摘要
目的探讨伴双胎输血综合征(TTTS)的单绒毛膜双胎胎儿在中孕末期时大脑中动脉的多普勒流速特征。方法选取2011年2月至2014年10月在嘉兴市第二医院就诊的单绒毛膜双胎(MCT)产妇32例,其中14例伴TTTS作为观察组,18例无TTTS作为对照组,对两组MCT行多普勒超声检查,比较两组脐动脉搏动指数(UAPI)、大脑中动脉搏动指数(MCAPI)、大脑-胎盘血流比值(CPR)、脐动脉收缩期峰值流速(UAPSV)、大脑中动脉收缩期峰值流速(MCAPSV)等指标。结果观察组供血胎估计体重低于对照组,而双胎体重差明显高于对照组(t值分别为-7.229、6.389,均P<0.05);观察组供血胎和受血胎出生时体重明显低于对照组(t值分别为-32.648、-27.791,均P<0.05),而两组双胎体重差比较差异无统计学意义(P>0.05)。观察组双胎最大垂直羊水深度差明显高于对照组(t=8.078,P<0.05);观察组胎儿出生时胎龄明显低于对照组(t=-3.427,P<0.05)。观察组受血胎和供血胎的UAPI、UAPSV及MCAPSV明显高于对照组,而MCAPI和CPR明显低于对照组,差异均有统计学意义(t值分别为5.256和7.164、-4.090和-3.292、-5.576和-5.199、4.333和2.855、5.437和4.375,均P<0.05)。结论中孕末期伴有TTTS的MCT大脑血流有阵发性过度充盈特征,这种特征可能有助于MCT伴TTTS的诊断。
Objective To investigate the Doppler velocity characteristics of middle cerebral artery of monochorionic twins （MCT） with twin- twin transfusion syndrome （TTI＇S） in late pregnancy. Methods From February 2011 to October 2014 in Jiaxing Second Hospital 32 cases MCT were selected, including 14 cases of TITS in observation group and 18 cases without TITS in control group. Two groups underwent Doppler ultrasonography to compare umbilical artery pulsatility index （ UAPI）, pulsatility index of middle cerebral artery （ MCAPI）, cerebral and placenta blood flow ratio （ CPR）, umbilical artery peak systolic velocity （ UAPSV）, middle cerebral artery peak systolic velocity （MCAPSV） and other indicators. Results In the observation group estimated weight of blood supply fetus was lower than in the control group, and the difference in estimated weight of twins was more significant in the observation group （ t value was - 7. 229 and 6.389, respectively, both P 〈 0. 05 ）. In the observation group weight of blood supply fetus and blood receiving fetus at birth was significantly lower than in the control group （ t value was - 32. 648 and - 27. 791, respectively, both P 〈 0.05 ） , while difference in twins weight difference was not significant between two groups （ P 〉 0.05 ）. Difference in twin vertical depth of amniotic fluid was greater in the observation group than the control group （t = 8. 078 ,P 〈0.05）. Fetal gestational age at birth in the observation group was lower than the control group （ t = - 3. 427, P 〈 0.05 ）. UAPI, UAPSV and MCAPSV of fetus in the observation group were obviously higher than the control group, while MCAPI and CPR were significantly lower （ t value was 5. 256 and 7. 164, - 4. 090 and - 3. 292, - 5. 576 and - 5.199, 4. 333 and 2. 855, 5. 437 and 4.375, respectively, all P 〈 0.05 ）. Conclusion MCT cerebral blood flow in late pregnancy with TITS has characteristics of paroxysmal overfilling, which may contribute to the diagnosis of MCT with TI
出处
《中国妇幼健康研究》
2015年第6期1234-1236,共3页
Chinese Journal of Woman and Child Health Research
关键词
多普勒超声
单绒毛膜双胎
双胎输血综合征
大脑中动脉
中孕末期
Doppler uhrasonography
monoehorionic twins
twin-twin transfusion syndrome （TTTS）
middle cerebral artery
late pregnancy
