静脉导管血流检测对妊娠高血压疾病胎儿右心舒张功能的评价  

Ductus venosus blood flow detection for fetal right ventricular diastolic function evaluation in hypertensive disorders of pregnancy

作　　者：李天刚[1] 车岩[1] 童明辉[1] 聂芳[1] 叶娜[1] 

机构地区：[1]兰州大学第二医院超声中心,兰州市730000

出　　处：《临床超声医学杂志》2013年第2期87-90,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的通过检测胎儿静脉导管血流参数,了解妊娠高血压疾病对胎儿右心舒张功能的影响。方法 92例妊娠高血压疾病孕妇,其中重度子痫前期组14例,轻度子痫前期组26例,妊娠高血压组52例,60例与其孕龄匹配且血压正常孕妇为对照组,彩色多普勒超声测量其胎儿静脉导管的搏动指数、阻力指数、静脉前负荷指数(PLI)及心室收缩峰值流速与心房收缩最大流速比值(S/A)。于治疗后24h及72h,监测重度子痫前期组胎儿静脉导管各项参数。结果对照组、轻度子痫前期组和重度子痫前期组的搏动指数、阻力指数、S/A及PLI依次增高,组间两两比较差异均有统计学意义(P﹤0.05);治疗后24h及72h,重度子痫前期组胎儿静脉导管各项参数较治疗前均减低(P﹤0.05);与轻度子痫前期组比较,重度子痫前期组三尖瓣反流和静脉导管反向波发生率增高(P﹤0.05)。结论通过胎儿静脉导管检测可以定性或定量判断胎儿右心舒张功能改变,为临床提供治疗及预后依据。Objective To investigate the effect of hypertensive disorders in pregnancy on fetal fight ventricular diastolic function by detecting the blood flow parameter of fetal ductus venosus. Methods Ninety-two cases of pregnant women with hypertension were enrolled including 14 cases of severe preeclampsia, 26 cases of mild preeclampsia, 52 cases of gestational hypertension, and 60 cases of normotensive pregnant women at gestational age were taken as the control. The parameters including pulsatility index, resistance index, pre-load index （PLI） and S/A ratio of duetus venosus in fetus were measured by elolor Dopler. The blood flow parameters in fetal ductus venosus in the severe preeclampsia group were monitored 24 h and 72 h after treatment. Results Compared with the control group, pulsatility index,resistance index, PLI and S/A of ductus venosus in fetus in mild and severe preeclampsia group were significantly increased（P〈0.05 ）. The parameters in severe preeclampsia group were reduced 24 h and 72 h after treatment （P〈0.05）, while the incidence of the ductus venosus backward wave （type Ⅱ and Ⅲ ） was increased compared to mild preeclampsia groups （P〈0.05）.Conclusion The fetal ductus venosus detection can be used for qualitative or quantitative assessment of fetal right ventricular diastolic function, which provides the basis for treatment and prognosis evaluation.

关 键 词：妊娠高血压疾病 静脉导管 舒张功能 右心 胎儿 

分 类 号：R714.246[医药卫生—妇产科学] R445.1[医药卫生—临床医学]