超声多普勒评估正常胎儿脐动脉、大脑中动脉血流参数临床研究

Clinical study on examining umbilical and middle cerebral artery blood flow parameters of normal fetus with ultrasonic doppler

目的:通过检测正常胎儿脐动脉(UA)、大脑中动脉(MCA)多普勒血流参数,得出血流参数的参考值范围,绘出血流参数的散点分布图,发现其随孕周的变化规律。方法:收集118例分别在18~23孕周,24~28孕周,29~33孕周和34~41孕周测量UA、MCA血流参数(包括S、D、S/D、PI和RI),绘制资料散点图,进行Pearson相关分析。结果:UA-S、UA-D、MCA-S和MCA-D均随孕周增加而增高,各参数值的变化与孕周呈正相关(P<0.05);UA-S/D、UA-PI和UA-RI均随孕周增加而减低,各参数值的变化与孕周呈负相关(P<0.05);MCA-S/D、MCA-PI和MCA-RI随孕周增加有一个先上升后下降的过程,散点图呈不对称抛物线状。结论:UA是连接母体与胎儿的唯一动脉血管,MCA是保证胎儿大脑发育的重要血管,超声多普勒测量其血流参数无创、准确、可重复性好,其正常参考值和变化规律的获得为进一步研究胎儿宫内缺氧奠定了基础。

Objective： To explore the reference range of UA, MCA doppler parameters of normal fetus and the way it changes with gestational age.Methods： We collected the UA、MCA blood flow parameters of fetuses of age 18-23 weeks, 24-28 weeks, 29-33 weeks and over respectively, including S, D, S/D, PI and RI parameters;drew with statistical software SPSS13.0 scatter diagrams and did Pearson analysis.Results： UA-S, UA-D, MCA-S and MCA-D increase with gestational age, showing a positive correlation（P〈0.05）;UA-S/D, UA-PI and UA-RI decrease with gestational age, showing a negative correlation（P〈0.05）;MCA-S/D, MCA-PI and MCA-RI increase first with gestational age, then decrease, showing an asymmetric parabola.Conclusion： UA represents peripheral vessel, whereas MCA represents visceral vessel.Ultrasonic doppler examination is noninvasive, accurate and has a good repeatability.Finding out reference range and rules of change lay the foundation for further study of fetal intrauterine anoxia.