胎儿主肺动脉多普勒参数与孕周相关性的研究

Study on the Correlation between Fetal Main Pulmonary Artery Doppler Parameters and Gestational Age

摘要: 目的：探讨正常胎儿在孕晚期其主肺动脉多普勒流速曲线参数与孕周的关系。方法：收集2021年8月至2022年7月在青岛大学附属威海市立第二医院进行超声检查的正常单胎孕妇共139例作为研究对象(孕龄28~40周)，根据孕龄为4组(28~31⁺⁶ W组、32~34⁺⁶ W组、35~36⁺⁶ W组、≥37 W组)，测量其胎儿主肺动脉多普勒参数，包括收缩期加速时间(AT)、射血时间(ET)、收缩期峰值流速(PSV)、搏动指数(PI)、阻力指数(RI)、胎儿主肺动脉内径等六项参数，并计算加速时间/射血时间(AT/ET)，比较不同孕周胎儿主肺动脉多普勒参数及内径之间的差异，进一步进行两两组间差异分析，并进行相关性及回归性分析，均以P < 0.05有统计学意义。结果：发现胎儿主肺动脉内径及多普勒参数AT、ET、AT/ET、PSV与孕龄呈显著正相关(r = 0.821、0.780、0.260、0.749、0.323，P均 < 0.05)，RI、PI均与孕龄无相关性(r = −0.164、−0.134，P均 > 0.05)，且组间差异具有统计学意义。结论：正常胎儿孕晚期时，主肺动脉内径及多普勒相关参数与孕周具有一定的相关性，其中以内径、AT、AT/ET与孕龄相关性最高，可为产前评估胎肺成熟度提供有价值的参考指标。

Abstract: Objective: To investigate the relationship between the parameters of Doppler flow velocity curve of main pulmonary artery of normal fetus in the third trimester of pregnancy and the gestational age. Methods: A total of 139 normal singleton pregnant women who underwent ultrasound examination in Weihai Municipal Second Hospital Affiliated to Qingdao University from August 2021 to July 2022 were collected as the study subjects (gestational age: 28~40 weeks). According to the gestational age of 4 groups (28~31⁺⁶ W group, 32~34⁺⁶ W group, 35~36⁺⁶ W group, ≥37 W group), their fetal main pulmonary artery Doppler parameters, including systolic acceleration time (AT), ejection time (ET), systolic peak velocity (PSV), six parameters such as pulsation index (PI), resistance index (RI) and fetal main pulmonary artery diameter were calculated, and the acceleration time/ejection time (AT/ET) was calculated to compare the differences between fetal main pulmonary artery Doppler parameters and diameter at different gestational weeks. The differences between the two groups were further analyzed, and the correlation and regression analysis were performed, all of which were statistically significant with P < 0.05. Results: The diameter of fetal main pulmonary artery and Doppler parameters AT, ET, AT/ET, PSV were significantly positively correlated with gestation-al age (r = 0.821, 0.780, 0.260, 0.749, 0.323, P < 0.05), while RI and PI were not correlated with gestational age (r = −0.164, −0.134, P > 0.05), and the difference between groups was statistically significant. Conclusion: In the third trimester of pregnancy, the diameter of the main pulmonary artery and Doppler parameters have certain correlation with the gestational age, among which the diameter, AT, AT/ET have the highest correlation with gestational age, which can provide valuable reference indicators for prenatal evaluation of fetal lung maturity.