先天性心脏病胎儿与正常胎儿脐静脉血流量的对比研究  

Comparative study of umbilical venous blood flow between congenital heart disease and normal fetus

作　　者：郭娟[1] 韩建成[2] 谷孝艳[2] 张烨[2] 刘晓伟[2] 孙琳[2] 赵映[2] 陈健 贡雪灏[1] 何怡华[2] Guo Juan;Han Jiancheng;Gu Xiaoyan;Zhang Ye;Liu Xiaowei;Sun Lin;Zhao Ying;Chen Jian;Gong Xuehao;He Yihua(Department of Ultrasound,the First Affiliated Hospital of Shenzhen University,the Second People′s Hospital of Shezhen,Shenzhen 518035,China;Echocardiography Medical Center,Beijing Anzhen Hospital,Capital Medical University Maternal-Fetal Medical Center in Fetal Heart Disease,Beijing Anzhen Hospital,Beijing 100029,China)

机构地区：[1]深圳大学第一附属医院深圳市第二人民医院超声科,深圳518035 [2]首都医科大学附属北京安贞医院心脏超声医学中心北京安贞医院胎儿心脏病母胎医学中心,北京100029

出　　处：《中华超声影像学杂志》2022年第9期774-778,共5页Chinese Journal of Ultrasonography

基　　金：国家重点研发计划(十三五项目)(2018YFC1002300);心血管疾病精准医学北京实验室(PXM2018_014226_000013);胎儿心脏病母胎医学研究北京重点实验室(BZ0308);2021校培育项目(自然类)(PYZ21124);深圳市医疗卫生三名工程(SZSM201612027);深圳市医学重点学科(SZXK052)。

摘　　要：目的探讨先天性心脏病胎儿与正常胎儿脐静脉内径(D)、时间平均峰值流速(TAmax)及血流量是否有差异。方法前瞻性研究2021年5-9月于北京安贞医院胎儿心脏病母胎医学中心就诊的69例22~27周先天性心脏病胎儿(病例组)的脐静脉D及TAmax,根据公式[Q=0.5TAmax·π·(D/2)^(2)]计算出Q_(1)(脐静脉血流量),再根据胎儿体重计算出Q_(2)(Q_(2)=Q_(1)/体重),同时选取同期孕周匹配的111例健康胎儿作为对照组。分析两组间胎儿脐静脉D、TAmax、Q_(1)及Q_(2)是否存在差异。结果病例组脐静脉D、TAmax、Q_(1)及Q_(2)低于对照组,差异有统计学意义(均P<0.05)。对照组脐静脉D、TAmax及Q_(1)随着孕周的增加而增加且呈正相关关系(r=0.608、0.320、0.626,均P≤0.001),Q_(2)与孕周之间不存在明显相关性(r=0.189,P=0.047)。结论先天性心脏病胎儿脐静脉D、TAmax、Q_(1)及Q_(2)减低,提示胎盘-胎儿循环有效血流量减低,间接反映出先天性心脏病胎儿胎盘功能减低。Objective To investigate the differences of umbilical vein diameter(D),time average peak velocity(TAmax)and blood flow between congenital heart disease and normal fetus.Methods The umbilical vein diameter and time average peak velocity of 69 fetuses with congenital heart disease(disease group)from 22 to 27 weeks were prospectively studied in Maternal-Fetal Medical Center in Fetal Heart Disease of Beijing Anzhen Hospital from May 2021 to September 2021.Q_(1)(umbilical venous blood flow)was calculated according to the formular[Q=0.5TAmax·π·(D/2)^(2)],and Q_(2)(Q_(2)=Q_(1)/weight)was calculated according to the fetal weight.At the same time,111 normal fetuses with matched gestational age were selected as control group.The differences of fetal umbilical vein D,TAmax,Q_(1) and Q_(2) between the two groups were analyzed.Results The inner diameter of umbilical vein D,TAmax,Q_(1) and Q_(2) in the congenital heart disease group were lower than those in the control group(all P<0.05).In the control group,the inner diameter of umbilical vein D,TAmax and Q_(1) increased with the increase of gestational age and showed a positive linear correlation(r=0.608,0.320,0.626;all P≤0.001),while there was no obvious linear correlation between Q_(2) and gestational age(r=0.189,P=0.047).Conclusions The decrease of umbilical vein D,TAmax,Q_(1) and Q_(2) in the fetus with congenital heart disease indicates the decrease of effective blood flow in placenta-fetus circulation,which indirectly reflects the decrease of placental function in the fetus with congenital heart disease.

关 键 词：超声检查 产前 先天性心脏病 胎儿 脐静脉 胎盘 血流量 

分 类 号：R725.4[医药卫生—儿科]