影响胎儿大脑中动脉血流峰速的临床相关因素

Related clinical effect factors of peak velocity of blood flow of fetal middle cerebral artery

目的:分析影响胎儿大脑中动脉血流峰速(MCA-PSV)的临床相关因素,为应用MCA-PSV预测胎儿贫血提供依据。方法:对海南医学院附属医院140例胎儿进行临床分析,其中正常对照组85例,无并发症双胎组22例,地中海贫血组15例,胎儿畸形组18例,每例均行彩超大脑中动脉血流峰速(MCA-PSV)测量及血红蛋白测量。以相应孕周正常值的中位数的倍数MOM值为单位,分析各组MCA-PSV及胎儿血红蛋白的差异。结果:①双胎组与正常单胎组比较,胎儿MCA-PSV及胎儿血红蛋白无统计学差异。②地中海贫血组MCA-PSV显著升高,胎儿血红蛋白下降。③畸形组与正常单胎组比较,MCA-PSV升高(P<0.05),但排除贫血因素后,畸形且无贫血组与正常单胎组MCA-PSV无统计学差异。结论:胎儿大脑中动脉血流峰值速度与胎儿贫血显著相关,与无并发症双胎妊娠无显著关系。初步研究显示排除贫血因素后,畸形且无贫血组与正常单胎组无统计学差异,仍需进一步的大样本研究。

Objective：To analyze the related clinical effect factors of peak velocity of blood flow of fetal middle cerebral artery（MCA）,provide a basis for predicting fetal anemia by peak velocity of blood flow of MCA.Methods：140 fetuses from the hospital were analyzed and divided into normal control group（85 fetuses）,uncomplicated twin group（22 fetuses）,thalassemia group（15 fetuses） and fetal anomaly group（18 fetuses）,all the fetuses received color Doppler examination of peak velocity of blood flow of MCA and hemoglobin detection.MOM value was used as the unit,the differences of peak velocities of blood flow of MCA and fetal hemoglobin contents among the four groups were analyzed.Results：There was no significant difference in peak velocity of blood flow of MCA and fetal hemoglobin content between uncomplicated twin group and single pregnancy group.In thalassemia group,the peak velocity of blood flow of MCA increased significantly,while fetal hemoglobin content decreased.Compared with normal single pregnancy group,the peak velocity of blood flow of MCA in fetal anomaly group increased significantly（P0.05）,but after exclusing anemia fetuses,there is no significant difference in the peak velocity of blood flow of MCA between fetal anomaly non-anemia group and normal single pregnancy group.Conclusion：The peak velocity of blood flow of MCA is significantly related to fetal anemia,but there was no correlation between peak velocity of blood flow of MCA and uncomplicated twin pregnancy;the study shows that there is no significant difference in the peak velocity of blood flow of MCA between fetal anomaly non-anemia group and normal single pregnancy group after exclusing anemia fetuses,a further study with large samples is needed.