本文選題：心室功能 + 左　； 參考：《中國臨床醫(yī)學(xué)影像雜志》2016年01期

【摘要】：目的 :探討妊娠期間正常雙胎妊娠孕婦左心結(jié)構(gòu)、功能及子宮動脈血流參數(shù)的變化規(guī)律。方法 :選擇2013年1月—2014年10月在首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院定期檢查并分娩雙胎妊娠孕婦,于妊娠早中期11~14周、妊娠中期21~26周及妊娠晚期28~34周行常規(guī)產(chǎn)前超聲檢查同時行成人超聲心動圖檢查,隨訪后篩選入組,對正常雙胎妊娠孕婦左心結(jié)構(gòu)、功能及子宮動脈血流參數(shù)進行縱向研究,并與單胎孕婦進行組間比較。結(jié)果:正常雙胎組50例,單胎對照組35例。1雙胎組左房舒張末期內(nèi)徑及左室舒張、收縮末期內(nèi)徑隨孕期增加而增加,以11~14周至21~26周間變化為著,但各孕期左心結(jié)構(gòu)與單胎孕婦相比差異無統(tǒng)計學(xué)意義;2雙胎組總血管阻力(TVR)、心輸出量(CO)、心率(HR)隨孕期增加而改變,以11~14周至21~26周間變化為著,E/E’隨孕期增加而增高,以21~26周至28~34周間變化為著;組間比較時雙胎組21~26周HR、CO及28~34周舒張壓(d BP)較單胎組高;3雙胎組雙側(cè)子宮動脈平均搏動指數(shù)(PI)、阻力指數(shù)(RI)、收縮期峰值流速/舒張末期流速(S/D)隨孕期增加而降低,雙側(cè)子宮動脈舒張早期切跡存在率隨孕期增加而降低,以11~14周至21~26周間變化為著;雙胎組各孕期雙側(cè)子宮動脈平均PI、RI、S/D及11~14周舒張早期切跡存在率較單胎組低(P0.05)。結(jié)論:1雙胎妊娠孕婦左心結(jié)構(gòu)內(nèi)徑、心輸出量、心率隨孕周增加而增長,總血管阻力及子宮動脈血流參數(shù)隨孕周增加而減低,以早中孕期變化顯著,中晚孕期左室充盈壓增長迅速;2與單胎孕婦相比,雙胎孕婦中孕期心率、心輸出量及晚孕期舒張期血壓高,各孕期子宮動脈血流參數(shù)低,早孕期舒張早期切跡存在率低。
[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.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院超聲科;
【基金】：首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院科研基金資助項目(201207) 北京市醫(yī)藥管理局“登峰”計劃專項經(jīng)費資助(DFL20151302)
【分類號】：R714.1;R445.1

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