CAJ | 학술논문

目的应用M型超声心动图测量正常中晚孕胎儿三尖瓣瓣环位移(tricuspid annular displacement,TAD),建立其正常参考范围并探讨TAD对正常中晚孕胎儿右室功能的定量研究价值.方法选取161例孕龄19～38周正常中晚孕单胎妊娠胎儿.应用M型超声心动图测量TAD；频谱多普勒(PW)测量三尖瓣口舒张早期血流峰值速度(E)、舒张晚期血流峰值速度(A)；组织多普勒(TDI)测量三尖瓣环舒张早期峰值速度(Em)、舒张晚期峰值速度(Am)及收缩期峰值速度(Sm).结果正常中晚孕胎儿TAD值为(9.38±1.71)mm,95％正常参考值范围分别为5.79～13.90 mm.TAD与孕周、E、A及Em、Am、Sm间呈显著相关性,r值分别为0.759、0.547、0.320、0.497、0.483和0.598(P＜0.001),与心率间无相关性(P＞0.05).晚孕组TAD值大于中孕组,差异有统计学意义(P＜0.05).结论正常中晚孕胎儿TAD值随孕周增加而增长,其评价胎儿右室功能与PW三尖瓣口E、A峰值流速及TDI三尖瓣瓣环Em、Am、Sm等传统右室功能评价参数有良好的相关性.TAD具有测量简单、可重复性高、对超声仪器要求低等优点,利于各级医院推广,并可能成为一些由于超声仪器没有多普勒测量功能的基层医院今后评价胎儿右室功能的主要参数之一.
목적 응용M형초성심동도측량정상중만잉태인삼첨판판배위이(tricuspid annular displacement,TAD),건립기정상삼고범위병탐토TAD대정상중만잉태인우실공능적정량연구개치.방법 선취161례잉령19～38주정상중만잉단태임신태인.응용M형초성심동도측량TAD；빈보다보륵(PW)측량삼첨판구서장조기혈류봉치속도(E)、서장만기혈류봉치속도(A)；조직다보륵(TDI)측량삼첨판배서장조기봉치속도(Em)、서장만기봉치속도(Am)급수축기봉치속도(Sm).결과 정상중만잉태인TAD치위(9.38±1.71)mm,95％정상삼고치범위분별위5.79～13.90 mm.TAD여잉주、E、A급Em、Am、Sm간정현저상관성,r치분별위0.759、0.547、0.320、0.497、0.483화0.598(P＜0.001),여심솔간무상관성(P＞0.05).만잉조TAD치대우중잉조,차이유통계학의의(P＜0.05).결론 정상중만잉태인TAD치수잉주증가이증장,기평개태인우실공능여PW삼첨판구E、A봉치류속급TDI삼첨판판배Em、Am、Sm등전통우실공능평개삼수유량호적상관성.TAD구유측량간단、가중복성고、대초성의기요구저등우점,리우각급의원추엄,병가능성위일사유우초성의기몰유다보륵측량공능적기층의원금후평개태인우실공능적주요삼수지일.
Objective To quantitatively study right ventricular function in the normal second and third trimester fetuses by M-mode tricuspid annular displacement(TAD).Methods TAD was measured using conventional M-mode echocardiography on 161 normal second and third trimester fetuses with gestation age (GA) between 19-38 weeks,meanwhile multiple parameters for evaluating right ventricular function were obtained using pulsed Doppler echocardiography (PW) and myocardial Dopple tissue imaging (DTI).The correlation between TAD and other parameters were analyzed using SPSS 17.0.Results In normal second and third trimester fetuses,the TAD was (9.38 ± 1.71)mm with a range of 5.79-13.90 mm,and was increased with the growth of GA.TAD was correlated with GA,E,A,Em,Am and Sm significantly (r =0.759,0.547,0.320,0.497,0.483 and 0.598 respectively,all P ＜0.001).TAD was not correlated with HR(P ＞0.05).TAD showed differences between the second trimester fetuses and the third trimester fetuses (P ＜ 0.05).Conclusions In normal second and third trimester fetuses,the TAD is increased with the growth of GA,and has good correlation with GA,E,A,Em,Am and Sm respectively,and may become a new promising modality to evaluate function of RV simply and accurately.The technique will be propitious to use in hospitals (without DTI) because of simplicity of operator and lower requirement on the technology and equipment precision.