二维斑点追踪技术评价低风险胎儿和小于胎龄儿心室整体纵向应变的临床价值  

Clinical Value of 2D Speckle Tracking for the Evaluation of Ventricular Global Longitudinal Strain in Low-risk Fetuses and Small-for-gestational-age Fetuses

作　　者：朱晨 任芸芸 李嫚 须成杰 熊钰 丁梦娟 刘芮 Zhu Chen;Ren Yunyun;Li Man;Xu ChengJie;Xiong Yu;Ding Mengjuan;Liu Rui(Department of Ultrasound,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 20001l,China;Department of Information Technology,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 20001l,China;Department of Obstetrics,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 20001l,China)

机构地区：[1]复旦大学附属妇产科医院超声科,上海市200011 [2]复旦大学附属妇产科医院信息科,上海市200011 [3]复旦大学附属妇产科医院产科,上海市200011

出　　处：《中国超声医学杂志》2023年第7期794-797,共4页Chinese Journal of Ultrasound in Medicine

基　　金：上海市卫生健康委员会卫生行业临床研究专项课题(No.202140217);中国超声医师“科技新星”项目(No.KJXX2020004)。

摘　　要：目的采用二维斑点追踪技术评价低风险胎儿心室整体纵向应变(GLS)并制定GLS参考值范围,进而在此基础上探讨小于胎龄儿(SGA)GLS的临床应用价值。方法本研究采用前瞻性队列设计。收集妊娠28周至39^(+6)周的单胎胎儿。采用胎儿心脏二维斑点追踪技术对453例低风险胎儿和210例SGA胎儿的GLS进行测量和分析。结果低风险胎儿左心室GLS与孕周不存在相关性(P=0.387),右心室GLS随孕周增加而轻度升高(P=0.008)。低风险胎儿左心室GLS绝对值明显大于右心室(P<0.001)。约15%脐动脉正常的SGA胎儿的左心室GLS>90^(th)%(P=0.031)。结论本研究制定了低风险胎儿GLS参考值范围,同时发现约15%的SGA胎儿出现GLS异常改变早于脐动脉搏动指数,为评估胎儿心脏重塑提供了重要依据。Objective To evaluate global longitudinal strain(GLS)in low-risk fetuses using 2D speckle-tracking and to formulate reference ranges of GLS values,and then to analyze the application value of GLS in small-for-gestational-age(SGA)fetuses.Methods A prospective cohort design was used in this study.Singletons at 28 to 39 gestational weeks of low-risk pregnancy were collected.GLS of 453 low-risk and 210 SGA fetuses were measured and analyzed by fetal echocardiography 2D speckle tracking technique.Results There was no correlation between left ventricular GLS values and gestational age in low-risk fetuses(P=0.387),while right ventricular GLS values increased slightly with advanced gestational age(P=0.008).In low-risk fetuses,the absolute values of left ventricular GLS were significantly greater than that of the right ventricle(P<0.001).About 15%of SGAs with normal umbilical artery showed left ventricular GLS 90^(th)%(P=0.031).Conclusions This study established reference ranges of GLS in low-risk fetuses,and found that about 15%of SGAs showed abnormal GLS earlier than umbilical artery pulsatility index,providing an important basis for assessing fetal cardiac remodeling.

关 键 词：二维斑点追踪 整体纵向应变 小于胎龄儿 胎儿 心脏功能 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]