晚孕期正常胎儿产前和产后肺静脉多普勒频谱的对比研究  

Comparative study of pulmonary venous Doppler spectrum from late pregnancy to neonatal stage

作　　者：王园园[1] 董凤群[2] 吴向玲[1] 王乾[3] 

机构地区：[1]河北省保定市第一中心医院超声科,河北保定071000 [2]河北省儿童医院胎儿先天性心脏病超声诊断中心,河北石家庄050031 [3]河北省保定市第一医院儿科,河北保定071000

出　　处：《河北医科大学学报》2015年第8期911-914,921,共5页Journal of Hebei Medical University

摘　　要：目的观察并对比正常胎儿期、生后1d、生后28d肺静脉血流频谱的变化,初步探讨其变化机制,及早发现和鉴别新生儿肺循环疾病。方法 296例受检者分别于胎儿期（孕32~40周）、生后1d、生后28d检查超声心动图,比较肺静脉心室收缩期流速（S波）、心室舒张期流速（D波）、心房收缩期流速（A波）测值。结果生后1d和生后28d左肺静脉S波、右肺静脉S波、左肺静脉D波、右肺静脉D波均较胎儿期增高（P〈0.05）,生后1d和生后28d各指标比较差异均无统计学意义（P〉0.05）。同一时期左右两侧肺静脉S波和D波比较差异均无统计学意义（P〉0.05）。胎儿期只有1个S波,生后1d和生后28d出现了S1和S2波。胎儿期A波均呈正向波（与S波、D波同向）,生后1d和生后28dA波具有不确定性,可出现正向（与S、D波同向）、消失（为零）及反向（与S、D波反向）3种情况。结论正常肺静脉的S波、D波新生儿期比晚孕期增高,但新生儿期变化不大,若测值明显增高需警惕肺静脉狭窄等疾病。新生儿肺静脉多数出现2个S波,A波方向具有不确定性,不同于胎儿期。Objective To observe and compare the change of pulmonary venous Doppler spectrum from the third trimester to neonatal period,and explore possible basis for early detection and identification of neonatal pulmonary circulation disorders.Methods A total of 296 cases were divided into three groups according to pregnancy week or neonatal stage for echocardiography examination,group A：late pregnancy（32-40 weeks）,group B：1day after birth,group C：28days after birth.Record data involved ventricular systolic velocity（S wave）,ventricular diastolic velocity（D wave）and atrial systolic velocity（A wave）of the pulmonary vein for each group,and statistical analysis was performed.Results S wave and D wave of left and right pulmonary vein on 1day after birth and 28 days after birth were all higher than those of late pregnancy stage（P〈0.05）.But,S wave and D wave of left and right pulmonary vein showed no significant difference on 1day and 28 days after birth（P〉0.05）.At the same time,the difference of S wave and D wave between left and right pulmonary vein had no statistical significance（P〉0.05）.The spectrum of pulmonary vein in the late pregnancy had only one S wave,but on 1day or 28 days after birth,S1 and S2 wave appeared.The A wave was all forward in the late pregnancy,but was uncertain on 1day or 28 days after birth.Conclusion Spectrum of S and D waves in the neonatal stage increase more than in late pregnancy,but become stable during neonatal stage.If the indexes raise obviously,pathological pulmonary stenosis should be in alarm.Pulmonary vein at neonatal stage often presents two S waves,the spectrum of A wave is uncertain,which is different from that of fetal stage.

关 键 词：肺静脉 超声心动描记术 多普勒 彩色 对比研究 

分 类 号：R322.123[医药卫生—人体解剖和组织胚胎学]