产前超声测量正常胎儿主动脉峡部收缩指数的临床价值  

The Clinical Value of Measurement of Normal Fetal Aortic Isthmus Systolic Index with Prenatal Ultrasound

作　　者：陈昌宇[1] 解丽梅[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,沈阳110004

出　　处：《中国医科大学学报》2015年第6期516-519,共4页Journal of China Medical University

基　　金：辽宁省科技厅科学技术计划项目(2012225019)

摘　　要：目的 应用产前超声获得胎儿主动脉峡部收缩指数（ISI）,建立正常胎儿ISI的正常范围参考值,并评价其与孕周之间的变化规律,为产前诊断胎儿心血管异常及评估胎儿宫内安危提供信息。方法 选取孕18-37周正常胎儿251例,应用频谱多普勒超声获得其主动脉峡部血流频谱图像,测量其收缩期峰值血流速度（PSV）、收缩末期最低点血流速度（NS）,计算ISI,ISI为NS与PSV的比值,并分析ISI与孕周之间的关系。结果 孕18-24周ISI值在0.19-0.21之间。随着孕周的增加,PSV逐渐增加,NS逐渐减低。28周左右,主动脉峡部血流频谱上可观察到一个明显的收缩末期减速,这种趋势导致ISI平均值在30周左右接近0。此后这一趋势继续增加,在妊娠末期ISI平均值约为-0.33。以孕周为自变量X,PSV、NS、ISI分别为因变量Y,进行曲线拟合,得出曲线方程分别为Y∧=-69.116＋9.542X-0.139X2,R^2=0.96,P〈0.001;Y∧=-99.881＋10.331X-0.232X2,R^2=0.99,P〈0.001;Y∧=-0.671＋0.086X-0.02X2,R^2=0.99,P〈0.001。结论 产前超声能够测量胎儿ISI,ISI能够为诊断胎儿心血管异常及评估胎儿宫内安危提供有用的信息。Objective To obtain the fatal aortic isthmic systolic index（ISI）with prenatal ultrasound,and to establish reference ranges for normal live fatal aortic isthmic systolic index（ISI）. Methods A total of 251 normal fetuses at 18-37 gestation weeks were collected and underwent Doppler ultrasound examination to obtain the fatal aortic isthmus waveforms. Peak systolic velocity（PSV）and systolic nadir（NS）were measured on the waveforms. ISI was derived from the ratio NS/PSV,and its relationship with gestational weeks was analyzed. Results ISI value was between 0.19 and 0.21,from 18 to 24 gestational weeks. As the gestational weeks increasing,PSV increased;however,NS decreased gradually. At about 28 weeks,a brief end-systolic deceleration wave was observed on the aortic isthmus waveforms,and this trend led to ISI towards a mean value of zero at about 30 weeks. At the end of pregnancy,ISI was about-0.33. The curve equations were established regarding the gestational age as the independent variable X,PSV,NS and ISI as the dependent variable Y respectively. Y∧=-69.116＋9.542X-0.139X2,R2=0.96,P 〈0.001;Y∧=-99.881＋10.331X-0.232X2,R^2=0.99,P 〈0.001;Y∧=-0.671＋0.086X-0.02X2,R^2=0.99,P 〈0.001. Conclusion Prenatal ultrasound can measure the fetal aortic isthmic systolic index,which is helpful in the diagnosis of fetal cardiovascular anomalies and evaluation of fetal intrauterine status.

关 键 词：胎儿 主动脉峡部 峡部收缩指数 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学]