围产期心脏超声诊断胎儿三尖瓣返流的临床意义

Clinical significance of perinatal Dopple Echocardiogram for the diagnosis of fetal tricuspid valve regurgitation

应用多普勒超声心动图研究胎儿三尖瓣返流(TR)的围产期产生机制及其临床意义。对656例孕周为20周～37周胎儿进行多普勒超声心动图检查,检出TR 88例,其中胎儿先心病组16例,心律失常组43例,双胎输血征7例,母亲患糖尿病者2例,而正常胎儿588例中仅发现TR 33例(占5.62％)。结果表明,胎儿时期右室占优势使右室处于高压腔状态,故正常胎儿的TR发生率极低,且多属生理性范围。因此,多普勒超声检出胎儿TR,首先提示其胎儿可能伴有先天性心脏异常或其它因素导致的心功能降低。

To explore the clinical significance of perinatal Dopple echocardiogram for the diagnosis of fetal tricuspid valve regurgitation (TR), color Doppler echocardiogram was regularly performed in 656 fetuses with a gestational age of 20 to 37 weeks. The results showed that 88 cases were found to have TR. Among them, 16 were with heart defects, 43 with arrhythmia,7 with twin-twin transfusion syndrome and 2 cases whose mothers with diabetes mellitus. No congenital heart defect was observed in other 33 fetuses with TR. It is concluded that the right ventricle of the fetuses is predomi-nate to other cardiac cavities, and lies in higherpressure state, so it is possible that the occurrence of TR is not common in the normal fetuses. It may be only physiological significance if TR occasionally occur. It is suggested that TR is screened out by Dopple e-chocardiogram, usually indicating the existence of the heart structural abnormality or other clinical conditions resulting in the decrease of cardiac function.