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目的分析重型α-地中海贫血、心源性因素及感染性因素引起胎儿水肿的脾动脉收缩期血流峰值(SpA-PSV)的改变。方法超声监测正常胎儿的SpA-PSV 457例,水肿胎SpA-PSV 90例,根据病因分为心源性水肿胎组和重型α-地中海贫血水肿胎组、感染性水肿胎组,与对照组之间比较采用t检验进行参数分析。结果与正常对照组比较,心源性水肿胎组SpA-PSV降低(P<0.01);重型α-地中海贫血水肿胎组SpA-PSV明显升高(P<0.01);感染性组水肿胎SpA-PSV多位于第50~95个百分位数之间,19周、22周、26周、27周SpA-PSV高于对照组(P<0.01);23周、24周SpA-PSV与对照组比较变化不大(P>0.01)。结论三组水肿胎儿SpA-PSV有着不同的改变,胎儿脾动脉血流检测有助于鉴别水肿胎病因及指导临床进一步诊疗提供一项实用、方便、无创的筛查新指标。
Objective To analyze the changes of SpA-PSV in patients with severe alpha-thalassemia, cardiogenic and infectious causes of fetal edema. Methods 457 cases of normal fetal SpA-PSV and 90 cases of hydatidiform SpA-PSV were enrolled in this study. According to the etiology, they were divided into two groups: cardiogenic edema group, heavy alpha-thalassemia fetal group, infectious edema fetal group and control group Comparison between the t test parameters analysis. Results SpA-PSV was decreased in the group of cardiogenic edema (P <0.01), SpA-PSV in the group of severe α-thalassemia was significantly higher than that in the control group (P <0.01) PSV was located between the 50th and 95th percentiles, SpA-PSV was higher at week 19, week 22, week 26, and week 27 (P <0.01); SpA-PSV at week 23 and 24 was significantly higher than that of control group Compared with little change (P> 0.01). Conclusion There are different changes in SpA-PSV in three groups of fetal edema. The detection of fetal splenic blood flow can help to identify the etiology of fetal edema and guide clinical further diagnosis and treatment to provide a practical, convenient and noninvasive screening index.