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目的:探讨和比较应用超声多普勒技术测量胎儿大脑中动脉收缩峰期血流速度(MCA-PSV)与二维超声预测胎儿重型α地中海贫血(地贫)的价值。方法:为129例具有重型α地贫风险的胎儿行二维及多普勒超声检查,测量胎儿MCA-PSV并行羊膜腔穿刺或脐血穿刺术进行α地贫基因诊断。MCA-PSV用中位数的倍数(MOM)表示。结果:重型α地贫胎儿MCA-PSV明显高于非重型α地贫胎儿,差异有显著的统计学意义(P<0.001)。MCA-PSV>1.29MOM预测胎儿重型α地贫的检出率为81.25%,高于二维超声(P<0.05);MCA-PSV联合二维超声对胎儿重型α地贫的检出率为90.63%。MCA-PSV最早可在孕16周预测胎儿重型α地贫,MCA-PSV预测胎儿重型α地贫的平均孕龄小于二维超声(P<0.05)。结论:MCA-PSV预测胎儿重型α地贫优于二维超声。MCA-PSV联合二维超声可提高胎儿重型α地贫的检出率。超声多普勒测量胎儿MCA-PSV对早期预测胎儿重型α地贫,早期处理以减少产科并发症的发生具有临床价值。
Objective: To explore and compare the value of using ultrasonic Doppler to measure the peak flow velocity (MCA-PSV) of fetal middle cerebral artery and the prediction of fetal severe α-thalassemia (Thalassemia) by two-dimensional ultrasound. Methods: One hundred and ninety-two fetuses with risk of thalassemia major were examined by two-dimensional and Doppler ultrasonography, and fetal amniocentesis or amniocentesis was performed for the diagnosis of alpha thalassemia gene. MCA-PSV is expressed as a multiple of the median (MOM). Results: The MCA-PSV in severe α-thalassemia fetus was significantly higher than that in non-severe α-thalassemia fetus (P <0.001). The detection rate of MCA-PSV> 1.29MOM in fetus was 81.25%, higher than that of two-dimensional ultrasound (P <0.05). The detection rate of MCA-PSV combined with two-dimensional ultrasound was 90.63 %. As early as 16 weeks of gestation, MCA-PSV predicted fetal severe α-thalassemia. The mean gestational age of MCA-PSV predicted fetal severe α-thalassemia was less than 2-dimensional ultrasound (P <0.05). Conclusion: MCA-PSV is superior to two-dimensional ultrasound in predicting fetal α-thalassemia major. MCA-PSV combined with two-dimensional ultrasound can improve the detection rate of fetal severe α-thalassemia. Ultrasound Doppler measurement of fetus MCA-PSV early prognosis of fetal severe alpha thalassemia, early treatment to reduce the incidence of obstetric complications with clinical value.