双多普勒测量 Tei 指数评价妊娠高血压综合征胎儿心室功能

摘要

目的：探讨实时双多普勒成像技术测量 Tei 指数（TI）并评价妊娠高血压综合征（简称妊高征）胎儿左、右心室功能的价值。方法将研究对象按美国妇产科医师学会公布的妊高征诊断标准分为3组：A 组为对照组，正常妊娠孕妇（60例）；B 组为妊娠期高血压及轻度子痫前期组（22例）；C 组为重度子痫前期组（24例）。采用实时双多普勒成像技术分别测量胎儿在同一心动周期内的左心室 Tei 指数（LTI）和右心室 Tei 指数（RTI）。结果TI 与孕周（GA）及胎心率（FHR）无明显相关性（P＞0．05）。A、B、C 3组 LTI 和 RTI 逐渐升高（P＜0．001）；C 组与 A 组比较，差异有统计学意义（P＜0．001）；C 组与 B组比较，差异有统计学意义（P＜0．001）；B 组与 A 组比较，差异无统计学意义（P＞0．05）；同一医师测量同一胎儿的 LTI 和 RTI 组内相关系数（ICC）分别为：0．973及0．979，不同医师测量同一胎儿的 LTI 和RTI 的 ICC 分别为0．805及0．822。结论实时双多普勒成像技术测量胎儿 LTI 及 RTI 能简便、准确、有效地综合评价妊高征患者胎儿左、右心室的整体功能，且重复性好。%Objective To explore the clinical value of Tei index(TI)measured by realtime dual Doppler modality in evaluating the fetal left and right ventricular function in pregnancy-induced hypertension syn-drome.Method According to American College of Obstetricians and Gynecologists(ACOG)categories, objects of this study were divided into three groups.Sixty fetuses of healthy mothers were assigned as the control group (Group A),22 fetuses of pregnancy-induced hypertension and mildly pre-eclamptic mothers constituted as Group B and 24 fetuses of severely pre-eclamptic mothers constituted as Group C TI was generated from the same fetal cardiac cycle by dual Doppler modality.Results The LTI and RTI have no significant correlation with gestational age and fetal heart rate (P>0.05).The LTI and RTI of group A, B,C were incre ased (P<0.001).There was a significant difference between group C and group A (P<0.001),and also between group C and group B (P<0.001 ).There was no difference between group B and group A (P>0.05).The intraclass correlation coefficient of LTI and RTI for intra-and inter-observer measurements were 0.973,0.979 and 0.805 ,0.822,respectively.Conclusions Tei index measured by dual Doppler modality was easy and valuable for estimating fetal biventricular integral functions.