彩超检测在妊娠高血压综合征合并胎儿生长受限胎儿肾动脉血流参数中的应用价值

Value of color Dopper ultrasonic examination in monitoring fetal renal artery blood flow parameters of patients with pregnancy- inducedhypertension syndrome and fetal growth restriction

目的探讨胎儿肾动脉(RA)的血流动力学指标在妊娠高血压综合征(PIH)合并胎儿生长受限(FGR)中的临床应用价值。方法 PIH合并FGR患者57例和正常妊娠对照组57例,均测收缩期峰值流速(Vmax)、舒张期最低流速(Vmin)、全心动周期的平均峰值流速(Tamax)、搏动指数(PI)、阻力指数(RI)、收缩期与舒张期的速度比值(S/D),对所测参数进行统计学分析。结果对照组胎儿肾动脉血流Vmax与孕龄呈正相关,RI、PI、S/D随孕龄增长呈缓慢下降趋势;PIH合并FGR与同孕周对照组之间RA的Vmax显著下降(P<0.001),S/D亦显著下降(P<0.05)。结论正常胎儿肾动脉血流速度与孕龄呈正相关,而肾动脉RI、PI、S/D随孕龄变化幅度小;PIH合并FGR时血流动力学指标RA的Vmax值显著下降,肾动脉的Vmax<11cm/s者提示胎儿预后极差。

Obj ective To explore the value of renal artery （RA）hemodynamic changes in assessment of women with pregnancy-induced hypertension syndrome （PIH）and fetal growth re-striction （FGR）.Methods 57 pregnant women with PIH and FGR and 57 normal pregnancy were examined by peak systolic flow velocity （Vmax）,peak diastolic flow velocity （Vd）,the average peak blood flow velocity cardiac cycle （Tamax）,pulse rhythm（PI）,resistance index（RI）,the ratio （S/D）maximum blood flow speed during umbilical artery systole and diastole telophase.Results Vmax of fetal renal artery flow in the control group had a positive relationship with gestational age, and RI、PI、S/D showed a slow downward trend.Vmax and S/D of RA in pregnant women with PIH and FGR were significantly lower than those of the control group （P〈0.001）.Conclusion Normal fetal RA blood flow velocity is positively correlated with gestational age.The Vmax of RA〈1 1 cm/s in pregnant women with PIH and FGR may predict a poor prognosis in fetal.