超声监测妊娠合并心脏病患者胎儿多器官血流指标变化  

Analysis of Changes in Fetal Multiorgan Blood Flow Parameters in Pregnant Patients with Combined Heart Disease Using Ultrasound

作　　者：郑烨[1] 陈洁[1] 赵青[1] 王立娟[1] 秦淮[1] 牛宏珍[1] Zheng Ye;Chen Jie;Zhao Qing;Wang Lijuan;Qin Huai;Niu Hongzhen(Department of Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院综合超声科,北京市100029

出　　处：《中国超声医学杂志》2023年第9期1026-1029,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨胎儿脐动脉(UA)、大脑中动脉(MCA)、肾动脉(RA)血流参数、Tei指数在妊娠合并心脏病患者胎儿的改变及其与孕妇肺动脉压力的相关性。方法纳入妊娠合并心脏病患者58例,对照组59例,比较两组胎儿UA、MCA、RA的阻力指数(RI)、搏动指数(PI)、S/D值及左右心室Tei指数指标变化。将疾病组分为肺动脉高压组33例,无肺动脉高压组25例,比较两亚组胎儿各项血流指标并分析其与孕妇肺动脉压力之间的相关性。结果疾病组胎儿UA及RA的RI、PI及S/D值均较对照组增高,MCA RI、PI及S/D值均减低,左右心室Tei指数均增高(P<0.05);亚组分析,肺动脉高压组RA PI、左右心室Tei指数较无肺动脉高压组增高(P<0.05)。胎儿左右心室Tei指数、RA PI与孕妇肺动脉压力呈正相关。结论应用胎儿UA、MCA、RA血流参数及Tei指数能全面评估妊娠合并心脏病患者胎儿多器官部位血流指标改变。Objective To investigate the changes of fetal umbilical artery(UA),middle cerebral artery(MCA),renal artery(RA)blood flow parameters and Tei index in pregnant women with heart disease and their correlation with maternal pulmonary artery pressure.Methods Total 117 singleton pregnancies were recruited,58 cases of pregnant women with heart disease formed the disease group and the others made up the control group.The resistance index(RI)and pulsatility index(PI)and S/D of UA,MCA and RA,left and right ventricular Tei index were examed by ultrasound and compared in two groups.The disease group was divided into 33 cases with pulmonary hypertension and 25 cases without pulmonary hypertension.Subgroup analysis was performed and various fetal indexes were compared and analyzed its relationship with maternal pulmonary artery pressure.Results UA RI,PI and S/D and RA RI,PI and S/D in the disease group were higher than those in the control group.MCA RI,PI and S/D were lower.Left and right ventricular Tei index were higher,the difference was statistically significant(P0.05).Subgroup analysis showed that RA PI in the pulmonary hypertension group was higher and left and right ventricular Tei index were higher than those in the non-pulmonary hypertension group(P0.05).There was a significant positive correlation between the left and right ventricular Tei index,RA PI with maternal pulmonary artery pressure.Conclusions The use of fetal UA,MCA,RA blood flow parameters and Tei index provides a comprehensive assessment of fetal multiorgan parts of blood flow in pregnant patients with heart disease.

关 键 词：肺动脉高压 脐动脉 大脑中动脉 肾动脉 TEI指数 

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]