胎心定量分析技术评估胎儿左心功能

Evaluation of fetal left ventricular function using fetal heart quantification

目的:本研究应用胎心定量分析技术(Fetal HQ)评估20~28周健康胎儿的左心功能,探讨此技术在评估胎儿心脏功能方面的应用价值。方法:应用Fetal HQ软件获取80例20~28周正常胎儿左心室功能参数,包括左心室舒张末期容量(EDV),每搏量(SV),心输出量(CO)及射血分数(EF)。评估各参数与孕周、双顶径、头围、腹围、股骨长及预估体质量之间的相关关系并进行回归分析。评估1例主动脉缩窄(CoA)胎儿及1例生长受限(IUGR)胎儿的左心功能。结果:正常胎儿中孕期左心室EDV、CO、SV与孕周及生物测量值呈正相关关系(r 0.78~<0.89)。而EF、CO/kg、SV/kg与孕周及生物测量值无相关关系(r-0.2~<0.2,P>0.05)。CoA胎儿及IUGR胎儿均显示存在心脏功能异常。结论:胎心定量分析技术提供了一种可靠的方法评估胎儿左心功能,为产前诊断与临床管理提供更多的理论依据。

Objective:To explore the application value of fetal heart quantification(Fetal HQ)in evaluation of fetal cardiac function in healthy fetuses from 20 to 28 weeks.Methods:Left ventricular functional parameters including left ventricular end diastolic volume(EDV),stroke volume(SV),cardiac output(CO)and ejection fraction(EF)were obtained by Fetal HQ in 80 nor-mal fetuses from 20 to 28 weeks.These were regressed against gestational age(GA),biparietal diameter(BPD),head circumfer-ence(HC),abdominal circumference(AC),femur length(FL)and estimated fetal weight(EFW).The left ventricular function of 1coarctation of the aorta(CoA)fetus and 1 intrauterine growth restriction(IUGR)fetus was evaluated.Results:Measurements of the EDV,CO and SV of fetal left ventricle were positively correlated with GA and other biometric values(r 0.78~0.89).However,EF,CO/kg and SV/kg had lower correlation with GA and other biometric values(r-0.2~0.2,P0.05).Both CoA fetus and IUGR fetus showed abnormal cardiac function.Conclusions:Fetal HQ provides a simple and reliable method to evaluate fetal left ventricular function,and provides more theoretical basis for prenatal diagnosis and clinical management.