心肌做功指数、心胸比率、大脑中动脉峰值流速评估胎儿重型α地中海贫血风险的价值  

Risks of Fetus with Severeα-Thalassemia Evaluated by Myocardial Performance Index,Cardiothoracic Ratio and Middle Cerebral Artery-Peak Systolic Velocity

作　　者：覃翠优 马燕[1] 金彬彬[1] 陈冬秀[1] 陈立宏[1] 滕懿玲 QIN Cuiyou;MA Yan;JIN Binbin;CHEN Dongxiu;CHEN Lihong;TENG Yiling(Department of Ultrasound,the First Affiliated Hospital,Guangxi Medical University,Nanning 530021,China;不详)

机构地区：[1]广西医科大学第一附属医院超声科,广西南宁530021 [2]广西桂林市妇幼保健院超声科,广西桂林541001

出　　处：《中国医学影像学杂志》2021年第9期909-913,共5页Chinese Journal of Medical Imaging

基　　金：广西科学基金资助项目(桂科自0640111)。

摘　　要：目的探讨超声自动测量技术测量胎儿左心室心肌做功指数(MPI),并结合心胸比率(CTR)与大脑中动脉峰值流速(MCA-PSV),评估胎儿重型α地中海贫血风险的价值。资料与方法收集经羊水或脐带血穿刺确诊地中海贫血基因型的单胎具有重型α地中海贫血风险胎儿79例及正常对照组65例,α地中海贫血胎儿分为重型、中间型、轻型、静止型,采用超声自动测量技术测量胎儿左心室MPI,同时测量胎儿CTR、MCA-PSV,并分析联合3个指标对胎儿重型α地中海贫血的评估效能。结果重型α地中海贫血胎儿左心室MPI(0.51±0.05)较中间型(0.47±0.02)、轻型(0.44±0.04)和对照组(0.44±0.03)显著增大(F=22.79,P<0.05)。MPI与MPI+CTR评估胎儿重型α地中海贫血风险的敏感度均为66.67%,特异度分别为90.24%、99.19%;MPI+MCA-PSV与MPI+CTR+MCA-PSV评估重型α地中海贫血风险的敏感度均为47.62%,特异度分别为97.56%、100.00%。结论MPI预测重型α地中海贫血风险价值中等,MPI联合CTR可以有效提高评估胎儿重型α地中海贫血风险的效能。Purpose To explore the clinical value of ultrasonic automatic measurement of fetal left ventricular myocardial performance index(MPI)combined with cardiothoracic ratio(CTR)and middle cerebral artery-peak systolic velocity(MCA-PSV)in evaluating the risk of fetal severeα-thalassemia.Materials and Methods Seventy-nine singleton fetuses with severeα-thalassemia at risk,who were diagnosed as thalassemia genotypes by amniotic fluid or umbilical cord blood puncture,and 65 normal controls were retrospectively selected.α-thalassemia fetuses were classified as severeα-thalassemia,mildα-thalassemia,α-thalassemia minor and stationaryα-thalassemia.Ultrasonic automatic measurement technique was performed to measure fetal left ventricular MPI,fetal CTR and MCA-PSV,combining these three indexes to study the evaluation efficacy of severeα-thalassemia fetuses.Results The left ventricular MPI of severeα-thalassemia fetus(0.51±0.05)was all significantly higher than that of mildα-thalassemia fetus(0.47±0.02),α-thalassemia minor fetus(0.44±0.04)and control group(0.44±0.03)(F=22.79,P<0.05).The sensitivity of fetal left ventricular MPI and fetal left ventricular MPI+CTR in evaluating the risk of severeα-thalassemia was all 66.67%,the specificity was 90.24%and 99.19%,respectively.The sensitivity of fetal left ventricular MPI+MCAPSV and fetal left ventricular MPI+CTR+MCA-PSV in evaluating the risk of severeα-thalassemia was all 47.62%,the specificity was 97.56%and 100.00%,respectively.Conclusion The prediction of the risk value of MPI in severeα-thalassemia could be moderate,and MPI combined with CTR can effectively improve the efficiency of evaluation risk of severeα-thalassemia.

关 键 词：地中海贫血 超声检查 产前 心肌做功指数 心胸比率 大脑中动脉峰值流速 胎儿 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.431[医药卫生—诊断学]