孕晚期健康胎儿及新生儿主肺动脉血流量正常范围及其变化机制

Comparative study of main pulmonary artery blood flow between fetuses in third trimester and neonates

目的观察健康孕晚期胎儿产前和产后主肺动脉血流量正常范围,探讨其可能的变化机制。方法按不同孕产阶段,将315例受检者分为三组,孕晚期（32~40周）为A组,产后1 d为B组,产后28 d为C组,分别测量主肺动脉的管径（the main pulmonary artery peak,DMPA）、速度时间积分（the velocity time integral,VTI）、流量（the main pulmonary artery flow,QMPA）,将三组对比并进行统计学分析。结果健康孕晚期胎儿、产后1 d及产后28 d新生儿两两比较：主肺动脉的管径[孕晚期（0.694±0.087）cm,产后1 d为（0.805±0.050）cm,产后28 d为（0.910±0.050）cm]、速度时间积分、流量差异均有统计学意义（P〈0.05）。结论管径不随年龄增加需警惕主肺动脉发育不良等情况;流量增加显著,需警惕继发性肺动脉高压;流量增加不显著,需警惕引起肺血流量减少的原发性及继发性疾病。

Objective To observe the change in main pulmonary artery blood flow between fetuses in the third trimester and neonates,and study the normal range and the change mechanism,providing basis for the early identification of neonatal disease.Methods The 315 objects were divided into three groups,fetuses in the third trimester（ 32-40 weeks） in group A,one day after birth in the group B,28 days after birth in the group C. DMPA,VTI,QMPA were recorded for statistical analysis. Results The differences in DMPA（ in the third trimester：（ 0. 694 ± 0. 087） cm,one day after birth：（ 0. 805 ± 0. 050） cm,28 days after birth：（ 0. 910 ±0. 050） cm,VTI[in the third trimester：（ 10. 245 ± 1. 016） cm,one day after birth： 12. 604 ± 0. 969 cm、28 days after birth： 15. 297 ±1. 129 cm]、QMPA [in the third trimester：（ 471. 665 ± 45. 553） cm3/ min,one day after birth：（ 857. 730 ± 76. 584） cm3/ min、28 days after birth：（ 1166. 575 ± 100. 456） cm3/ min） between the group A and group B,group B and group C,group A and group C were statistically significant（ P〈0. 05）. Conclusions Attention should be paid to the pulmonary hypoplasia if the diameter of the main pulmanary does not increase following the age. Be cautious of secondary pulmonary hypertension if the blood flow increases so obviously and of other diseases if the blood flow does not increase normally.