宫内发育迟缓胎儿组织多普勒成像的心功能评价研究

Tissue Doppler imaging in the evaluation of cardiac function of intrauterine growth retardation fetus

目的探讨组织多普勒成像(TDI)在宫内发育迟缓(IUGR)心功能评价中的作用。方法选取2014年11月至2015年12月接诊的确诊为IUGR且伴有大脑-胎盘血流重分配的住院孕妇25例作为研究组,同期接待的健康体检孕妇50例作为对照组。两组孕妇均进行TDI诊断,观察记录舒张早期峰值(E)、舒张晚期峰值(A)、舒张早期峰值速度(E')、舒张晚期峰值速度(A')、收缩期峰值速度(S')、等容收缩期时间(ICT)、等容舒张期时间(IRT)、射血时间(ET),根据前述值进一步计算E/A、E'/A'、E/E'、E/(E'×S')、心功能指数(MPI),并对比分析。结果研究组左室和右室E、A、E/A、E'、A'、S'、E'/A'较对照组有一定下降,其中E'、A'、S'、E'/A'比较差异有统计学意义(P<0.05);研究组E/E'、E/(E'×S')、MPI均明显高于对照组(P<0.05)。结论 IUGR胎儿心功能表现为右心优势型,以舒张中心房收缩为主导;IUGR因宫内缺氧,心脏舒张与收缩功能明显比正常胎儿更差。TDI可用于评价IUGR心功能,敏感、准确,值得临床应用。

Objective To investigate tissue Doppler imaging in the evaluation of cardiac function of intrauterine growth reterdatio order to provide reference for clinical diagnosis and treatment. Methods From November 2014 to December 2015 25 cases of pregnant women di-agnosed with IUGR and brain - placental blood flow redistribution were selected as the study group, and at the same period, 50 cases healthy preg-nant women as the control group. Two groups of pregnant women underwent diagnostic TDI. Early diastolic peak （E） , late diastolic peak （A）, early diastolic peak velocity （E ＂） , late diastolic peak velocity （A′） , systolic peak velocity （S′） , isovolumic contraction time （ICT） , isovolumic relaxation time （IRT） , ejection time （eT） were observed and recorded, further calculates were performed with the preceding value, including E/A, E′/A′, E′/ E′, E/（E′× S′） , cardiac function index, and comparative analysis. Results E , A, E /A , E′, A′, S′, E′/A′of the right or left ven-tricular chamber in the Study Group were decreased compared with the control group and the difference of E′, A′, S′, E/A′between the two groups was statistically significant （ P 〈0.05）. E/ E′, E/（ E′× S′） , MPI in the study group were significantly higher （ P 〈0.05） . Conclusion Fetal cardiac function shows right ventricular dominant pattern, diastolic atrial contraction is predominant. IUGR due to intrauterine hypoxia, diastolic and systolic function is significantly worse than that of normal fetus; TDI IUGR can be used to evaluate cardiac function with good sensitive, and accurate rate.