胎儿大脑中动脉血流动力学参数及脐血乳酸值预测胎儿窘迫的价值  

Value of blood flow parameters of fetal middle cerebral artery and lactic acid level in umbilical arterial blood in predicting fetal distress

作　　者：柴月荣[1] 施萍[1] 章晓兰[1] 周婉萍[1] 刘爱民[1] CHAI Yuerong SHI Ping ZHANG Xiaolan et al(Department of Obstetrics and Gynecology, Wujin People＇s Hospital of Changzhou , Changzhou 213002, CHINA)

机构地区：[1]常州市武进人民医院妇产科,江苏省213002

出　　处：《江苏医药》2017年第10期697-699,共3页Jiangsu Medical Journal

基　　金：江苏省武进科技局社会发展科技计划项目(WS201512)

摘　　要：目的探讨检测胎儿大脑中动脉(MCA)血流参数和脐血乳酸水平预测胎儿宫内窘迫的临床价值。方法妊娠≥37周产妇68例;其中,诊断为慢性胎儿宫内窘迫34例(研究组),无慢性胎儿宫内窘迫34例(对照组)。采用彩色多普勒超声检测胎儿MCA的搏动指数(PI)、阻力指数(RI)和收缩期峰值流速与舒张末期流速比值(S/D),干片比色法测定胎儿脐动脉血乳酸值。结果研究组RI和S/D比值分别为0.56±0.21和2.80±1.08,低于对照组的1.21±0.49和4.48±1.14(P<0.05)。研究组脐血乳酸值高于对照组[(4.11±1.27)mmol/L vs.(3.32±1.07)mmol/L](P<0.05)。结论胎儿MCA血流参数及脐血乳酸水平测定有助于预测胎儿宫内窘迫的诊断和选择临床干预时机。Objective To study the clinical significance of blood flow parameters of fetal middle cerebral artery （MCA） and lactic acid （LA） level in umbilical arterial blood in predicting fetal intrauterus distress. Methods Sixty-eight puerpera with 37 gestation weeks or more were assigned to two groups of A（with fetal distress syndrome, 34 cases） and B（without fetal distress syndrome, 34 cases）. The fetal MCA pulsatility index（PI）,resistenee index（RI） and the ratio of systolic to diastolic peak flow velocity（S/D） were measured by color Doppler technique. The LA level of umbilical arterial blood was measured by dry slice colorimetry. Results The values of RI and S/D were significantly lower in group A than those in group B（0.56±0.21 vs. 1.21±0. 49 and 2.80±1.08 vs. 4. 48±1.14） （P〈0.05）. The LA level of umbilical arterial blood was significantly higher in group A than that in group BE（4.11±1.27） mmol/L vs. （3.32±1.07） mmol/L]（P〈0.05）. Conclusion The detection of fetal MCA blood flow parameters and umbilical arterial blood LA is helpful in predicting the diagnosis of fetal intrauterus distress and selecting the time to take clinical intervention.

关 键 词：胎儿宫内窘迫 大脑中动脉 乳酸 

分 类 号：R714[医药卫生—妇产科学]