组织多普勒与脉冲多普勒超声定量测定胎儿心脏传导时间的应用

摘要

Objective: To observe and compare application of tissue Doppler (TDI) and pulsed Doppler (PD) echocardio-graphy in quantitative determination of fetal cardiac conduction time. Methods: 178 pregnant women, who received the routine check, were selected as the object of study. They were given TDI and PD measurement, orderly. The fetal atrioventricular (AV) conduction time and the time period (VA) from beginning searching the ventricle to the atrium in the next cardiac cycle were recorded. Results:(1) According to TDI and PD , except that 12 cases (6. 7% ) had occasional arrhythmia, all selected fetal heart structures were nor-mal. (2) The success rates of TDI and PD were 95. 5% (170 / 178) and 96. 6% (172 / 178), respectively, and no significant differ-ence was found (P>0. 05). (3) The TDI measurement showed that the AV average value of the 172 fetuses was (127. 39±17. 20)ms, 95% CI: (124. 33 ~ 130. 45)ms, and the mean value of VA was (286. 42±25. 32)ms, 95% CI: (281. 44 ~ 291. 40)ms; PD measure-ment showed that that the AV average value of the 172 fetuses was (127. 74±12. 57) ms, 95% CI: (124. 71-125. 77) ms, and the mean value of VA was (288. 51±24. 92) ms, 95% CI: (284. 42-289. 60) ms, no significant differences the two groups were found (P>0. 05). (4) Taking the TDI measurement results as the standard, AV was positively correlated with gestational age (r=0. 37, P<0. 05), and negatively correlated with heart rate (r= -0. 52, P<0. 05); and VA was positively correlated with gestational age (r =0. 22, P<0. 05), and negatively correlated with heart rate (r= -0. 39, P<0. 05). Conclusions: Fetal cardiac conduction time is posi-tively correlated with gestational age, and negatively correlated with heart rate. TDI and PD echocardiography are both effective in the determination of fetal heart conduction time.%目的：：观察并对比组织多普勒(TDI)与脉冲多普勒(PD)超声定量测定胎儿心脏传导时间。方法：入选常规产检的178例孕妇为研究对象,均先行 TDI 测量,续行 PD 测量,获取并对比胎儿房室传导时间(AV)及心室开始搜索至下一心动周期心房开始搜索的时间周期(VA)值。结果：①综合 TDI 及 PD 测量结果,显示入选胎儿心脏结构均正常,偶发心率失常12例,占6.7%；②TDI 测量成功率为95.5%(170/178),PD 测量成功率为96.6%(172/178),差异无统计学意义(P>0.05)；③TDI 测量显示,172例胎儿 AV 平均值(127.39±17.20) ms,95% CI：(124.33~130.45)ms、VA 平均值(286.42±25.32) ms,95% CI：(281.44~291.40) ms；PD 测量显示,172例胎儿 AV 平均值(127.74±12.57)ms,95% CI：(124.71~125.77)ms、VA 平均值(288.51±24.92)ms,95% CI：(284.42~289.60)ms,组间差异无统计学意义(P>0.05)；④以 TDI 测量结果为标准,显示 AV 与孕周呈正相关(r=0.37,P<0.05),与心率呈负相关(r=-0.52,P<0.05)；VA 与孕周呈正相关(r =0.22,P<0.05),与心率呈负相关(r=-0.39,P<0.05)。结论：胎儿心脏传导时间与孕周呈正相关,与心率呈负相关；组织多普勒与脉冲多普勒均是测定胎儿心脏传导时间的有效方案。