摘要
目的探讨频谱多普勒超声评价胎盘血管瘤孕妇胎儿血流参数变化的应用价值。资料与方法回顾性选择2015年9月—2018年12月首都医科大学附属北京妇产医院病理确诊胎盘血管瘤孕妇胎儿15例(胎盘血管瘤组)及正常胎儿91例(对照组),孕龄28~40周,比较两组左心室心肌做功指数(MPI)、二、三尖瓣口E/A值、脐动脉、大脑中动脉和静脉导管多普勒参数及围生结局,并分析MPI与妊娠结局的相关性。结果与对照组比较,胎盘血管瘤组胎儿左心室MPI[(0.44±0.05)ms比(0.47±0.06)ms;t=2.156,P<0.05]、二、三尖瓣口E/A值显著增高(0.69±0.11比0.75±0.16,0.71±0.10比0.76±0.14;t=1.988、1.764,P均<0.05),脐动脉搏动指数显著降低(0.88±0.12比0.78±0.15;t=-3.143,P<0.05),大脑中动脉搏动指数及静脉导管搏动指数差异无统计学意义(P均>0.05)。与对照组比较,胎盘血管瘤组新生儿出生孕龄、身高及体重降低(P均<0.05),胎盘血管瘤组左心室MPI每升高0.1,新生儿转ICU风险增加的比值比为10.754(95%CI 2.354~49.140)。结论胎盘血管瘤组胎儿心功能受损,左心室MPI与不良结局具有相关性。多普勒超声能够为早期监测宫内状况提供依据。
Purpose To explore the value of spectral Doppler ultrasound evaluation of fetal haemodynamic parameters change in pregnant women with placenta chorioangioma.Materials and Methods A total of 15 singleton pregnant women diagnosed with placental chorioangioma at 28-40 weeks of gestation were recruited to the study from September 2015 to December 2018 in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Ninety-one healthy women with normal pregnancies were enrolled in this study.Using Doppler echocardiography,the left ventricular myocardial performance index(MPI)and E wave/A wave peak velocities(E/A)ratios were determined.The Doppler indices of ductus venosus,umbilical and middle cerebral arteries were also determined in both groups.The correlation between MPI and pregnancy outcome was further analyzed.Results The MPI[(0.44±0.05)ms vs.(0.47±0.06)ms;t=2.156,P<0.05]and atrioventricular valves E/A ratio of pregnant women with placenta chorioangioma group were significantly higher than those of control group(0.69±0.11 vs.0.75±0.16,0.71±0.10 vs.0.76±0.14;t=1.988,1.764);umbilical artery pulsation index was significantly decreased in fetuses of pregnant women with placenta chorioangioma compared with controls(0.88±0.12 vs.0.78±0.15;t=-3.143,P<0.05).There were no significant differences in middle cerebral artery pulsation index and ductus venosus pulsation index between the two groups(all P>0.05).Gestational age,height and weight of newborns with placenta chorioangioma were significantly lower than those of controls(all P<0.05).For every 0.1 increase in left ventricular MPI in the placental hemangioma group,the odds ratio value of risks of neonatal ICU transfer was 10.754(95%CI 2.354-49.140).Conclusion Fetuses of pregnant women with placenta chorioangioma have significant impairment of cardiac function,with the association between the MPI elevation and adverse perinatal outcome to some extent.Spectral doppler ultrasound can provide more evidences for early intrauterine monitoring of fetus with pla
作者
张娜
吴青青
孙丽娟
韩吉晶
李贞
ZHANG Na;WU Qingqing;SUN Lijuan;HAN Jijing;LI Zhen(Department of Ultrasound,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing Maternal and Child Health Care Hospital,Beijing 100026,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2023年第9期958-961,共4页
Chinese Journal of Medical Imaging
基金
北京市科委首都市民健康培育项目(Z161100000116089)。
关键词
胎盘血管瘤
血流动力学
频谱多普勒超声
Placenta chorioangioma
Haemodynamic
Spectral Doppler ultrasound
