Hb Bart胎儿水肿综合征心脏结构和功能的超声心动图研究

Echocardiography study of cardiac structure and function in Hb Bart′s fetal edema syndrome

目的 了解不同孕周HbBart胎儿水肿综合征的心脏各房室大小及心功能变化。方法 应用彩色多普勒超声心动图探测 67例不同胎龄HbBart胎儿水肿综合征的心脏各房室内径和心功能的相关参数值 ,并与同龄正常胎儿进行对照。结果 HbBart胎儿水肿综合征的心脏从妊娠中期 ( 2 5周 )开始增大 ,以右心房增大最早出现 ,此后随着孕周的增加而加重 ,继之右心室及左心房室增大 ;2 9周起左、右心的舒张功能受累 ,若合并心包、胸 (腹 )腔积液时更为明显 ,3 3周时左右心收缩功能开始受累 ;胎儿卵圆孔从2 5周起增大 ,而增大的卵圆孔与继发性房间隔缺损难以鉴别。结论 超声心动图对HbBart胎儿水肿综合征的筛查和监测较为敏感 。

Objective To search different weeks′ gestation atrioventricular size and cardiac function change in Hb Bart′s fetal edema syndrome. Methods Color Doppler echocardiography was adopted to study 67 cases with Hb Bart′s fetal edema syndrome in different weeks′ gestation.Atrial and ventricular diameter and cardiac function were measured, and compared with those of normal fetuses in same weeks′ gestation.Results In the cases with Hb Bart′s fetal edema syndrome,the heart was enlarged from 25 weeks′ gestation,right atrial enlargement came earliest, along with gestation weeks′ followed with right ventricle,left atrium and left ventricle aggravated enlargement.From 29 weeks′ gestation left and right cardiac diastolic function was involved with complicated pericardial,pleural,peritoneal effusion the damage was clearer.During 33 weeks′ gestation,left and right heart systolic function was involved.From 25 weeks′ gestation,fetal foramen ovale began to enlarge,and the enlarged foramen was difficult to be differentiated from secondary atrial septal defect.Conclusions Echocardiography is sensitive to Hb Bart′s fetal edema syndrome,and provides reliable basis for early clinical intervention.