复杂先天性心脏病胎儿脐动脉及大脑中动脉血流动力学研究

Hemodynamic study on fetal umbilical artery and middle cerebral artery in fetuses with complex congenital heart disease

目的:探讨复杂先天性心脏病胎儿的脐动脉(UMA)及大脑中动脉(MCA)血流动力学变化的检测方法。方法:应用彩色多普勒超声检测14例患有复杂先天性心脏病胎儿的大脑中动脉和脐动脉的血流动力学指标,包括阻力指数(RI)、搏动指数(PI)、收缩期最大流速(S)与舒张末期血流速度(D)的比值(S/D值)、MCA-RI/UMA-RI和MCA-PI/UMA-PI值。另选取80例正常胎儿作为对照组。结果:病例组MCA的S/D值、PI值和RI值明显低于对照组(P<0.05)。病例组UMA的S/D值、PI值和RI值均高于对照组(P<0.05),MCA-RI/UMA-RI和MCA-PI/UMA-PI值低于对照组(P<0.05)。结论:复杂先天性心脏病胎儿存在脑血管阻力降低现象,彩色多普勒超声可检测到这一血流动力学变化。

Objective： To explore the detection method of hemodynamic changes of fetal umbilical artery （ UMA） and middle cerebral artery （ MCA） in fetuses with complex congenital heart disease. Methods： The hemodynamic indexes of fetal UMA and MCA in 14 fetuses with complex congenital heart disease were detected by color Doppler ultrasound,including resistance index （ RI） ,pulsatility index （ PI） ,the peak systolic velocity/peak diastolic velocity （ S/D） ratio,MCA RI/UMA RI ratio and MCA PI/UMA PI ratio; 80 normal fetuses were selected as control group. Results： S/D ratio,PI and RI of MCA in case group were significantly lower than those in control group （ P 0. 05） ; S/D ratio,PI and RI of UMA in case group were significantly higher than those in control group （ P 0. 05） ,MCA RI/UMA RI ratio and MCA PI/UMA PI ratio in case group were significantly lower than those in control group （ P 0. 05） . Conclusion： The phenomenon of cerebrovascular resistance decrease exists in the fetuses with complex congenital heart disease,color Doppler ultrasound can detect the hemodynamic change.