胎儿生长受限母体心脏泵血和肝静脉供血动态变化趋势分析

Dynamic trend analysis of cardiac pumping and hepatic venous blood supply in mothers with fetal growth restriction

目的研究胎儿生长受限(FGR)母体心脏泵血和肝静脉供血动态变化趋势。方法收集2016年至2018年于本院行产前超声筛查的妊娠期女性274例,分为正常妊娠组(UP组)237例和FGR组37例。分别于妊娠16~19周(T1)、20~23周(T2)、24~27周(T3)、28~31周(T4)、32~35周(T5)、36~40周(T6)检测孕妇心输出量(CO)、肝静脉血流阻力指数(HVI)和静脉脉搏传递时间(VPTT)在两组间的变化趋势。结果随着妊娠时间的延长,UP组HVI呈下降趋势,不同时间点间差异有统计学意义(均P<0.05);而CO和VPTT呈增高趋势,不同时间点间差异有统计学意义(均P<0.05)。FGR组和UP组FGR、HVI和VPTT水平差异均有统计学意义(均P<0.05)。结论妊娠期间出现FGR的孕妇,心脏泵血肝静脉供血功能出现自适应异常,与生理情况下变化趋势相反。

Objective To analyze the dynamic changes of heart pumping and hepatic venous blood supply in women with fetal growth restriction (FGR). Methods 274 pregnant women who underwent prenatal ultrasound screening in our hospital from 2016 to 2018 were divided into a normal pregnancy group (UP group, n=237) and a FGR group (n=37). Cardiac output (CO), hepatic venous resistance index (HVI) and venous pulse transit time (VPTT) were measured when the women were 16-19 (T1), 20-23 (T2), 24-27 (T3), 28-31 (T4), 32-35 (T5) and 36-40 weeks (T6) pregnant. Results With the prolongation of pregnancy time, HVI in UP group showed a downward trend, with statistical differences among those at different time points (all P < 0.05);while CO and VPTT showed an upward trend, with statistical differences among those at different time points (all P < 0.05). There were statistical differences in FGR, HVI and VPTT between the two groups (all P < 0.05). Conclusion In pregnant women with FGR, the function of heart pumping blood and hepatic venous blood supply appear adaptive abnormality, with contrary to the change trend under physiological conditions.