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目的探讨静脉导管(DV)血流频谱各参数在预测妊娠期高血压疾病(HDCP)胎儿结局中的应用价值。方法应用彩色多普勒超声检查2012年1月至2013年10月在沈阳市妇婴医院就诊的60例正常单胎胎儿及38例HDCP单胎胎儿,测量DV血流频谱速度参数值及阻力参数值。结果轻度子痫前期组各阻力参数较正常组明显升高(P<0.05),速度参数无明显变化(P>0.05);重度子痫前期组各速度参数较正常组及轻度组明显下降(P<0.05),Va尤为显著,2例出现“a”谷反转,均胎死宫内,各阻力参数较正常组及轻度组明显升高(P<0.05),其中Vs/Va对于提示重度子痫前期胎儿生长受限的敏感度为80.0%,特异度为66.7%。结论轻度子痫前期胎儿DV血流频谱速度参数与正常胎儿相比无明显差异,重度子痫前期胎儿速度参数较正常、轻度子痫前期胎儿明显下降;阻力参数在正常、轻度子痫前期、重度子痫前期胎儿中呈递增趋势;Vs/Va对于预测重度子痫前期胎儿生长受限有一定的价值,“a”谷反转对于预测胎儿不良结局有一定意义。
Objective To investigate the value of venous catheter (DV) blood flow spectrum parameters in predicting fetal outcome of HDCP. Methods Sixty normal singleton fetuses and 38 single HDCP fetuses treated in Shenyang Maternal and Child Hospital from January 2012 to October 2013 were examined by color Doppler ultrasonography to measure the frequency and velocity parameters of DV blood flow spectrum value. Results The resistance parameters in mild preeclampsia group were significantly higher than those in normal group (P <0.05), but no significant changes in velocity parameters were found (P> 0.05). The velocity parameters in severe preeclampsia group were significantly lower than those in normal group and mild group (P <0.05). The Va was especially significant. In 2 cases, the “a” valley was reversed and all of them were still alive. The resistance parameters were significantly higher than those in the normal and mild groups (P <0.05) The sensitivity of Va to prompt fetal growth restriction in severe preeclampsia was 80.0% with a specificity of 66.7%. Conclusions There is no significant difference in frequency parameters of fetal DV blood flow in mild preeclampsia compared with normal fetuses. Fetal speed parameters in severe preeclampsia are lower than those in normal preeclampsia and mild preeclampsia fetuses. The resistance parameters are lower in normal and mild preeclampsia Pre-eclampsia fetuses showed an increasing trend; Vs / Va had a certain value in predicting the fetal growth restriction in severe preeclampsia, and the “a” valley reversal had some significance in predicting adverse fetal outcomes.