母体抗SSA/SSB抗体阳性胎儿完全性房室传导阻滞超声表现  

Ultrasonic manifestations of complete atrioventricular block in fetuses with positive maternal anti-SSA/SSB antibodies

作　　者：李岩[1] 王清国[2] 耿斌[3] 秦金霞[1] 帖永新[1] 常凤玲[1] 冯俊[1] 翟慧萍 LI Yan;WANG Qingguo;GENG Bin;QIN Jinxia;TIE Yongxin;CHANG Fengling;FENG Jun;ZHAI Huiping(First Department of Ultrasound,Central Hospital of Xinxiang,Xinxiang 453000,China;Department of Ultrasound,People Hospital of Binzhou,Binzhou 256603,China;Pediatric Cardiovascular Center,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China;Department of Ultrasound,Second People's Hospital of Xinxiang,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院超声一科,河南新乡453000 [2]滨州市人民医院超声科,山东滨州256603 [3]首都医科大学附属北京安贞医院小儿心脏中心,北京100029 [4]新乡市第二人民医院超声科,河南新乡453000

出　　处：《中国医学影像技术》2021年第7期1034-1038,共5页Chinese Journal of Medical Imaging Technology

基　　金：2019年度河南省医学科技攻关计划联合共建项目(LHGJ20191324)。

摘　　要：目的观察母体抗SSA/SSB抗体阳性胎儿完全性房室传导阻滞(CAVB)超声表现。方法以二维、M型及多普勒超声技术观察7胎母体抗SSA/SSB抗体阳性CAVB胎儿心脏,获取二尖瓣、左心室流入道及流出道、脐动脉(UA)、静脉导管(DV)及大脑中动脉(MCA)血流频谱。结果7名孕妇抗SSA抗体、抗Ro52抗体均呈阳性,其中4名抗SSB抗体呈阳性。7胎均见房室分离,心房律正常而心室律缓慢,二尖瓣、UA、DV及MCA血流异常;其中4胎心房壁、房间隔、二尖瓣环或腱索回声增强。7胎均未合并其他心内外结构畸形。结论母体抗SSA/SSB抗体阳性可致胎儿发生CAVB;超声观察胎儿心脏及血流动力学变化有利于判断胎儿预后。Objective To observe the ultrasonic manifestations of complete atrioventricular block(CAVB)in fetuses with positive maternal anti-SSA/SSB antibodies.Methods Seven CAVB fetuses with positive maternal anti-SSA/SSB antibodies were enrolled.Two dimensional,M-type and Doppler ultrasonography were used to observe the fetal ultrasonic manifestations,and the blood flow spectrums of the mitral valve,left ventricular inflow and outflow tract,umbilical artery(UA),venous catheter(DV)and middle cerebral artery(MCA)were obtained.Results All 7 pregnant women were positive for anti-SSA and anti-Ro52 antibodies,and 4 of them were positive for anti-SSB antibody.Ultrasound showed enhanced echoes in atrial wall,interatrial septum,mitral annulus or chordae tendineae in 4 fetuses.All 7 fetuses had atrioventricular dissociation,with normal atrial rhythms,slow ventricular rhythms and abnormal blood flow of mitral valve,UA,DV and MCA.No other internal and external cardiac malformations was detected in 7 fetuses.Conclusion Positive maternal anti-SSA/SSB antibodies could lead to fetal CAVB.Detecting the changes of fetal heart and hemodynamics by ultrasound was helpful to evaluation on prognosis of fetus.

关 键 词：胎儿 房室传导阻滞 抗SSA抗体 抗SSB抗体 超声检查 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]