中晚孕正常胎儿静脉导管多普勒血流参数正常值参考范围研究

The Reference Range of the Normal Value of Venosus Ductus Doppler Blood Flow Parameters of the Normal Fetus in Metaphase and Late Pregnancy

目的建立攀枝花地区中晚孕正常胎儿静脉导管多普勒血流参数参考值。方法应用彩色多普勒超声检查2260例12-40孕周正常单胎胎儿。在静脉导管入口记录静脉导管血流波形,测定血流参数包括：心室收缩期峰值流速（PSV）、心室舒张期峰值流速（PDV）、心房收缩期最大流速（PAV）、平均流速（TAMXV）、S/A值、搏动指数（PIV）、前负荷指数（PLI）、静脉峰值流速指数（PVIV）而后进行统计分析。结果胎儿静脉导管的血流参数为PSV、PDV、PAV及TAMXV与孕周呈正相关,静脉导管阻力参数（PIV、PLI、PVIV及S/A比值）与孕周呈负相关。结论通过大样本胎儿超声心动图普查正常胎儿静脉导管血流波形,形呈特殊的三相波形,得到8个参数正常值为诊断胎儿先天性心脏病提供依据。

Objective To establish the normal value of venosus ductus Doppler blood flow parameters of the normal fetus in metaphase and late pregnancy in Panzhihua area. Methods Color Doppler ultrasonography was used in 2260 cases of normal singleton fetus in 12 to 40 weeks of gestation. The venous catheter blood flow waveforms were recorded at the entrance of the venous catheter,and the blood flow parameters were measured including left ventricular peak systolic velocity（ PSV）,ventricular diastolic peak flow velocity（ PDV）,atrial systolic maximal velocity（ PAV）,mean velocity（ tamxv）,S / a value,the pulsatility index（ PIV）,pre load index（ PLI）,venous peak velocity index（ PVIV） and then were statistically analyzed. Results The blood flow parameters of fetal ductus venosus as PSV,PDV,PAV and TAMXV were positively correlated with gestational age,while the parameters of venous catheter resistance（ PIV,PLI,PVIV and S / a ratio were negatively correlated with gestational age. Conclusion Through a large sample of fetal echocardiography to survey the normal fetal venous catheter blood flow waveform,the shape of a special three-phase waveform,we get the normal value of 8 parameters to provide the basis for the diagnosis of fetal congenital heart disease.