胎儿心脏定量分析技术评价中晚孕期胎儿心室功能变化研究  

Assessment of fetal ventricular function in second and third trimester by fetal heart quantification

作　　者：姜新魁 卫红艳 庞慧贤 洪菲 程健怡 张红梅 李静 JIANG Xin-kui;WEI Hong-yan;PANG Hui-xian;HONG Fei;CHENG Jian-yi;ZHANG Hong-mei;LI Jing(Department of Medical Ultrasound,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,Guangdong,China;Department of Obstetrics,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,Guangdong,China;Department of Endocrinology,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,Guangdong,China)

机构地区：[1]华中科技大学协和深圳医院超声医学科,广东深圳518052 [2]华中科技大学协和深圳医院产科,广东深圳518052 [3]华中科技大学协和深圳医院内分泌科,广东深圳518052

出　　处：《生物医学工程与临床》2024年第3期324-330,共7页Biomedical Engineering and Clinical Medicine

基　　金：深圳市南山区卫生科技项目资助(NS2021048)。

摘　　要：目的探讨应用胎儿心脏定量分析技术(fetal HQ)分析正常中晚孕胎儿不同孕周左心室(LV)、右心室心脏功能和形态变化规律。方法选择行产前超声检查的60例中晚孕正常单胎孕妇,年龄23~40岁,平均年龄30.7岁;孕周21~40周,平均孕周29.5周;胎龄21~40周,平均胎龄29.3周;按照孕周分为3组,即21~25周组、28~32周组和35~40周组,每组20例。对孕妇行超声心动图检查,采集四腔心动态图像,应用fetal HQ分析各组LV、右心室24个节段球形指数(SI)及短轴缩短率(FS),并比较其差异。结果将同一孕周、同一心室24个节段SI值进行比较,各孕周组内,左右心室心尖部第24个节段与组内其余23个节段SI值两两比较,差异均有统计学意义(均P<0.05)。随孕周增长,各组间的同一个节段SI值进行比较,差异无统计学意义(P>0.05)。28~32周组左心室基底部第1~4段FS值低于21~25周组同节段FS值[LV-FS1(12.50±2.60)%vs(17.19±4.89)%、LV-FS2(14.88±3.48)%vs(18.42±4.84)%、LV-FS3(17.09±4.07)%vs(21.20±4.86)%、LV-FS4(18.03±4.37)%vs(23.13±5.44)%。P<0.05],余节段两组间FS值差异无统计学意义(P>0.05)。35~40周组左心室基底第1~6段FS值低于21~25周组同节段FS值[LV-FS1(12.71±3.96)%vs(17.19±4.89)%,LV-FS2(14.29±4.62)%vs(18.42±4.84)%,LV-FS3(15.73±5.81)%vs(23.13±5.44)%,LVFS4(17.92±5.88)%vs(23.13±5.44)%,LV-FS5(19.81±6.39)%vs(24.62±5.97)%,LV-FS6(22.04±6.45)%vs(27.24±5.94)%。P<0.05]。余节段的FS值与21~25周比较,差异无统计学意义(P>0.05)。28~32周组胎儿右心室所有节段FS值均低于21~25周组同节段FS值(P<0.05)。随着孕周推进,35~40周组所有节段FS值与28~32周组同节段FS值比较,差异无统计学意义(P>0.05)。结论fetal HQ可对胎儿左右心室24个节段SI值和FS值进行定量检测,为预测中晚期胎儿的心功能及形态学改变提供了一种新的手段。Objective To evaluate the feasibility of fetal heart quantification(fetal HQ)for assessment of left ventricular(LV)and right ventricular function in the second and third trimester of normal pregnancy.Methods A total of 60 normal singleton pregnant women in second and third trimester performed prenatal ultrasound examination were enrolled,which aged 23-40years old with mean age of 30.7 years old,gestational aged 21-40 weeks with mean of 29.5 weeks,fetal aged 21-40 weeks with mean of 29.3 weeks.According to gestational age,all of the pregnant women were divided into 3 groups:21-25 weeks group,28-32 weeks group and 35-40 weeks group.The echocardiography was performed on pregnant women,and fourchamber dynamic images were collected,the fetal HQ was used to analyze the 24-segment spherical index(SI)and fractional shortening rate(FS)of LV and right ventricle in each group,and the differences were compared.Results The SI of 24-segment of the same ventricle at the same gestational week was compared.In each gestational week group,the SI of 24th segment of LV and right ventricular apex was higher than that of the basal and middle segments(P<0.05).With the increase of gestational age,there was no significant difference of the same segment SI in each group(P>0.05).The 1-4 segments FS of the LV basal in28-32 weeks group was lower than that in 21-25 weeks group[LV-FS1(12.50±2.60)%vs(17.19±4.89)%,LV-FS2(14.88±3.48)%vs(18.42±4.84)%,LV-FS3(17.09±4.07)%vs(21.20±4.86)%,LV-FS4(18.03±4.37)%vs(23.13±5.44)%.P<0.05],there was no significant difference in FS between 2 groups of other segments(P>0.05).The FS of 1-6 segments of LV basal in 35-40 weeks group was lower than that in 21-25 weeks group[LV-FS1(12.71±3.96)%vs(17.19±4.89)%,LV-FS2(14.29±4.62)%vs(18.42±4.84)%,LV-FS3(15.73±5.81)%vs(23.13±5.44)%,LV-FS4(17.92±5.88)%vs(23.13±5.44)%,LV-FS5(19.81±6.39)%vs(24.62±5.97)%,LV-FS6(22.04±6.45)%vs(27.24±5.94)%.P<0.05].There was no significant difference in FS between the other segments and 21-25 weeks group(P>0.05).All segments

关 键 词：胎儿心功能 胎儿心脏定量分析技术(fetal HQ) 中晚期胎儿 超声心动图 

分 类 号：R714.5[医药卫生—妇产科学]