组织多普勒指标Aa-IV Aa-Sa在胎儿房室传导时间测量中的应用  

Amplication of time measurement of the tissue Doppler indicators Aa-IV Aa-Sa in fetal atrioventricular conduction

作　　者：郭敏[1,2] 朱琦[2] 

机构地区：[1]电子科技大学医院妇产科,四川成都611731 [2]四川大学华西第二医院超声科,四川成都610041

出　　处：《西部医学》2013年第4期501-504,共4页Medical Journal of West China

基　　金：国家重点研究发展计划(973计划)资助项目(2007CB511905)

摘　　要：目的探讨组织多普勒成像(TDI)指标Aa-IV、Aa-Sa在评价胎儿房室传导方面的临床应用价值。方法选择111例正常孕妇进行TDI检测,记录Aa-IV(心房收缩期起点至等容收缩期起点的时间间隔)及Aa-Sa(心房收缩期起点至心室收缩射血期起点的时间间隔),作为胎儿房室传导时间的评价指标。使用直线回归分析,比较Aa-IV、Aa-Sa与孕周及胎心率的相关性。选择62例晚孕孕妇进行TDI检测,记录Aa-IV及Aa-Sa;并于出生后一周内行新生儿心电图检查,测量PR间期。采用直线回归分析,比较Aa-IV、Aa-Sa与PR的相关性;绘制受试者工作特征曲线(ROC曲线),比较Aa-IV、Aa-Sa对胎儿Ⅰ°房室传导阻滞的诊断价值。结果 Aa-IV、Aa-Sa均与孕周及新生儿PR间期呈正相关,与胎心率呈负相关,其中Aa-IV与各指标相关性更好。ROC曲线显示Aa-IV具有中等诊断价值,而Aa-Sa诊断价值较低。结论 TDI技术能准确评价胎儿房室传导时间。在心肌收缩力下降等病理情况下,Aa-IV能更准确地进行胎儿房室传导阻滞的筛查。Objective To compare the application value in fetal atrioventrieular time interval （AV） measurement between Aa-Iv and Aa-Sa . Methods （1） 111 normal pregnant women were enrolled and Tissue Doppler imaging（TDI） examination was performed. The TDI-derived AV intervals were measured as the intervals from atrial contraction （Aa） to isovolumic contraction （IV） and from Aa to ventricular systole （Sa）. By line regression,the correlation of Aa-Iv, Aa-Sa vs. gestational age , {etal heart rate was compared. （2） 62 pregnant women in third trimester（≥38 week） were erolled. TDI-derived AV intervals （Aa-Iv, Aa-Sa） and their neonatal ECG-derived PR intervals were measured. By line regression,the correlation of Aa-Iv, Aa-Sa and PR interval were compared, Receiver Operator Characteristic Curve was established to compare the diagnostic value of Aa-Ⅳ and Aa-Sa. Results Fetal Aa-Ⅳ.Aa-Sa both were positively correlated with their gestational age and neonatal PR, and nagetively correlated with their heart rate. Aa-Ⅳ correlated significantly better with them than did Aa-Sa. The Receiver Operator Characteristic Curve showed secondery diagnostic value of Aa-Ⅳ and little diagnostic value of Aa-Sa. Conclution TDI can assess the fetal atrioventricular time interval accurately. Aa-Ⅳ can screen the fetal first degree atrioventricular block more accurately than did Aa-Sa.

关 键 词：组织多普勒成像 房室传导时间 房室传导阻滞 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学]