孕周正常胎儿静脉导管血流频谱参数分析_赵雪婷

论著

文章编号：1000-

5404（2014）06-0604-0411 13+6孕周正常胎儿静脉导管血流频谱参数分析

赵雪婷，漆洪波

（400016重庆，重庆医科大学附属第一医院妇产科）

［摘要］目的测量分析在11 13+6

孕周正常胎儿静脉导管（ductus venosus ，DV ）各血流频谱参数与孕周的关系，

建立各自参考曲线。方法选取11 13+6

孕周在我科行超声检查的单胎孕妇904例，进行胎儿DV 多普勒血流检查，分别

测量心室收缩期血流峰值（S-wave ）、心室舒张早期血流峰值（D-wave ）、心房收缩期血流速度（A-wave ）、平均时间最大血流

速度（time-average maximum velocity ，TAMXV ）、搏动指数（pulstility index ，PI ）、前负荷指数（preload index ，PLI ）、心室收缩期血流峰值/心房收缩期血流速度（S /A ）。随访妊娠结局，

503名正常妊娠孕妇纳入研究。结果S-wave （r =0.237，P ＜0.01）、D-wave （r =0.251，P ＜0.01）、A-wave （r =0.217，P ＜0.01）、TAMXV （r =0.272，P ＜0.01）与孕龄显著正相关，PI （r =－0.159，

P =0.006）与孕龄显著负相关，PLI （r =－0.096，P =0.098）、S /A （r =－0.089，P =0.128）与孕龄无相关性。结论孕早

期胎儿DV 血流速度随孕周增加而增加，

PI 随孕周增加而降低，PLI 和S /A 无显著变化。［关键词］静脉导管；多普勒；超声；搏动指数

［中图法分类号］Ｒ445．1；Ｒ714．51

［文献标志码］A

［基金项目］国家临床重点专科建设项目（2013-544）［通信作者］漆洪波，E-mail ：qihongbo@sina．com

［优先出版］http ：//www．cnki．net /kcms /detail /51．1095．Ｒ．20140224．1723．007．

html （2014-02-24）

Correlation of ductus venosus Doppler velocimetric parameters with gestation period in fetus venosus between 11and 13+6weeks of gestation

Zhao Xueting ，Qi Hongbo （Department of Obstetrics and Gynecology ，First Affiliated Hospital ，Chongqing Medical University ，

Chongqing ，400016，China ）

［Abstract ］Objective To investigate the correlation of ductus venosus （DV ）Doppler velocimetric

parameters with gestation period in women at 11to 13+6weeks gestation in normal pregnancies．Methods A prospective observational study was performed on 904pregnant women who underwent ultrasound examination during 11to 13+6weeks of gestation in our department from July 2011to January 2013．The following variables

of the ductus venosus were measured ：peak velocity during ventricular systole （S-wave ），peak velocity during ventricular diastole （D-wave ），lowest forward velocity during atrial contraction （A-wave ），time-average maxi-mum velocity （TAMXV ），pulsatility index （PI ），preload index （PLI ），and the ratio of maximum peak systolic

velocity during ventricular systole to end-diastolic velocity during atrial contraction （S /A ）．Pregnant outcomes

were followed up．Finally a total of 503normal pregnancies out of 904pregnant women were analyzed．Ｒesults There were significant increase for the S-wave （r =0.237，P ＜0.01），D-wave （r =0.251，P ＜0.01），

A-wave （r =0.217，P ＜0.01），TAMXV （r =0.272，P ＜0.01），and significant decrease for the PI （r =－0.159，P =0．006）with the advancing of gestational age in the group with normal outcomes．While ，PLI （r =－0.096，P =0.098）and the ratio of S /A （r =－0.089，P =0．128）had no significant change during gestational age．Conclusion The S-wave ，D-wave ，A-wave ，and TAMXV velocity are increased ，while PI is decreased in

ductus venosus indexes along with gestational age．

［Key words ］ductus venosus ；Doppler velocimetry ；pulsatility index ；ultrasound

Supported by the Constructive Project of National Clinical Key Departments （2013-544）．Corresponding author ：Qi Hongbo ，E-mail ：qihongbo@sina．com

静脉导管（ductus venosus ，DV ）是胎儿血液循环

里1条重要的血管，它是3处生理性分流的第1处血管。DV 直接将富含氧气的血液从脐静脉绕过肝脏微

循环运送到下腔静脉，

经卵圆孔到达左心，然后运至大脑和躯干［1］。目前，在11 13+6

孕周DV 多普勒检查越来越受到重视。DV 的评定通常采用两种方法：DV 搏动指数（DV pulsatility index ，DVPI ）的定量测定和心房收缩末期A 波缺失或倒置的定性测定。DVPI 异常与颈后透明层（NT ）及孕妇血清结合可提高早孕期