中晚孕胎儿三尖瓣环运位移对评估胎儿右心室功能的有效性分析

目的 探讨解剖M型超声心动图( FAM)测量中晚孕胎儿三尖瓣环运位移( TAPSE)对评估胎儿右心室功能的有效性,并建立测量值参考范围.方法 前瞻性选取213例胎儿,根据孕周分为5组:20~24周、24+1 ~28周、28+1 ~32周、32+1 ~36周、36+1 ~40周,分别采用普通M型超声心动图( CM)、FAM测量TAPSE,组织多普勒检测Em,Sm以及右室短轴缩短率,并对其进行统计学分析.结果 不同孕周组FAM-TAPSE,CM-TAPSE,Em,Sm之间差异具有显著统计学意义(P<0. 01);各孕周组右室短轴缩短率之间差异无统计学意义(P>0. 05).正常胎儿FAM-TAPSE值明显高于CM-TAPSE值,差异具有统计学意义(P<0. 05). FAM-TAPSE,CM-TAPSE均与孕周、Em、Sm之间呈明显正相关,但FAM-TAPSE相关性更好.结论 FAM通过调整角度,测量得到三尖瓣环垂直方向的最大位移,能够更有效地评估胎儿右室功能.

Assessment Analysis of Fetus Three Tricuspid Annulus Movement Effective Displacement on Right Ventricular during Middle and Late Pregnancy Function

Objective To investigate the anatomic M-mode echocardiography ( FAM) measurement in the middle and late gestation fetal tricuspid valve ring transport ( TAPSE) displacement effectiveness to evaluate the fetal right ventricular function and establish measurement value of the reference range. Method 213 cases of fetal were selected and divided into 5 groups according to the gestational ages:20 ~24 w,24+1 ~28 w,28+1 ~32 w, 32+1 ~36 w,36+1 ~40 w,CM and FAM were measured respectively to TAPSE,and right ventricular short axis shortening rate, statistical analysis was carried on. Results There were significant differences in Em, SmCM-TAPSE and FAM-TAPSE among different gestational age groups (P<0. 01),but there was no significant difference between the right ventricular shortening rate in the gestational age group(P>0. 05). Normal fetal FAM-TAPSE was significantly higher than the CM-TAPSE value (P<0. 05). FAM-TAPSE and CM-TAPSE were significantly positively correlated with gestational age,Sm and Em,but the correlation of FAM-TAPSE was better. Conclusion The maximum displacement of the vertical direction of the three-point valve ring can be measured by the adjustment of the angle of FAM.