组织多普勒成像对胎儿心律失常分型的研究

摘要

目的 探讨组织多普勒成像(tissue Doppler imaging,TDI)对胎儿心律失常分型的价值,总结各型心律失常的TDI波形特征,为临床诊断提供依据.方法 对临床怀疑心律失常的55例胎儿同时进行M型、频谱多普勒(pulsed wave Doppler,PW)及TDI检查并判断心律失常的类型,以M型和PW的诊断结果 为对照标准,判断TDI诊断胎儿心律失常的敏感性和特异性以及在分型方面的准确性.对两种方法 诊断一致的病例进行TDI波形特征总结,并结合心动梯形图判断异常心律的起源.所有纳入研究的胎儿出生后尽量进行心电图和超声心动图检查.结果 TDI诊断诊断胎儿心律失常的敏感性为98%,特异性为100%,在分型方面的准确性为100%;总结了8种类型心律失常的TDI波形以及心动梯形图特征.结论 TDI诊断胎儿心律失常的敏感性、特异性以及分型的准确性均较高,不失为诊断胎儿心律失常的良好方法.%Objective To evaluate the diagnostic value of tissue Doppler imaging (TDI) in classification of fetal arrhythmias, and conclude characters of each type of arrhythmias by analyzing wave forms of TDI. Methods Fifty-five fetuses suffered arrhythmia were included in study group. By comparing the results with control standard(M and PW), the sensitivity, specificity and reliability of TDI in diagnosis of fetal arrhythmias was calculated. At last, the character of waves by TDI of each type of arrhythmia was concluded. Fetal kinetocardiogram was made to identify the origin of arrhythmias. All cases were asked to perform electrocardiography and echocardiography examination after birth. Results The sensitivity, specificity and reliability of TDI was 98%, 100% and 100%, respectively. The character of atrioventricular waves and kinetocardiogram of 8 types fetal arrhythmias were conclude. Conclusions TDI has great value in classification of fetal arrhythmias.