| 刘彦超,赵鑫,赵彩雯,邢庆娜,张小安.子痫前期孕妇胎儿血流频谱与早产儿脑发育的相关性[J].中国医学影像技术,2020,36(5): |
| 子痫前期孕妇胎儿血流频谱与早产儿脑发育的相关性 |
| Correlation between the fetal blood flow spectrum of pregnant women with Preeclampsia and brain development of premature infants |
| 投稿时间：2019-07-06 修订日期：2020-05-18 |
| DOI： |
| 中文关键词: 子痫 胎儿 婴儿, 早产 脑 超声检查, 产前 磁共振成像 |
| 英文关键词:eclampsia fetus infant, premature brain ultrasonography, prenatal magnetic resonance imaging |
| 基金项目:国家自然科学基金（编号：80870983） |
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| 中文摘要: |
| [摘 要] 目的 探讨子痫前期孕妇胎儿期脐动脉（UA）及大脑中动脉（MCA）血流频谱与新生儿期颅脑各向异性分数（FA）值的相关性。方法 选取子痫前期孕妇分娩的早产儿43例为观察组，同期孕龄相匹配且无高危围产因素孕妇分娩的早产儿43例为对照组，回顾性分析2组胎儿期血流频谱参数，包括脐动脉（UA）的收缩期峰值流速／舒张末期流速及搏动指数(UA-S/D、UA-PI)，大脑中动脉（MCA）的收缩期峰值流速／舒张末期流速及搏动指数(MCA-S/D、MCA-PI)，UA-S/D与MCA-S/D的比值[(UA/MCA)-S/D]；比较新生儿期脑各部位FA值；分析血流频谱参数与FA值的相关性。结果 观察组胎儿UA-S/D、UA-PI及(UA/MCA)-S/D较对照组高，而MCA-PI及MCA-S/D较对照组低(P均＜0.001)，观察组张路指数(ZLI)值较对照组低、NICU（新生儿重症监护病房）住院时间较长及皮质脊髓束稀疏率较高(P均＜0.05)；观察组早产儿颅脑内囊后肢、丘脑、尾状核、额叶白质、顶叶白质、大脑脚及小脑的FA值较对照组低(P均＜0.05)。观察组FA均值与UA-S/D、MCA-S/D均呈负相关(r=—0.668、—0.957，P=0.025、0.002)。两组中内囊后肢FA值与UA-PI呈负相关(r=—0.220,P=0.021),与MCA-S/D呈正相关(r=0.462,P＜0.001)；FA均值与UA-PI呈负相关(r=—0.341,P=0.001)，与MCA-PI呈正相关(r=0.206,P=0.049)。结论 胎儿UA联合MCA的血流频谱参数与FA值具有一定相关性，可用于评估PE孕妇分娩早产儿脑发育情况。 |
| 英文摘要: |
| [Abstract] Objective To explore the correlation between fetal umbilical artery(UA), middle cerebral artery(MCA) blood flow spectrum of pregnant women with Preeclampsia and neonatal brain fractional anisotropy(FA). Methods 43 premature infants delivered by pregnant women with preeclampsia were selected as the observation group, 43 premature infants with matched gestational age and no high-risk perinatal factors were selected as the control group. The fetal blood flow spectrum parameters of the two groups were analyzed retrospectively, including peak systolic velocity/end diastolic velocity and pulsatility index (UA-S/D, UA-PI) of umbilical artery (UA), peak systolic velocity/ end diastolic velocity and pulsatility index (MCA-S/D, MCA-PI) of middle cerebral artery (MCA),the ratio of UA-S/D to MCA-S/D[(UA/MCA)-S/D]; The FA values of different parts of the brain in the neonatal period were compared, and the correlation between blood flow spectrum parameters and FA values were analyzed. Results The fetal UA-S/D, UA-PI and (UA/MCA)-S/D in the observation group were higher than those in the control group, while the MCA-PI and MCA-S/D in the observation group were lower than those in the control group (all P<0.001).The Zhang Lu index(ZLI) was lower ,Neonatal intensive care unit(NICU) hospitalization time was longer and the probability of slight thinning of corticospinal tract is higher in the observation group(all P<0.05).FA values of Posterior limb of internal capsule,Thalamus,Caudate nucleus,White matter of frontal lobe ,White matter of parietal lobe,Cerebral peduncle and Cerebellar hemisphere were lower in observation group(all P<0.05).In the observation group,FA mean was negatively correlated with UA-S/D and UA-PI(r=—0.668,—0.957),(P=0.025,0.002).In the two groups,the FA value of the posterior limb of the internal capsule was negatively correlated with UA-PI(r=—0.220,P=0.021) and positively correlated with MCA-S/D(r=0.462,P<0.001).FA mean was negatively correlated with UA-PI(r=—0.341,P<0.01) and positively correlated with MCA-PI(r=0.206,P=0.049).Conclusion The blood flow spectrum parameters of fetal UA combined with MCA have a certain correlation with FA, which can be used to evaluate the brain development of premature infants delivered by pregnant women with PE. |
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