Tei指数对妊娠早中期胎儿心室功能的评估

Evaluation of fetal cardiac function in the first and second trimester by Tei index

目的测量妊娠早中期胚胎/胎儿心脏的Tei指数,观察与胎龄的关系,初步评估其临床应用价值。方法胎龄为7～15周胚胎/胎儿165例,胎龄小于12周的胚胎/胎儿采用阴道超声,胎龄大于12周的胎儿采用阴道超声或腹部超声,应用脉冲多普勒技术获取左室流入、流出道血流流速频谱,分别测量等容收缩时间(ICT)、等容舒张时间(IRT)、射血时间(ET),根据公式计算Tei指数,分析Tei指数与胎龄之间的关系。结果妊娠早期,Tei指数随胎龄增大而减小,妊娠9周流出道流速波形变为双峰(a峰出现),Tei指数明显较前缩短;妊娠中期Tei指数的变化与胎龄无关。结论妊娠早期胎儿心脏的整体功能随胎龄的增大明显改善,妊娠中期胎儿心脏整体功能相对稳定;Tei指数测量方法简单,快捷、可靠,是评价妊娠早中期胎儿心功能的理想指标。

Objective To measure Tei index of fetal heart in the first and early second trimester and its changes with gestation and assess its clinical value.Methods One hundred and sixty-five normal fetuses of 7-15 weeks gestation were scanned by transvaginal（≤12 weeks）or transabdonimal（〉12 weeks）ultrasound.The blood flow waveforms of the left ventricular outlet and inlet of every fetuses were imaged by pulse Doppler.The left ventricular isovolumic contraction time（ICT）,isovolumic relaxation time（IRT）and ejection time（ET）were measured,then the Tei index was calculated by using the formula Tei index,and its changes with gestation age were analyzed.Results In the first trimester,Tei index decreased with gestation age and the most prominent was in 9 weeks gestation when the blood flow waveform became bi-wave（＇a＇ wave appeared）.In the second trimester,the changes of Tei index seemed to have no relation with gestation age.Conclusion The fetal combined systolic and diastolic ventricular function is improved with gestation age in the first trimester and appeared little change in the second trimester.Tei index is quickly and easily obtained and reliable.It＇s a perfect index for assessing fetal cardiac function in the first and early second trimester.