中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2010年
2期
148-152
,共5页
徐赣琼%周启昌%欧阳竹%章鸣%蒲大容%田蕾琪%谢锋%曾施%谭宜
徐贛瓊%週啟昌%歐暘竹%章鳴%蒲大容%田蕾琪%謝鋒%曾施%譚宜
서공경%주계창%구양죽%장명%포대용%전뢰기%사봉%증시%담의
超声检查,产前%心脏缺损,先天性%大脑中动脉%血液动力学现象
超聲檢查,產前%心髒缺損,先天性%大腦中動脈%血液動力學現象
초성검사,산전%심장결손,선천성%대뇌중동맥%혈액동역학현상
Ultrasonography,prenatal%Heart defects,congenital%Middle cerebral artery%Hemodynamic phenomena
目的 探讨先天性心脏病(CHD)对胎儿脑血流动力学的影响,及不同类型CHD对脑血流动力学的影响程度.方法 正常胎儿200例和产前超声心动图诊断为CHD胎儿159例,其中左心发育不良综合征(HLHS)23例,左心梗阻性病变(LSOL)19例,右心发育不良综合征(HRHS)15例,右心梗阻性病变(RSOL)33例,间隔缺损36例,圆锥动脉干畸形(CTD)33例.测量胎儿大脑中动脉搏动指数(MCA-PI)、脐动脉搏动指数(UA-PI)及脑/脐血管PL管PI比值(CPR).结果 HLHS、HRHS、RSOL、CTD及SD组胎儿的MCA-PI和CPR均较对照组减低,UA-PI均较对照组升高,差异均有统计学意义(P<0.05);LSOL组的各参数与对照组比较差异均无尤统计学意义(P>0.05).结论 宫内CHD胎儿出现脑血管阻力下降,不同类型CHD脑血管阻力的改变程度不同,提示不同类型CHD胎儿存在不同程度的脑循环代偿反应.
目的 探討先天性心髒病(CHD)對胎兒腦血流動力學的影響,及不同類型CHD對腦血流動力學的影響程度.方法 正常胎兒200例和產前超聲心動圖診斷為CHD胎兒159例,其中左心髮育不良綜閤徵(HLHS)23例,左心梗阻性病變(LSOL)19例,右心髮育不良綜閤徵(HRHS)15例,右心梗阻性病變(RSOL)33例,間隔缺損36例,圓錐動脈榦畸形(CTD)33例.測量胎兒大腦中動脈搏動指數(MCA-PI)、臍動脈搏動指數(UA-PI)及腦/臍血管PL管PI比值(CPR).結果 HLHS、HRHS、RSOL、CTD及SD組胎兒的MCA-PI和CPR均較對照組減低,UA-PI均較對照組升高,差異均有統計學意義(P<0.05);LSOL組的各參數與對照組比較差異均無尤統計學意義(P>0.05).結論 宮內CHD胎兒齣現腦血管阻力下降,不同類型CHD腦血管阻力的改變程度不同,提示不同類型CHD胎兒存在不同程度的腦循環代償反應.
목적 탐토선천성심장병(CHD)대태인뇌혈류동역학적영향,급불동류형CHD대뇌혈류동역학적영향정도.방법 정상태인200례화산전초성심동도진단위CHD태인159례,기중좌심발육불량종합정(HLHS)23례,좌심경조성병변(LSOL)19례,우심발육불량종합정(HRHS)15례,우심경조성병변(RSOL)33례,간격결손36례,원추동맥간기형(CTD)33례.측량태인대뇌중동맥박동지수(MCA-PI)、제동맥박동지수(UA-PI)급뇌/제혈관PL관PI비치(CPR).결과 HLHS、HRHS、RSOL、CTD급SD조태인적MCA-PI화CPR균교대조조감저,UA-PI균교대조조승고,차이균유통계학의의(P<0.05);LSOL조적각삼수여대조조비교차이균무우통계학의의(P>0.05).결론 궁내CHD태인출현뇌혈관조력하강,불동류형CHD뇌혈관조력적개변정도불동,제시불동류형CHD태인존재불동정도적뇌순배대상반응.
Objective To determine whether CHD modify cerebrovascular flow dynamics in CHD fetuses,and the influence on different types of CHD.Methods Two hundred normal fefuses and 159 fetuses who were diagnosed CHD by prenatal echocardiogram were studied.CHD fetuses were divided into 6 groups according to hemodynamics:hypoplastic left heart syndrome(HLHS,n=23),left-sided obstructive lesions(LSOL,n=19),hypoplastic right heart syndrome(HRHS,n=15),right-sided obstructive lesions (RSOL,n=33),septal defect(SD,n=36),conotruneal defects(CTD,n=33).The pulsatility index(PI) and the cerebroplacental Doppler ratio(CPR)of the middle cerebral artery(MCA)and umbilical artery(UA) in normal and CHD group were measured by color Doppler flow system.Results MCA-PI and CPR in HLHS,HRHS,RSOL,CTD and SD groups all decreased compared with normal fetuses(P<0.05),and UA-PI in these groups increased compared with normal fetuses(P<0.05), whereas none parameters in LSOL changed significantly compared with the control group(P>0.05).Conclusions Fetuses with CHD had decreasing eerebrovascular impedance.Different types of CHD had different levels of eerebrovascular impedance,which indicated that different types of CHD induced different levels of cerebrovascular circulationcompensation.
