正常中晚孕期胎儿肺静脉血流频谱分析

摘要

目的 探讨正常中晚孕期单胎胎儿肺静脉血流频谱特点,建立肺静脉血流参数正常参考值范围.方法 应用彩色多普勒超声检测340例19～40孕周正常单胎胎儿肺静脉血流参数:心室收缩期峰值速度(S)、心室舒张期峰值速度(D)、心房收缩期血流速度(A)、速度时间积分(velocity time integral,VTI)、静脉峰值速度指数(peak velocity index,PVI)、静脉搏动指数(pulsatility index,PI)、心室收缩期峰值速度与心室舒张期峰值速度比值(S/D).结果 肺静脉血流参数S、D、A、VTI随孕龄增大逐渐增高,PVI、PI随孕龄增大逐渐降低,各参数拟合的回归方程均有统计学意义；S/D与孕龄无线性关系.所有病例心房收缩期均无反向血流出现.结论 正常胎儿肺静脉血流频谱形态与成人不同.相关参数正常参考值范围曲线可为评价病理情况下胎儿肺静脉血流变化及心功能改变提供依据.%Objective To study pulmonary venous flow characteristics of normal fetus during second and third trimet pregnancy and establish normal reference value range of all parameters of pulmonary venous. Methods To test the blood flow parameters: peak systolic velocity (S),peak diastolic velocity (D) .end-diastolic velocity(A), time velocity integral(VTI), peak velocity index (PV1) , pulsatility index (PI), peak systolic velocity/peak diastolic velocity (S/D)of 340 cases of normal singleton fetus from 19 to 40 weeks of pregnancy by doppler ultrasonagraphy. Results The S,D,A, VTI of pulmonary venous flow increased with gestational age, but PVI,PI declined with gestational age. The corresponding regression equation was statistically significant. S/D was independent from gestational age. No reverse A wave appeared in all cases. Conclusions Pulmonary venous flow pattern of normal fetus was different from that of adults. Normal reference value range curve of pulmonary venous parameters may provide the basis for the changes of pulmonary venous flow and cardiac function of fetus with pathological conditions.