeks. Conclusion： Measurement of MCA -PSV by Doppler ultrasound can be used as a noninvasive tool to predict Hemoglobin Bart＇s Hydrops Fetalis Syndrome and reduce unwanted invasive operation.

关 键 词：大脑中动脉 Α地中海贫血 胎儿 超声多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.5[医药卫生—诊断学]