能量多普勒超声对妊娠高血压综合征患者胎盘血流动力学的研究  

The Value of power Doppler ultrasound on PIH hemodynamics

作　　者：王莹[1] 叶春媚[1] 李燕[1] 陈明[1] 

机构地区：[1]南方医科大学附属深圳宝安医院超声科,广东深圳518100

出　　处：《中国中西医结合影像学杂志》2015年第6期623-625,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：深圳市宝安区科技计划社会公益项目

摘　　要：目的 :分析妊娠高血压综合征(pregnancy-induced hypertension,PIH)患者孕晚期超声多普勒检测的胎盘血流动力学指标与围生儿妊娠结局的关系,探讨能量多普勒超声对PIH患者胎盘血流动力学的价值。方法:选择晚孕期49例正常孕妇(正常组)和49例PIH患者(PIH组),采用彩色多普勒超声诊断仪监测胎盘内绒毛动脉血流参数:收缩期与舒张期血流峰值速度比值(S/D)、RI、搏动指数(PI)、时间平均流速(TAV),绘制各参数受试者特征曲线(ROC曲线),计算曲线下面积。三维能量多普勒图观察胎盘内绒毛动脉形态。随访产后胎儿妊娠结局。结果:在孕晚期,PIH组胎盘内绒毛动脉血流参数S/D、RI、PI值较正常孕妇显著增高(P<0.05),而TAV显著降低(P<0.05);PIH患者胎盘内绒毛动脉血流各参数中S/D值的ROC曲线下面积最大。三维能量多普勒图显示重度PIH患者较正常孕妇胎盘内绒毛动脉数目减少,管径变细。结论:胎盘内绒毛动脉血流S/D、RI、PI值测定可作为反映胎盘功能、监测胎儿宫内情况及预测妊娠结局的重要指标。能量多普勒超声在PIH患者胎盘血流动力学改变研究中具有重要价值。Objective：To explore value of power Doppler ultrasound on patients with pregnancy-induced hypertension （PIH） by analyzing the relation of fetal and placenta hemodynamics parameters with the outcomes of pregnancy. Methods：The placenta artery blood flow parameters were acquired in 49 patients with PIH （PIH group） and 49 normal patients （control group） by color doppler ultrasonic diagnostic instrument （GE Volusoun 730 pro,equipted 5-8 MHZ probe）. The ratio of peak systolic velocity/diastolic ratio velocity （S/D） value and pulse index （PI）,resistance index （RI） were calculated. The receiver operating characteristic curve （ROC curve） was drawn,and placental arterial blood flow parameters areas under ROC curve was calculated. The structure of placenta artery was observed by three-dimensional power Doppler ultrasonography. Follow up the fetal out-comes of the pregnant women. Results：The placental artery blood flow parameters （S/D,RI,PI） of the patients with PIH increased significantly than those of normal pregnant women（P〈0.05） and TAV value declined （P〈0.05）. The area under the curve of the S/D value in placenta artery was biggest. 3D-CPA results showed that placental villous vascular branches were reduced in severe PIH patients,the vascular became thin and the blood perfusion of placental was also reduced. Conclusion：The parameters （S/D,RI,PI） of placenta artery can be used as reflection of placental function. Power Doppler Ultrasound has vital value on evaluating hemodynamic situation of placenta in PIH.

关 键 词：子痫 高血压 妊娠性 超声检查 多普勒 彩色 胎盘 血流动力学 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.246[医药卫生—诊断学]