彩色多普勒超声评价双胎输血综合征受血儿心功能的临床价值

摘要

目的：探讨彩色多普勒超声评价双胎输血综合征（ TTTS）受血儿右心心肌运动功能的临床价值。方法选取16例确诊为TTTS的孕妇为研究对象，应用彩色多普勒测量两组胎儿脐静脉、脐动脉、大脑中动脉、静脉导管、半月瓣、房室瓣的血流频谱、右心心肌做功指数及胎儿心胸面积比值。结果 TTTS受血儿体质量、心胸面积比值、右心心肌做功指数、左心心肌做功指数显著高于供血儿（均P <0.05）。TTTS受血儿静脉脉搏动征（ PUV）、静脉导管A波缺失或反向（ARDV）、三尖瓣反流（TR）、三尖瓣舒张期血流单峰（ATVI）比率显著高于供血儿，差异有统计学意义（ P <0.05）。结论彩色多普勒超声能有效评价TTTS受血儿心功能尤其是舒张功能异常，可为TTTS产前诊断提供有效重要的信息。%Objective To evaluate the clinical significance of color Doppler ultrasound in evaluation of the myocardial function in fetuses with twin transfusion syndrome( TTTS). Methods A total of 16 pregnant women having fetuses with TTTS were selected for this study. The fetal umbilical vein,umbilical artery,middle cerebral artery,vein catheters,half flap,atrioventricular valve flow spectrum,right ventricular myocardial performance index and fetal cardiothoracic area ratio of fetuses with TTTS were measured with color Doppler ultrasound. Results The cardiothoracic area ratio,right ventricular myocardial performance index,left ventricular myocardial performance index of blood received fetus body mass were higher than the blood supply to fetuses(all P <0. 05). The intravenous pulse moving sign(PUV)and intravenous catheter A wave were missed or reversed ( ARDV),tricuspid regurgitation( TR),tricuspid diastolic flow unimodal( ATVI)ratio of blood received fetus body mass were higher than those of blood supply to fetuses(all P <0. 05). Conclusion Color Doppler ultrasound can effectively evaluate the cardiac function of TTTS through the blood of fetuses,especially diastolic dysfunction,and it may provide important information for effective prenatal diagnosis of TTTS.