【摘要】 目的评价三维能量多普勒超声及其定量参数在妊娠期高血压疾病患者胎盘血流灌注监测中的价值。方法选择2016年1月至2017年1月在甘肃省妇幼保健院诊断为妊娠期高血压疾病的200例单胎孕妇为研究组,将其分为轻度子痫前期组(100例)、重度子痫前期组(100例),选择同期正常单胎孕妇200例为对照组。测算胎盘三维能量多普勒指数,包括血管化指数(vascularization index,VI)、血流指数(flow index,FI)、血管化-血流指数(vascularization flow index,VFI),并与孕妇子宫动脉、胎儿脐动脉、大脑中动脉的血流参数作相关分析。结果 3组孕妇胎盘VI、FI及VFI比较,差异有统计学意义(P<0.05),重度子痫前期组和对照组、轻度子痫前期组孕妇脐动脉收缩末期峰值/舒张末期峰值(S/D)、双侧子宫动脉搏动指数(pulsatility index,PI)以及大脑中动脉PI比较,差异有统计学意义(P<0.05),但轻度子痫前期组和对照组比较,差异无统计学意义(P>0.05)。相关性分析发现3组胎盘VI、FI、VFI与脐动脉、子宫动脉、大脑中动脉血流指数相关,且胎盘VI、FI、VFI与孕龄呈明显正相关。结论三维能量多普勒超声可定量分析前壁胎盘血流灌注情况,为产前诊断妊娠期高血压疾病患者胎盘血流灌注评估提供量化依据。更多还原

【Abstract】 Objective To evaluate the value of three-dimensional power Doppler ultrasound and its quantitative parameters in the monitoring of placental perfusion in patients with hypertensive disorder complicating pregnancy. Methods 200 cases of singleton pregnant women diagnosed as hypertensive disorder complicating pregnancy in Gansu Provincial Maternity and Child-care Hospital from January 2016 to January 2017 were selected as the study group,and they were divided into mild preeclampsia group( 100 cases)and severe preeclampsia group( 100 cases),200 normal pregnant women with single birth were selected as the control group. The three dimensional power Doppler indexes of the placenta were measured,including the vascularization index( VI),the flow index( FI),the vascularization flow index( VFI),and analyzed its correlation with blood flow parameters of the uterine artery,fetal umbilical artery and middle cerebral artery. Results There were significant differences in the placental VI,FI and VFI between the three groups( P <0. 05). The umbilical artery S/D,bilateral uterine artery PI and middle cerebral artery PI of severe preeclampsia group had significant difference with those of control group and mild preeclampsia group( P < 0. 05). However,there was no significant difference between the mild preeclampsia group and the control group( P > 0. 05). Correlation analysis found that placental VI,FI,VFI of the three groups had correlation with blood flow indexes of umbilical artery,uterine artery,middle cerebral artery,and placental VI,FI,VFI and gestational age were significantly positively correlated. Conclusion Three-dimensional power Doppler ultrasound can quantitatively analyze the blood flow perfusion of placenta in the anterior wall,and provide a quantitative basis for the prenatal diagnosis of placental perfusion in patients with hypertensive disorder complicating pregnancy.更多还原