产前超声测量正常双胎脐动脉与大脑中动脉血流指数的临床应用价值  

Clinical application value of prenatal ultrasound measurement of normal twin uterine artery and middle cerebral artery blood flow index

作　　者：廖姗姗[1] 刘彩霞[1] LIAO Shan-shan;LIU Cai-xia(Department of Materal and Fetal Medical Centery Shengjing Hospital of China Medical University, Shenyang Liaoning 110004, P.R. China)

机构地区：[1]中国医科大学附属盛京医院母胎医学中心

出　　处：《中国计划生育和妇产科》2019年第8期27-32,共6页Chinese Journal of Family Planning & Gynecotokology

基　　金：国家公益性行业科研专项项目(项目编号:201402006);辽宁省产科疾病临床医学研究中心及协同网络建设(项目编号:2016007014)

摘　　要：目的应用产前多普勒超声测量正常双胎脐动脉和大脑中动脉血流指数并计算脑-胎盘血流比(cerebroplacental ratio,CPR)。分别建立单绒毛膜囊双羊膜囊双胎(monochorionic diamniotic,MCDA)以及双绒毛囊双羊膜囊双胎(dichorionic diamniotic,DCDA)脐动脉和大脑中动脉血流指数以及CPR的正常参考值范围,评价其与孕周之间的关系,为产前双胎管理提供有用的信息。方法收集2016年6月至2017年6月在中国医科大学附属盛京医院母胎医学中心进行产前超声检查的18~30周正常双胎共104例,其中MCDA 41例,DCDA 63例,测量脐动脉收缩压/舒张压(umbilical artery systolic/diastolic,UA-S/D)、脐动脉搏动指数(umbilical artery pulsatility index,UA-PI)、脐动脉阻力指数(umbilical artery resistive index,UA-RI),大脑中动脉峰值血流速度(middle cerebral artery peak systolic velocity,MCA-PSV)、大脑中动脉搏动指数(middle cerebral artery pulsatility index,MCA-PI)、并计算CPR,分析其与孕周之间的关系。结果 MCDA和DCDA的UA-S/D、UA-PI、UA-RI、MCA-PSV、MCA-PI与孕周呈曲线相关;MCDA与DCDA相比,UA-S/D、UA-PI、UARI、MCA-PI轻度升高;MCA-PSV、CPR无明显差别。结论产前多普勒超声测量双胎胎儿脐动脉和大脑中动脉血流指数,能够对评估双胎胎儿宫内安危以及双胎管理提供有用信息。Objective To measure the blood flow index of normal twin uterus artery and middle cerebral artery by prenatal Doppler ultrasound and calculate the cerebrovascular ratio( CPR). The normal nucleus index of the umbilical artery and middle cerebral artery and the normal reference value range of CPR were established in the monochorionic diamniotic( MCDA) and the double choriocapsule dichoniotic( DCDA). Its relationship with gestational weeks provides useful information for prenatal twin management.Methods From June 2016 to June 2017,a total of 104 normal twins from 18 to 30 weeks of prenatal ultrasound examination at Department of Materal and Fetal Medical Center,Shengjing Hospital of China Medical University were collected. Among them,41 cases of MCDA,63 cases of DCDA,and umbilical artery systolic/diastolic( UA-S/D),umbilical artery pulsatility index( UA-PI),umbilical artery resistive index( UA-RI),brain Middle cerebral artery peak systolic velocity( MCA-PSV),middle cerebral artery pulsatility index( MCA-PI) were measured,and CPR were calculated to analyze its relationship with gestational age. Results UA-S/D,UA-PI,UA-RI,MCA-PSV and MCA-PI of MCDA and DCDA were curve correlated with gestational age. Compared with DCDA,MCDA was slightly elevated in UA-S/D,UA-PI,UA-RI,and MCA-PI. There was no significant difference between MCA-PSV and CPR. Conclusion Prenatal Doppler ultrasound measurement of fetal umbilical artery and middle cerebral artery blood flow index can provide useful information for assessing intrauterine safety and twin management.

关 键 词：双胎 超声检查 脐动脉 大脑中动脉 

分 类 号：R714.23[医药卫生—妇产科学]