中国医科大学学报
中國醫科大學學報
중국의과대학학보
JOURNAL OF CHINA MEDICAL UNIVERSITY
2015年
6期
516-519
,共4页
胎儿%主动脉峡部%峡部收缩指数%超声检查
胎兒%主動脈峽部%峽部收縮指數%超聲檢查
태인%주동맥협부%협부수축지수%초성검사
fetal%aortic isthmus%isthmic systolic index%ultrasonography
目的：应用产前超声获得胎儿主动脉峡部收缩指数（ISI），建立正常胎儿ISI的正常范围参考值，并评价其与孕周之间的变化规律，为产前诊断胎儿心血管异常及评估胎儿宫内安危提供信息。方法选取孕18~37周正常胎儿251例，应用频谱多普勒超声获得其主动脉峡部血流频谱图像，测量其收缩期峰值血流速度（PSV）、收缩末期最低点血流速度（NS），计算ISI，ISI为NS与PSV的比值，并分析ISI与孕周之间的关系。结果孕18~24周ISI值在0.19~0.21之间。随着孕周的增加，PSV逐渐增加，NS逐渐减低。28周左右，主动脉峡部血流频谱上可观察到一个明显的收缩末期减速，这种趋势导致ISI平均值在30周左右接近0。此后这一趋势继续增加，在妊娠末期ISI平均值约为-0.33。以孕周为自变量X，PSV、NS、ISI分别为因变量Y，进行曲线拟合，得出曲线方程分别为Y∧=-69.116+9.542X-0.139X2，R2=0.96，P<0.001；Y∧=-99.881+10.331X-0.232X2，R2=0.99，P<0.001；Y∧=-0.671+0.086X-0.02X2，R2=0.99，P<0.001。结论产前超声能够测量胎儿ISI，ISI能够为诊断胎儿心血管异常及评估胎儿宫内安危提供有用的信息。
目的：應用產前超聲穫得胎兒主動脈峽部收縮指數（ISI），建立正常胎兒ISI的正常範圍參攷值，併評價其與孕週之間的變化規律，為產前診斷胎兒心血管異常及評估胎兒宮內安危提供信息。方法選取孕18~37週正常胎兒251例，應用頻譜多普勒超聲穫得其主動脈峽部血流頻譜圖像，測量其收縮期峰值血流速度（PSV）、收縮末期最低點血流速度（NS），計算ISI，ISI為NS與PSV的比值，併分析ISI與孕週之間的關繫。結果孕18~24週ISI值在0.19~0.21之間。隨著孕週的增加，PSV逐漸增加，NS逐漸減低。28週左右，主動脈峽部血流頻譜上可觀察到一箇明顯的收縮末期減速，這種趨勢導緻ISI平均值在30週左右接近0。此後這一趨勢繼續增加，在妊娠末期ISI平均值約為-0.33。以孕週為自變量X，PSV、NS、ISI分彆為因變量Y，進行麯線擬閤，得齣麯線方程分彆為Y∧=-69.116+9.542X-0.139X2，R2=0.96，P<0.001；Y∧=-99.881+10.331X-0.232X2，R2=0.99，P<0.001；Y∧=-0.671+0.086X-0.02X2，R2=0.99，P<0.001。結論產前超聲能夠測量胎兒ISI，ISI能夠為診斷胎兒心血管異常及評估胎兒宮內安危提供有用的信息。
목적：응용산전초성획득태인주동맥협부수축지수（ISI），건립정상태인ISI적정상범위삼고치，병평개기여잉주지간적변화규률，위산전진단태인심혈관이상급평고태인궁내안위제공신식。방법선취잉18~37주정상태인251례，응용빈보다보륵초성획득기주동맥협부혈류빈보도상，측량기수축기봉치혈류속도（PSV）、수축말기최저점혈류속도（NS），계산ISI，ISI위NS여PSV적비치，병분석ISI여잉주지간적관계。결과잉18~24주ISI치재0.19~0.21지간。수착잉주적증가，PSV축점증가，NS축점감저。28주좌우，주동맥협부혈류빈보상가관찰도일개명현적수축말기감속，저충추세도치ISI평균치재30주좌우접근0。차후저일추세계속증가，재임신말기ISI평균치약위-0.33。이잉주위자변량X，PSV、NS、ISI분별위인변량Y，진행곡선의합，득출곡선방정분별위Y∧=-69.116+9.542X-0.139X2，R2=0.96，P<0.001；Y∧=-99.881+10.331X-0.232X2，R2=0.99，P<0.001；Y∧=-0.671+0.086X-0.02X2，R2=0.99，P<0.001。결론산전초성능구측량태인ISI，ISI능구위진단태인심혈관이상급평고태인궁내안위제공유용적신식。
Objective To obtain the fatal aortic isthmic systolic index(ISI)with prenatal ultrasound,and to establish reference ranges for normal live fatal aortic isthmic systolic index(ISI). Methods A total of 251 normal fetuses at 18?37 gestation weeks were collected and underwent Dop?pler ultrasound examination to obtain the fatal aortic isthmus waveforms. Peak systolic velocity(PSV)and systolic nadir(NS)were measured on the waveforms. ISI was derived from the ratio NS/PSV,and its relationship with gestational weeks was analyzed. Results ISI value was between 0.19 and 0.21,from 18 to 24 gestational weeks. As the gestational weeks increasing,PSV increased;however,NS decreased gradually. At about 28 weeks,a brief end?systolic deceleration wave was observed on the aortic isthmus waveforms,and this trend led to ISI towards a mean value of zero at about 30 weeks. At the end of pregnancy,ISI was about-0.33. The curve equations were established regarding the gestational age as the independent variable X,PSV,NS and ISI as the dependent variable Y respectively. Y∧=-69.116+9.542X-0.139X2,R2=0.96,P<0.001;Y∧=-99.881+10.331X-0.232X2,R2=0.99,P<0.001;Y∧=-0.671+0.086X-0.02X2,R2=0.99,P<0.001. Conclusion Prenatal ultrasound can measure the fetal aortic isthmic systolic index,which is helpful in the diagnosis of fetal cardiovascular anomalies and evaluation of fetal intrauterine status.
