摘要
目的确立正常胎儿的心脏传导时间参考值，探讨不同孕龄及心率对该值的影响。方法189例孕妇，分别采用组织多普勒成像（TDI）和脉冲多普勒技术（PD）测量胎儿的房室传导时间（AV）和心室开始收缩到下一心动周期心房开始收缩的时间间期（VA），采用配对￡检验比较两种方法测量的一致性，胎儿心脏传导时间与孕周、胎心率进行直线相关分析。结果TDI测量AV为（126．56±15．33）ms，95％CI（124．10～129．03）ms；VA为（285．22±24．53）UIS，95％CI（281．27～289．16）ms；PD测量AV为（127．42±12．88）ms，95％CI（125．35～129．49）ms；VA为（287．42±25．19）InS，95％CI（283．37～291．47）ms。TDI、PD测量胎儿心脏传导时间差异无统计学意义。胎儿心脏传导时间与孕周呈正相关，与胎心率呈负相关。PD、TDI测量AV在不同心率胎儿的比较差异无统计学意义，VA在不同心率胎儿的比较差异有统计学意义；PD、TDI测量AV、VA在不同孕周胎儿的比较差异无统计学意义。17例阵发性心律失常胎儿表现为AV、VA值的改变。结论TDI、PD均可简单快速地定量测定胎儿心脏传导时间，胎儿心脏传导时间参考值的测定对于胎儿心律失常的评估具有潜在的应用价值。
Objective To establish reference values of normal fetal heart conduction time intervals by tissue Doppler imaging（TDI） and pulsed Doppler（PD） echocardiography,and to assess their correlation with gestational age and fetal heart rate. Methods One hundred and eighty-nine pregnant women underwent detailed echocardiographic examinations. Atrio-ventricular conduction time interval （AV） and the time interval from onset of ventricular contraction to the onset of atrial contraction of next cardiac cycle（VA） were measured by TDI and PD echocardiography. Results TDI AV was （ 126.56 ± 15.33） ms （95 % CI 124.10- 129.03 ms）, TDI-VA was （ 285.22 ± 24.53 ） ms （ 95 % CI 281.27 - 289.16 ms ）, PD-AV was （127.42± 12.88）ms （95%CI 125. 35-129. 49 ms）,PD-VA was （287.42± 25.19）ms （95%CI 283.37- 291.47 ms）. A paired t test revealed no systematic difference between the two approaches used to measure AV and VA. AV and VA were significantly positively correlated with gestational age, and significantly negatively correlated with fetal heart rate. Heart conduction time intervals were altered in fetus with paroxysmal arrhythmia. Conclusions This study established the normal values of fetal heart conduction time intervals. Prenatal determination of fetal heart conductional time intervals has important potential clinical utility in assessing fetal arrhythmia.
出处
《中华超声影像学杂志》
CSCD
2008年第9期753-758,共6页
Chinese Journal of Ultrasonography
基金
浙江省科技计划项目（2003C30041）
