孕中晚期胎儿脐静脉及其分支静脉标化血流率、分流率与新生儿出生体质量的关系

Relationships between normalized vein volume blood flow,shunt rate of umbilical vein and its branches in second and third trimester of pregnancy and neonatal mass at birth

目的 观察孕中晚期胎儿脐静脉(UV)及其分支静脉标化血流率(nQ)、分流率与新生儿出生体质量的关系。方法 前瞻性纳入251名接受产前超声检查的孕中晚期单胎妊娠孕妇,根据新生儿体质量将分为大于胎龄儿(LGA)组(n=25)、适于胎龄儿(AGA)组(n=216)及小于胎龄儿(SGA)组(n=10);比较3组胎儿UV及其分流进入肝脏(LIVER)、静脉导管(DV)及门静脉左(LPV)、右支(RPV)的nQ和分流率的差异,观察上述参数与新生儿出生体质量的相关性。结果 3组胎儿nQ_(DV)及nQ_(RPV)差异均有统计学意义(P均<0.05),SGA组nQ_(DV)显著高于、nQ_(RPV)显著低于LGA组和AGA组(P均<0.05)。3组胎儿LIVER、DV及RPV分流率差异均有统计学意义(P均<0.05),且SGA组LIVER及RPV分流率均显著低于、DV分流率显著高于LGA组和AGA组(P均<0.05)。nQ_(LIVER)、nQ_(RPV)、LIVER分流率及RPV分流率与新生儿出生体质量呈正相关(r=0.148、0.171、0.214、0.148,P均<0.05),nQ_(DV)及DV分流率与新生儿出生体质量呈负相关(r=-0.129、-0.214,P均<0.05)。结论 孕中晚期胎儿nQ_(LIVER)、nQ_(DV)、nQ_(RPV)、LIVER分流率、DV分流率及RPV分流率与新生儿出生体质量相关。

Objective To observe the relationships between the normalized vein volume blood flow(nQ),shunt rate of umbilical vein(UV)and its branches in the second and third trimester of pregnancy and neonatal mass at birth.Methods A total of 251 single pregnancy women in the second and third trimester of pregnancy who underwent prenatal ultrasound examination were prospectively enrolled and divided into large for gestational age(LGA)group(n=25),appropriate for gestational age(AGA)group(n=216)and small for gestational age(SGA)group(n=10)according to neonatal mass at birth after delivery.The nQ and shunt rate of UV and its branches that shunt into liver(LIVER),ductus venosus(DV),left portal vein(LPV)and right portal vein(RPV)were compared among 3 groups,and the correlations of the above parameters and neonatal mass at birth were analyzed.Results There were significant differences of fetal nQ_(DV) and nQ_(RPV) among 3 groups(both P<0.05),and nQ_(DV) of SGA group was significantly higher than that of LGA group and AGA group(P<0.05),and nQ_(RPV) of SGA group was significantly lower than that of LGA group and AGA group(P<0.05).There were significant differences of fetal LIVER,DV and RPV shunt rates among 3 groups(all P<0.05),and LIVER and RPV shunt rates of SGA group were significantly lower than those of LGA group and AGA group(both P<0.05),while DV shunt rate of SGA group was significantly higher than that of LGA group and AGA group(P<0.05).nQ_(LIVER),nQ_(RPV),LIVER shunt rate and RPV shunt rate were positively correlated with neonatal mass at birth(r=0.148,0.171,0.214,0.148,all P<0.05),but nQ_(DV) and DV shunt rate were negatively correlated with neonatal mass at birth(r=-0.129,-0.214,both P<0.05).Conclusion Fetal nQ_(LIVER),nQ_(DV),nQ_(RPV),LIVER shunt rate,DV shunt rate and RPV shunt rate in the second and third trimester were correlated with neonatal mass at birth.