对高原缺氧环境下世居藏族和移居汉族胎儿脐动脉及大脑中动脉血流参数的研究  

Study on fetal umbilical artery and middle cerebral artery blood flow parameters of native Tibetan pregnant women and migrant Han pregnant women in high altitude hypoxic environment

作　　者：陈鲜霞[1] 张玉英[1] 罗冬梅 马钦风[1] CHEN Xian-Xia;ZHANG Yu-Ying;LUO Dong-Mei(Qinghai Provincial People's Hospital,Xining,Qinghai 810007,China)

机构地区：[1]青海省人民医院,青海西宁810007

出　　处：《中国妇幼保健》2021年第2期318-324,共7页Maternal and Child Health Care of China

基　　金：青海省科技计划项目(2017-ZJ-755)。

摘　　要：目的通过检测高原缺氧环境下高原人群(世居藏族和移居汉族)晚孕期胎儿脐动脉(UA)及和大脑中动脉(MCA)血流参数,绘出血流参数散点图,找寻其随孕周的变化规律。探讨高原缺氧环境下世居者(藏族)及移居者(汉族)胎儿UA及MCA血流参数的差异及意义。方法选取2017年10月-2019年6月青海省玉树地区(平均海拔3500 m以上)世居者组、移居者组(居住时间2年以上)及移居者组(居住时间2年以下)晚孕期产妇胎儿各30例,在进行常规超声检查后应用彩色多普勒超声诊断仪检测UA及MCA血流参数[血流速度峰谷比(S/D)、阻力指数(RI)、搏动指数(PI)],绘出血流参数散点图,比较晚孕期世居者组和移居者组胎儿血流参数随孕周变化情况,分析血流参数与孕周的关系;比较3组胎儿UA及MCA血流参数值,发现其两两之间是否存在差异,并分析高原缺氧环境与其差异的关系。结果高原缺氧环境下,世居者和移居者胎儿UA-S/D、UA-RI及UA-PI值与孕周呈负相关的线性图;MCA-S/D、MCA-RI及MCA-PI值在30周左右出现转折点,28~30周各参数值与孕周关系图呈上升趋势,30~40周各参数值与孕周关系图呈下降趋势。高原缺氧环境下,相同孕周段世居者组和移居者组(居住时间2年以上)胎儿UA和MCA血流参数值(S/D、RI、PI)均低于移居者组(居住时间2年以下),差异有统计学意义(P<0.05)。高原缺氧环境下,相同孕周段世居者组与移居者组(居住时间2年以上)胎儿UA和MCA血流参数值(S/D、RI、PI)相差甚少,差异无统计学意义(P>0.05)。结论高原缺氧环境下,世居者与移居者胎儿UA-S/D、UARI及UA-PI随着孕周增加而数值减低;世居者与移居者胎儿MCA-S/D、MCA-RI及MCA-PI值与孕周散点图似抛物线状,存在一个先上升后下降的过程。高原缺氧环境下,移居者(居住时间2年以下)胎儿UA及MCA血流参数值均高于世居者和移居者胎儿(居住时间2年以上),说明高原缺氧环境�Objective To detect fetal umbilical artery(UA)and middle cerebral artery(MCA)blood flow parameters of native Tibetan pregnant women and migrant Han pregnant women during the third trimester of pregnancy in high altitude hypoxic environment,draw scatter diagram of blood flow parameters,seek the change rule with gestational week,explore the difference and significance of blood flow parameters of UA and MCA in native Tibetan pregnant women and migrant Han pregnant women.Methods From October 2017 to June 2019,30 native Tibetan pregnant women(native group),30 migrant Han pregnant women(more than two years),and 30 migrant Han pregnant women(less than two years)were selected from Yushu area of Qinghai Province,after routine ultrasonography,color Doppler ultrasonic diagnosis apparatus was used to detect UA and MCA blood flow parameters[blood flow velocity peak-to-valley ratio(S/D),resistance index(RI),and pulsatility index(PI)],scatter diagram of blood flow parameters was drawn.The changes of blood flow parameters with gestational week in the three groups were compared,the relationships between blood flow parameters and gestational week were analyzed.Blood flow parameters of UA and MCA in the three groups were compared,the difference was analyzed,the relationship between high altitude hypoxic environment and difference was analyzed.Results In high altitude hypoxic environment,UA-S/D,UA-RI,and UA-PI of native Tibetan pregnant women and migrant Han pregnant women were negatively correlated with gestational week,linear graph showed that turning points of MCA-S/D,MCA-RI,and MCA-PI were observed at the 30th gestational week,from the 28th gestational week to the 30th gestational week,MCA-S/D,MCA-RI,and MCA-PI increased with gestational week,from the 30th gestational week to the 40th gestational week,MCA-S/D,MCA-RI,and MCA-PI decreased with gestational week.In high altitude hypoxic environment,S/D,RI,and PI of UA and MCA in native Tibetan pregnant women and migrant Han pregnant women(more than two years)were statistically signi

关 键 词：高原习服 世居藏族 移居汉族 胎儿脐动脉 胎儿大脑中动脉 

分 类 号：R714.5[医药卫生—妇产科学]