彩色多普勒超声观察不同孕周正常胎儿动脉血流的价值

Value of color Doppler ultrasonography to observe normal fetal arterial blood flow of different gestational ages

目的：探讨不同孕周胎儿肾动脉（RA）、脐动脉（UA）、大脑中动脉（MCA）血流参数的变化情况，确定正常胎儿RA、UA、MCA血流参考值，并分析RA、UA、MCA血流参数与孕龄的关系。方法选取2013年1～12月在该院行产前检查的185例孕周为4～41周的正常单胎孕妇为研究对象，采用彩色多普勒超声测量胎儿 RA、UA、MCA的阻力指数（RI）、搏动指数（PI）、收缩期峰值流速（PS）及收缩期峰值流速与舒张末期流速比值（S/D）。结果随着孕周的增加，胎儿RA、UA、MCA中PS值显著增加，而RA、UA中RI、PI、S/D值显著减少。经相关性分析可知，RA、UA、MCA中RI、PI、S/D与孕周呈负相关性（P＜0．05），而RA、UA、MCA中PS与孕周呈正相关性（P＜0．05）。结论应用彩色多普勒测量不同孕周胎儿RA、UA、MCA血流动力学参数能有效了解胎儿颅脑循环、胎盘循环及全身血流循环状态。通过建立正常胎儿血流参数参考范围可为超声预测胎儿宫内生长情况提供参考依据。

Objective To explore the changes of blood flow parameters of different gestational ages fetus renal artery （RA） ,changes in the umbilical artery （UA） ,middle cerebral artery （MCA） .To determine the blood flow reference value of normal fetal RA ,UA ,MCA ,and to analyze the relationship between RA ,UA ,MCA blood flow parameters and gestational age .Methods 185 cases of prenatal gestational of 4 to 41 weeks were selected from January 2013 to December 2013 .The resistance index （RI） ,pulsatility index （PI） ,peak systolic velocity （PS） and peak systolic velocity and end diastolic velocity ratio （S/D） of RA ,UA ,MCA were measured with color Doppler ultrasound from January 2013 to December 2013 .Results The value of PS of RA ,UA ,MCA were increased with increasing gestational age .The values of RI ,PI ,S/D of RA ,UA ,MCA were significantly reduced .The values of RI ,PI ,S/D of RA , UA ,MCA were correlated with gestational age （P〈0 .05） .The PS of RA ,UA ,MCA were correlated with gestational age （P〈0 .05） .Conclusion Color Doppler measurement of different gestational age fetus RA ,UA ,MCA hemodynamic parameters can effectively understand the fetal brain circulation ,placental circulation and systemic blood circulation state .Through the establishment of normal reference range of fetal blood flow parameters for ultrasound fetal grow th forecast to provide a reference .