频谱多普勒超声联合三维能量多普勒超声评估妊娠高血压综合征患者的胎盘功能

Combination of spetral Doppler ultrasound and three-dimensional power Doppler ultrasound in assessment of placental function in pregnancy-induced hypertension patients

目的:探讨频谱多普勒超声联合三维能量多普勒超声评估妊娠高血压综合征(pregnancy-induced hypertension,PIH)患者胎盘功能的研究价值。方法:选取孕周为30～42周的161例孕妇,其中101例为PIH患者(重度子痫前期19例、子痫前期82例),60例为正常孕妇。采用频谱多普勒超声测量胎儿脐动脉血流参数[收缩期/舒张期血流比值(systolic velocity/diastolic velocity,S/D)、阻力指数(resistance index,RI)、搏动指数(pulsatile index,PI)]、胎儿大脑中动脉血流参数(S/D、RI、PI)及孕妇子宫动脉血流参数(S/D、RI、PI)。采用三维能量多普勒超声监测胎盘绒毛血流,采集胎盘血流灌注参数[血管指数(vascularization index,VI)、血流指数(?ow index,FI)、血管血流指数(vascularization?ow index,VFI)]。结果:PIH组胎儿脐动脉血流参数(S/D、RI、PI)增高,差异有统计学意义;孕妇子宫动脉血流参数(S/D、RI、PI)增高,差异有统计学意义;三维能量胎盘血流灌注参数(VI、FI、VFI)降低,差异有统计学意义;胎儿大脑中动脉血流参数略有变化,但差异无统计学意义。结论:胎儿脐动脉血流参数、孕妇子宫动脉血流参数及胎盘三维能量灌注参数可反映PIH患者的胎盘血流灌注情况。

Objective:To explore the value of spectral Doppler ultrasound combined with three-dimensional power Doppler ultrasound in evaluating placental function in the patients with pregnancy-induced hypertension(PIH).Methods:A total of 161 pregnant women with gestational age of 30-42 weeks were selected.Among them,101 were enrolled in PIH group(19 cases of severe preeclampsia and 82 cases of preeclampsia)and 60 in control group(normal pregnant women).Fetal umbilical artery blood flow parameters such as systolic velocity/diastolic velocity(S/D),resistance index(RI),pulsatile index(PI),fetal middle cerebral artery parameters(S/D,RI,PI)and maternal uterine artery blood flow parameters(S/D,RI,PI)were measured by spectral Doppler ultrasound.Three-dimensional power Doppler ultrasound was used to monitor placental villus blood flow.Placental blood flow perfusion parameters such as vascularization index(VI),flow index(FI),vascularization flow index(VFI)were collected.Results:In PIH group fetal umbilical artery blood flow parameters(S/D,RI,PI)and the uterine artery blood flow parameters(S/D,RI,PI)increased significantly,while placental blood flow perfusion parameters(VI,FI,VFI)decreased significantly,and there were slight changes in fetal middle cerebral artery blood flow parameters without significant difference.Conclusion:Fetal umbilical artery blood flow parameters,uterine artery blood flow parameters and placental perfusion parameters can reflect the placental blood flow perfusion in PIH patients.