胎儿肺静脉血流频谱在心肺功能评价中的应用

Study on fetal pulmonary venous Doppler spectrum in cardiorespiratory function

目的 探讨正常妊娠中晚期胎儿肺静脉多普勒血流频谱特征及其在心脏功能评价中的应用价值.方法 86例正常孕23～41周胎儿,应用彩色多普勒超声心动图检测胎儿肺静脉,测量指标包括：右上肺静脉舒张期峰值速度（D）、D波减速时间、D波减速度（Ddec）,右上肺静脉收缩期峰值速度（S）、S波加速时间、S波加速度（Sacc）,计算Sacc/Ddec值.计算左室Tei指数.结果 D波峰值速度、减速时间及Ddec与孕周呈正相关（P ＜0.05）；S波峰值速度、S波加速时间及Sacc与孕周无明显相关性.以孕28周分组,孕龄小于28周Sacc/Ddec比值多小于1,大于28周多大于1,组间差异有统计学意义（P＜0.05）,一致性检验系数为0.88.Tei指数与孕周呈正相关（P＜0.05）.结论 右上肺静脉D波血流速度,D波减速时间及Ddec与心脏整体功能指标有良好的相关性.Sacc/Ddec可以作为反映心脏整体功能与肺组织发育程度的新指标.

Objective To explore the characteristics of the fetal pulmonary venous Doppler spectrum in medium-term and terminal pregnancy and to evaluate its application in the cardiac function assessment and lung maturation.Methods The study group consisted of 86 normal fetuses aged from 23rd to 41st week＇s gestation.The Doppler echocardiography was used to record the pulmonary venous spectra.The peak diastolic velocity （D）,deceleration time of D wave,deceleration of D wave （Ddec）,the peak systolic velocity （S）,acceleration time of S wave,and acceleration of S wave of the right superior pulmonary vein （Sac.c） were measured.Sacc/Ddec was calculated.The Tei index of the left ventricle was calculated.ResultsThe D and deceleration time of D wave and Ddec increased with gestational age （P 〈 0.05）.S,the acceleration time of S wave and Sacc showed no significant correlation with gestational age.Sacc/Ddec ratio was more likely smaller than 1 with the gestational age less than 28 weeks and larger than 1 with the gestational age longer than 28 weeks （ P 〈0.05）.Conclusions D wave flow velocity,deceleration time of D wave and the Ddec of the right superior pulmonary vein had a good correlation with the global left ventricular function.The Sac/Ddec ratio might be new index for assessing cardiac function and lung maturation.