摘要
目的探讨早孕期不同类型胎儿静脉导管频谱波型与胎儿生长发育及预后之间的关系。方法165例头臀长（CRL）在25-80mm之间的高危胎儿接受了经腹壁早孕期超声检查及绒毛活检。根据胎儿静脉导管血流不同波型将频谱形态分为三型：Ⅰ型：在整个心动周期内无反向血流;Ⅱ型：在心房收缩期的起始段出现很短时间内的反向血流信号,随后的大部分心房收缩期内为正向血流信号;Ⅲ型：在整个心房收缩期内为持续反向血流。所有本组胎儿进行了产前染色体核型分析、基因学及酶学检查,并随访至生后。结果在本组病例中,只有2例胎儿静脉导管频谱波型为Ⅲ型,绒毛检查结果证实其中一例为21-三体,另一例为黏多糖储积症。26例胎儿经基因学诊断为遗传性疾病,2例胎儿宫内死亡。在其余135例正常发育胎儿组中,95例（70.4%）胎儿静脉导管频谱为Ⅰ型,40例（29.6%）胎儿频谱为Ⅱ型。按胎儿头臀长分为5组（≤39mm,40-49mm,50-59mm,60-69mm,≥70mm）后,Ⅰ型/Ⅱ型胎儿例数分别为24/16、31/8、15/13、11/2、14/1。应用非参数检验的统计学方法分析,结果显示Ⅰ型及Ⅱ型频谱波型的出现频率与胎儿头臀长分组密切相关（P=0.015）,绝大多数的Ⅱ型静脉导管频谱出现在头臀长小于60mm的胎儿组中。结论通过本组正常胎儿的研究显示,早孕期胎儿静脉导管频谱波型中心房收缩早期出现的很短的反向血流信号应被视为一种“正常变异”现象,而非一种异常的静脉导管频谱类型,特别是在胎儿头臀长小于60mm时。
Objective To investigate the associations of the different types of Doppler waveforms of fetal ductus venosus （DV） with fetal growth and outcome in the first trimester. Methods One hundred and sixty-five high risk fetuses with a crown-rump length （CRL） ranging from 25-80 mm received transabdominal ultrasound screening and chorionic sampling. The patterns of the flow waveforms of DV were divided into 3 types. TypeⅠ, no reversed flow during the entire cardiac cycle; type Ⅱ, absent or reversal flow of a very short time was only present at the beginning of the atrial systolic period, followed by antegrade flow during the rest of the atrial systole; type Ⅲ, the reversal flow persisted during the entire atrial systolic period. The fetal outcome was demonstrated by prenatal karyotyping, genetic or enzymic analysis and follow up until after birth. Results Doppler waveform pattern of type Ⅲ was found in only 2 fetuses in our group, one was trisomy 21 and the other was mucopolysaccharidosis. Other 26 fetuses were diagnosed as genetic disorders, 2 fetuses died in utero spontaneously. In the remaining 135 normal fetuses, DV waveform of typeⅠ was shown in 95 （70.4%） fetuses and type Ⅱ in 40 （29.6%） fetuses. After dividing the CRL of the fetuses into five groups （≤39 mm, 40-49 mm, 50-59 mm, 60-69 mm, ≥70 mm）, the number of fetuses with type Ⅰ/or typeⅡ was 24/16, 31/8, 15/13, 11/2, 14/1 in the five groups respectively. By using nonparametric test, it was found that the frequencies of the typeⅠ and Ⅱwere significantly affected by different CRL groups （P=0.015）, with type Ⅱ mostly appeared in the group with CRL less than 60 mm. Conclusion The absent or short reversal flow at the very beginning of the atrial systolic period of the fetal DV should be considered as a normal variation rather than abnormal DV flow pattern in the first trimester, especially in those fetuses with CRL less than 60 mm in the first trimester.
出处
《中国医学影像技术》
CSCD
北大核心
2007年第8期1208-1210,共3页
Chinese Journal of Medical Imaging Technology
基金
教育部留学回国人员科研启动基金资助。
关键词
胎儿
早孕
静脉导管
超声检查
多普勒
彩色
Fetus
the first trimester
Ductus venosus
Ultrasonography, Doppler, color
