脑钠肽联合速度向量成像技术评估先天性心脏病胎儿心功能的临床价值  

Evaluation of fetal cardiac function by brain natriuretic peptide and velocity vector imaging in congenital heart disease

作　　者：颜璨[1,2] 李胜利 余艳红[3] 夏珣[1] 欧阳淑媛[4] 姚远[1] 陈琮瑛[1] 文华轩[1] 

机构地区：[1]南方医科大学附属深圳市妇幼保健院超声科,518028 [2]广州市妇女儿童医疗中心 [3]南方医科大学南方医院妇产科,广州510515 [4]南方医科大学附属深圳市妇幼保健院中心实验室,518028

出　　处：《中华医学超声杂志（电子版）》2015年第5期369-373,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金面上项目(81270707);国家自然科学基金青年基金项目(61101026);2011年深圳市科技计划项目(201101013)

摘　　要：目的探讨羊水脑钠肽(BNP)联合速度向量成像技术(VVI)评估先天性心脏病胎儿心功能的临床价值。方法应用ELISA方法测定正常对照组304例胎儿与先天性心脏病组47例胎儿羊水中BNP浓度,分析两组胎儿羊水中BNP浓度的差异及其与孕周的关系,同时联合运用速度向量成像技术对胎儿心功能进行评估。结果先天性心脏病组胎儿羊水中BNP浓度值高于正常对照组,两组胎儿羊水中BNP浓度值比较差异有统计学意义(F=4.032,P<0.05),且先天性心脏病组胎儿羊水中BNP浓度值随着羊水穿刺孕周增加而升高(r=0.289,P<0.05),同时先天性心脏病组胎儿左心室心肌整体运动速度、应变、应变率较正常对照组胎儿降低,差异有统计学意义(P<0.05)。结论先天性心脏病组胎儿左心室心肌整体运动参数下降,羊水中BNP浓度增高,且与孕周呈正相关性,羊水BNP浓度测定值可作为产前评价胎儿心功能潜在损害的一个生物学指标。Objective To investigate the clinical value of evaluation of fetal cardiac function in congenital heart disease by brain natriuretic peptide （BNP） and velocity vector imaging （VVI）. Methods Fetuses who came from Shenzhen Maternity ＆ Child healthcare Hospital were divided into the congenital heart disease group and the control group. At the same time we collected amniotic fluid and assayed BNP concentration. Using the VVI software, the velocity, strain and strain rate of the global and segmental of the left ventricle were measured. Comparison and correlation were made between the two groups. Results There was significantly difference of BNP concentrations in amniotic fluid between two groups. The gestational age had significant positive correlation with BNP concentrations in disease group. The comparison of global velocity, strain and strain rate of left ventricle between the two groups showed significant differences. All of the left ventricular dynamic parameters in disease group were lower than those of the control group. Conclusions Compared with the control group, the disease group had a high level of BNP in amniotic fluid and a lower level of dynamic parameters of left ventricular. There was a positive correlation between BNP concentration and gestational age in disease group. So we can conclude that the BNP concentration can be a biological parameter for evaluating the latent impairments of fetal cardiac function.

关 键 词：超声检查 多肽类 胎儿 心脏病 心脏功能 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]