中孕期左心发育不良综合征胎儿脑生物学指标和脑血流动力学研究

The study on brain biometry and cerebral hemodynamics in fetuses with hypoplastic left heart syndrome in the second trimester of gestation

目的探讨中孕期左心发育不良综合征(HLHS)胎儿双顶径、头围和脑血流动力学的变化。方法回顾性分析2015年1月至2019年12月北京安贞医院41例HLHS胎儿(HLHS组)的双顶径、头围、大脑中动脉搏动指数(MCA-PI)、脐动脉搏动指数(UA-PI)、MCA-PI/UA-PI(CPR),并与同期82例孕周匹配的正常胎儿(对照组)结果进行比较。结果HLHS组头围、MCA-PI和CPR的Z值低于对照组(均P<0.05);HLHS组头围与MCA-PI和CPR呈弱正相关(r=0.385、0.416,均P<0.05)。结论中孕期HLHS胎儿头围和脑血流动力学有一定的改变,且头围与MCA-PI和CPR呈弱正相关,具有临床意义。

Objective To explore the changes of biparietal diameter,head circumference and cerebrovascular hemodynamics in fetuses with hypoplastic left heart syndrome(HLHS)during middle pregnancy.Methods The biparietal diameter,head circumference,middle cerebral artery pulsatility index(MCA-PI),umbilical artery pulsatility index(UA-PI)and MCA-PI/UA-PI(CPR)of 41 fetuses with HLHS(HLHS group)were retrospectively analyzed from January 2015 to December 2019 in Beijing Anzhen Hospital,and were compared with those of 82 normal fetuses matched for gestational age at the same period(control group).Results The Z-scores of head circumference,MCA-PI and CPR in with HLHS group were lower than in control group(all P<0.05);Head circumference in HLHS group were weakly and positively correlated with the MCA-PI and CPR(r=0.385,0.416;all P<0.05).Conclusions There are some changes in the head circumference and cerebral hemodynamics in fetuses with HLHS during mid-gestational age,and the head circumference is weakly and positively correlated with MCA-PI and CPR,which has clinical significance.