胎儿心率变异功率谱与胎儿窘迫状态的关系

摘要

Objective: To study the relationship between power spectral analysis of fetal heart rate variability and different stages of fetal distress. Methods: A total of 301 women with a singleton uncomplicated pregnancy underwent cardiotocography (CTG). The modeling signals of CTG were converted to digital signals by digital signal processing technique, and the character of fetal heart rate variability was extracted by power spectral analysis methods. Relationships among power spectral density of very - low - frequency (VLF) , low - frequency(LF1 , LF2), high-frequency ( HF1 , HF2, HF3, HF4) and umbilical arterial blood gas analysis, concentrations of umbilical erythropoietin and adrenine were analyzed. Results: LF2 was positively correlated with bicarbonate (HCO-3 ) and total carbon dioxide (TCO2) (P<0. 01) ; HF1 was negatively correlated with HCO3 and TCO2 (P<0. 01) ; VLF was negatively correlated with concentrations of erythropoietin (P<0. 01) ;LF1 was positively correlated with concentrations of adrenine (P<0. 05). Conclusions: Power spectral density of fetal heart rate variability is associated with different stages of fetal distress.%目的:评价胎心率变异功率谱与胎儿窘迫状态的关系.方法:对301例单胎妊娠孕妇行产前胎儿电子监护,将所得胎心率模拟信号转化为数字信号后再行功率谱分析,分析极低频(very low frequency 1,VLF)、低频1(low frequency,LF1)、LF2、高频1(high frequency 1,HF1)、HF2、HF3、HF4功率谱密度与脐动脉血血气分析指标、脐血促红细胞生成素和肾上腺素浓度的关系.结果:LF2与碳酸氢根(HCO-3)、二氧化碳总量(TCO2)呈正相关(P<0.01);HF1与碳酸氢根(HCO-3)、二氧化碳总量(TCO2)呈负相关(P<0.01);VLF与促红细胞生成素浓度呈负相关(P<0.01);LF1与肾上腺素浓度呈正相关(P<0.05).结论:胎心率变异性的功率谱密度反映了胎儿窘迫不同发展阶段的状态.