正常双胎妊娠孕妇左心结构、功能及子宫动脉血流参数纵向研究

发布时间：2018-04-18 15:02

本文选题：心室功能 + 左　；参考：《中国临床医学影像杂志》2016年01期

【摘要】：目的 :探讨妊娠期间正常双胎妊娠孕妇左心结构、功能及子宫动脉血流参数的变化规律。方法 :选择2013年1月—2014年10月在首都医科大学附属北京妇产医院定期检查并分娩双胎妊娠孕妇,于妊娠早中期11~14周、妊娠中期21~26周及妊娠晚期28~34周行常规产前超声检查同时行成人超声心动图检查,随访后筛选入组,对正常双胎妊娠孕妇左心结构、功能及子宫动脉血流参数进行纵向研究,并与单胎孕妇进行组间比较。结果:正常双胎组50例,单胎对照组35例。1双胎组左房舒张末期内径及左室舒张、收缩末期内径随孕期增加而增加,以11~14周至21~26周间变化为著,但各孕期左心结构与单胎孕妇相比差异无统计学意义;2双胎组总血管阻力(TVR)、心输出量(CO)、心率(HR)随孕期增加而改变,以11~14周至21~26周间变化为著,E/E’随孕期增加而增高,以21~26周至28~34周间变化为著;组间比较时双胎组21~26周HR、CO及28~34周舒张压(d BP)较单胎组高;3双胎组双侧子宫动脉平均搏动指数(PI)、阻力指数(RI)、收缩期峰值流速/舒张末期流速(S/D)随孕期增加而降低,双侧子宫动脉舒张早期切迹存在率随孕期增加而降低,以11~14周至21~26周间变化为著;双胎组各孕期双侧子宫动脉平均PI、RI、S/D及11~14周舒张早期切迹存在率较单胎组低(P0.05)。结论:1双胎妊娠孕妇左心结构内径、心输出量、心率随孕周增加而增长,总血管阻力及子宫动脉血流参数随孕周增加而减低,以早中孕期变化显著,中晚孕期左室充盈压增长迅速;2与单胎孕妇相比,双胎孕妇中孕期心率、心输出量及晚孕期舒张期血压高,各孕期子宫动脉血流参数低,早孕期舒张早期切迹存在率低。
[Abstract]:Objective: to investigate the changes of left ventricular structure, function and uterine artery blood flow parameters in pregnant women with normal twin pregnancy.Methods: from January 2013 to October 2014, pregnant women with twin pregnancy were examined and delivered at Beijing Maternity Hospital affiliated to Capital Medical University from January 2013 to October 2014.Normal prenatal echocardiography and adult echocardiography were performed at 2126 weeks in the second trimester of pregnancy and 2834 weeks in the third trimester of pregnancy. After follow-up, left ventricular structure, function and uterine artery blood flow parameters of normal twin pregnancy were studied longitudinally.And compared with single pregnancy group.Results: the left atrial end-diastolic diameter and left ventricular end-diastolic diameter and end-systolic diameter increased with the increase of pregnancy in the normal twin group (n = 50) and the control group (n = 35).However, there was no significant difference in left ventricular structure between pregnant women and single pregnant women. There was no significant difference in total vascular resistance (TVRV), cardiac output (CO), heart rate (HRR) with the increase of pregnancy, and the change of E- / E' between 1114 weeks and 2126 weeks was increased with the increase of pregnancy.The change was from 21 ~ 26 weeks to 28 ~ 34 weeks.The mean pulsatile index (Pi), resistance index (RI), peak systolic velocity / end diastolic velocity (S / D) of bilateral uterine artery in twin group (21 ~ 26 weeks) and diastolic blood pressure (DBP) at 2834 weeks in twin group were lower than those in single pregnancy group, and the mean pulsatile index (Pi) and peak systolic velocity / end diastolic velocity (S / D) of bilateral uterine artery were decreased with the increase of pregnancy.The rate of early diastolic notch of bilateral uterine artery decreased with the increase of gestation, and the mean PII-RI / S / D and early diastolic notch rate of bilateral uterine artery in twin group were lower than that in single fetus group during 1114 ~ 2126 weeks.Conclusion the diameter of left ventricular structure, cardiac output and heart rate increase with the increase of gestational weeks, and the total vascular resistance and uterine artery blood flow parameters decrease with the increase of gestational weeks, especially in early and middle pregnancy.Compared with single pregnancy, the heart rate, cardiac output and diastolic blood pressure of twin pregnant women were higher, uterine artery blood flow parameters were lower and the rate of early diastolic notch was lower.
【作者单位】：首都医科大学附属北京妇产医院超声科;
【基金】：首都医科大学附属北京妇产医院科研基金资助项目(201207) 北京市医药管理局“登峰”计划专项经费资助(DFL20151302)
【分类号】：R714.1;R445.1

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