彩色多普勒超声监测子痫前期孕妇胎儿脐动脉以及大脑中动脉的临床意义

Clinical significance of color Doppler ultrasound in monitoring fetal umbilical artery and middle cerebral artery in pregnant women with preeclampsia

目的探讨彩色多普勒超声联合监测子痫前期孕妇胎儿脐动脉及大脑中动脉的临床意义。方法选择2013年1月~2016年12月子痫前期孕妇58例及正常妊娠孕妇30例为研究对象,子痫前期孕妇中34例为轻度子痫前期,24例为重度子痫前期。彩色多普勒超声检查仪联合监测胎儿脐动脉以及大脑中动脉血流参数,包括血流阻力指数(RI)、收缩期血流速度/舒张期血流速度(S/D)、搏动指数(PI)。比较三组脐动脉及大脑中动脉血流参数以及三组胎儿平均体重,分析胎儿体重与脐动脉以及大脑中动脉血流参数的相关性。结果三组胎儿大脑中动脉血流参数比较:对照组RI、S/D以及PI均显著高于轻度子痫组与重度子痫组,差异有统计学意义(P<0.05);轻度子痫组RI、S/D以及PI均显著高于重度子痫组,差异有统计学意义(P<0.05)。三组脐动脉血流参数比较:对照组RI、S/D以及PI均显著低于轻度子痫组与重度子痫组,差异有统计学意义(P<0.05);轻度子痫组RI、S/D以及PI均显著低于重度子痫组,差异有统计学意义(P<0.05)。对照组平均体重(2102±251)g,轻度子痫组平均体重(2004±218)g,重度子痫组平均体重(1618±211)g,三组比较差异有统计学意义(P<0.05)。大脑中动脉血流参数RI、S/D、PI与胎儿体重呈显著正相关的关系(r=0.45、0.43、0.61,P均<0.05);脐动脉血流参数RI、S/D、PI与胎儿体重呈显著负相关的关系(r=-0.47、-0.35、-0.51,P均<0.05)。结论子痫前期孕妇胎儿脐动脉血流参数下降,大脑中动脉血流参数升高,并且随着病情的加重变化越加明显。大脑中动脉血流参数与胎儿体重呈显著正相关,脐动脉血流参数与胎儿体重呈显著负相关。

Objective To discuss the clinical significance of color Doppler ultrasound in monitoring fetal umbilical artery and middle cerebral artery in pregnant women with preeclampsia. Methods 58 cases with preeclampsia and 30 cases of normal pregnant women from Jan 2013 to Dec 2016 were selected as subjects. In 58 cases with preeclampsia, 34 cases were mild preeclampsia, and 24 cases were severe preeclampsia. Fetal umbilical artery and middle cerebral artery blood flow parameters were monitored by color Doppler ultrasound, including RI, S/D and PI. Umbilical artery and middle cerebral artery blood flow parameters and fetal weight of three groups were compared, and correlation between blood flow parameters with fetal weight was analyzed. Results Comparison of middle cerebral artery blood flow parameters in three groups： RI, S/D and PI of control group were higher than those of the mild preeclampsia group and the severe preeclampsia group, and those of the mild preeclampsia group were higher than the severe preeclampsia group, which showed significant difference（P〈0.05）. Comparison of umbilical artery blood flow parameters： RI, S/D and PI of control group were lower than those of the mild preeelampsia group and the severe preeclampsia group, and those of the mild preeclampsia group were lower than the severe preeclampsia group, which showed significant difference （P〈 0.05）. The mean fetal weight of control group was （2102±251）g, the mild preeclarnpsia group was （2004±218）g,and the severe preeclampsia group was （1618±211）g, which showed significant difference in three groups（P〈0.05）. The middle cerebral artery blood flow parameters RI, S/D and PI showed positive correlation with fetal weight（r=0.45, 0.43, 0.61, all P〈0.05）; The umbilical artery blood flow parameters RI, S/D and PI showed negative correlation with fetal weight （r=-0.47,-0.35,-0.51 ,all P〈0.05）. Conclusion Umbilical artery blood flow parameters in preeclampsia decreases, middle cerebral artery blood flow parameters increases, and the change is more obvious with the aggravation of the disease. The middle cerebral artery blood flow parameters is positive correlation with fetal weight and the umbilical artery blood flow parameters is negative correlation with fetalweight.