摘要
目的:探讨应用超声多普勒联合测量胎儿大脑中动脉(MCA)和肝内脐静脉(IHUV)血流速度预测胎儿α地中海贫血(简称地贫)的价值。方法:对127例具有α地贫风险的胎儿和正常对照组44例胎儿行二维及多普勒超声检查,测量胎儿MCA收缩期峰值血流速度(PSV)和IHUV最大速度(Vmax),并行羊膜腔穿刺或脐血穿刺术进行α地贫基因诊断。MCA-PSV和IHUV-Vmax均用中位数的倍数(MOM)表示。结果:重型α地贫胎儿MCA-PSV、IHUV-Vmax明显高于中间型α地贫、轻型α地贫和正常胎儿,差异有统计学意义(均P<0.05)。MCA-PSV和IHUV-Vmax预测胎儿重型α地贫的最佳临界点分别为1.29,1.27 MOM。MCA-PSV>1.29 MOMI、HUV-Vmax>1.27 MOM预测胎儿重型α地贫的灵敏度分别为80.00%、63.33%,特异度分别为93.62%、75.18%。MCA-PSV和IHUV-Vmax相结合预测胎儿重型α地贫的灵敏度、特异度分别为96.67%、98.42%。结论:超声多普勒测量胎儿MCA-PSVI、HUV-Vmax可作为预测胎儿重型α地贫的一种非侵入性方法。MCA-PSV是预测胎儿重型α地贫的可靠参数,优于IHUV-Vmax。MCA-PSV和IHUV-Vmax相结合,可以提高预测胎儿重型α地贫的灵敏度、特异度,降低重型α地贫漏诊率。
Objective：To investigate and compare the value of the blood flow velocity of the middle cerebral artery and the intra-hepatic umbilical vein by color Doppler ultrasonography in predicting fetal α-thalassemia.Methods：A total of 127 pregnancies of the experiment group at risk due to fetal α-thalassemia and 44 pregnancies of the normal control,were performed with two-dimensional ultrasound and Doppler imaging.The MCA peak systolic velocity（PSV）,and IHUV maximum velocity（Vmax） were measured.All fetuses of the experiment group were detected α-thalassemia genotypes by amniocentesis or cordocentesis.Both MCA-PSV and IHUV-Vmax were expressed as multiples of the median（MOM）.Results：The group of fetuses with Hemoglobin Bart＇s Hydrops Fetalis Syndrome had significantly higher MCA-PSV,IHUV-Vmax compared to the fetuses with Hemoglobin H disease,α-thalassemia Trait and the normal fetuses（P0.05 for each）.However,there were no statistical significant difference in the MCA-PSV,IHUV-Vmax between the other groups（P0.05）.The best cut-off point of MCA-PSV and IHUV-Vmax in predicting Hemoglobin Bart＇s Hydrops Fetalis Syndrome were 1.29 MOM,1.27 MOM,respectively.The sensitivity of MCA-PSV1.29 MOM and IHUV-Vmax 1.27 MOM in prediction of Hemoglobin Bart＇s Hydrops Fetalis Syndrome was 80.00%,63.33%,respectively;and the specificity was 93.62%,75.18%,respectively.The sensitivity and specificity of combining MCA-PSV with IHUV-Vmax in prediction of Hemoglobin Bart＇s Hydrops Fetalis Syndrome were 96.67%,98.42%,respectively.Conclusion：Measurement of MCA-PSV and IHUV-Vmax by Doppler ultrasound can be a noninvasive tool to predict Hemoglobin Bart＇s Hydrops Fetalis Syndrome.MCA-PSV is an accurate parameter for the prediction of fetal anemia,better than IHUV-Vmax.Combined MCA-PSV with IHUV-Vmax could raise the sensitivity or the specificity,reduce the rate of missed diagnosis in prediction of Hemoglobin Bart＇s Hydrops Fetalis Syndrome.
出处
《广西医科大学学报》
CAS
2011年第2期218-222,共5页
Journal of Guangxi Medical University
基金
广西科学基金资助项目(No.桂科自0640111)
关键词
大脑中动脉
肝内脐静脉
Α地中海贫血
胎儿
超声
多普勒
middle cerebral artery
intra-hepatic umbilical vein
α-thalassemia
fetal
ultrasound
doppler
