多普勒超声对正常胎儿二尖瓣口及三尖瓣口血流频谱的分析

Analysis on mitral inflow and tricuspid inflow velocity patterns in normal fetal by Dopple echocardiography

目的利用多普勒超声观察孕22～28周和37～41周的正常胎儿二尖瓣口血流频谱(MIF)及三尖瓣口血流频谱(TIF)形态,探讨其特点及相互联系。方法选取2011年8月～2012年8月在我院妇产科就诊的200例孕妇作为观察对象,按孕龄不同分为两组,其中22～28周组100例,平均孕龄(24.00±1.42)周,37～41周组100例,平均孕龄(38.00±2.08)周。对胎儿的二尖瓣口及三尖瓣口血流进行动态频谱监测,测定二尖瓣及三尖瓣舒张早期峰值流速(PFVe,E)及舒张晚期峰值流速(PFVa,A),计算A/E值。结果不同孕龄间二尖瓣和三尖瓣血流参数比较,E值、A值及A/E值差异均有高度统计学意义(均P<0.01),同孕龄二尖瓣和三尖瓣的E值、A值均明显相关(均P<0.01)。结论应用多普勒超声心动图对胎儿心脏瓣膜的血流监测是必要的,在胎儿期诊断先天性心脏畸形和减低新生儿病死率方面有着积极的作用。

Objective To observe the state of MIF and TIF between fetuses fecundated 22-28 weeks and 37-41 weeks by transthoracic Doppler echocardiography, to discuss the characteristics and interrelation of the MIF and TIF veloci- ties in normal fetal. Methods 200 cases of pregnant women from August 2011 to August 2012 in our hospital were se- lected and divided into two groups according to the gestational age; average for gestational age in 22-28 weeks group （100 cases） was （24.00±1.42） weeks, and average for gestational age in 37-41 weeks group （100 cases） was （38.00±2.08） weeks. Early diastolic peak flow （PFVe, E） and diastolic peak flow velocity late （PFVa, A） were measured by, thus E/A was calculated. Results The differences of E value, A value and A/E value of mitral valve and tricuspid valve were all statistically significant （all P 〈 0.01） between the different gestational ages; positive relationship was found between the E value and A value of the same gestational age （all P 〈 0.01）. Conclusion It is necessary to apply the Doppler e- chocardiography in the monitoring of blood flow on fetal mitral valve. The Doppler echocardiography plays an active role in the diagnosis of congenital cardiac malformations in fetal period and reducing neonatal mortality rate.