中孕期胎儿完全性大动脉转位的脑血流动力学研究

Cerebral hemodynamics in fetuses with complete transposition of the great arteries in the second trimester of pregnancy

目的探讨中孕期血氧饱和度对无流出道梗阻完全性大动脉转位（complete transposition of great artery，CTGA）胎儿大脑血流动力学的影响。方法回顾分析38例中孕期CTGA胎儿（CTGA组）的脑血流动力学参数。根据是否合并室间隔缺损（ventricular septal defect，VSD）分为无VsD组（24例）和合并VSD组（14例）；选取同期孕周匹配的正常胎儿24例作为对照组，分析三组间胎儿双顶径、头围、大脑中动脉搏动指数（pulsatility index，PI）、脐动脉PI值以及脑胎盘血流比（cerebroplacental ratio，CPR）是否存在差异。结果对照组、合并VSD组和无VSD组三组之间胎儿双顶径、头围、大脑中动脉PI值、脐动脉PI值以及CPR差异均无统计学意义（P〉0．05）。结论中孕期cTGA胎儿脑血氧饱和度的变化对胎儿脑生物学指标及脑血流动力学无影响。

Objective To explore the effect of blood oxygen saturation on the hemodynamics in fetuses with complete transposition of the great artery （CTGA） without outflow tract obstruction in the second trimester of pregnancy. Methods The brain biometry and hemodynamics parameters were retrospectively analyzed in 38 fetuses with CTGA from multiple medical centers. All the fetuses with CTGA were divided into two groups, ventricular septal defect （VSD） group（14 cases） and no VSD group（24 cases） according to the VSD. Twenty-four gestational age （GA）-matched fetuses were ehosed as control group. The biparietal diameter （BPD） and head circumference （HC）, pulsatility indexes （PI） in the middle cerebral artery （MCA） and the umbilical artery, the cerebroplacental ratio （CPR） were compared among different groups. Results There were no significant differences in GA, BPD, HC, MCA PI, UA-PI and CPR among control group, CTGA with VSD group and CTGA without VSD group in the second trimester of pregnancy （ P 〉0.05）. Conclusions The altered oxygen saturation of the cerebral circulation in CTGA does not affect the brain biometry and hemodynamics in fetuses in the mid-gestational age.