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目的测量妊娠中晚期胎儿孤立性心包积液左心室的Tei指数,分析Tei指数与胎龄的关系,初步评估其临床应用价值。方法选择产前经彩色多普勒超声检查显示有心包积液、没有结构异常及心律异常胎儿的孕妇(异常组)53例,其胎儿均为孤立性心包积液[胎儿53例,男28例,女25例,胎龄18～23(20.3±0.4)周]。分别于<23、≥23～<27、≥27～<31、≥31～<35、≥35孕周进行胎儿超声心动图检查,同时应用组织多普勒技术测量左心室的Tei指数,并与正常对照组进行比较。结果心包积液大量组<23孕周ICT+IRT、Tei指数值均明显高于正常对照组(均P<0.05),中量组<23、≥31～<35孕周ICT+IRT值均明显低于大量组(均P<0.05),大量组、中量组≥23～<27、≥27～<31、≥31～<35、≥35孕周ICT+IRT值明显高于正常对照组、少量组(均P<0.05),中量组≥23～<27、≥27～<31孕周ICT+IRT、Tei指数值均明显低于大量组(均P<0.05),大量组≥23～<27、≥27～<31、≥31～<35、≥35孕周的Tei指数值均明显高于正常对照组、少量组(均P<0.05),中量组≥27～<31、≥35孕周Tei指数值均明显高于正常对照组、少量组(均P<0.05)。结论妊娠中晚期胎儿孤立性心包积液有少量的,其左心室的整体功能正常;胎儿孤立性心包积液有中量及大量的,其左心室的整体功能减低。Tei指数测量方法简单、快捷、可靠,Tei指数是评价妊娠期心包积液胎儿心功能和预后的理想指标。
Objective To measure the Tei index of left ventricle in isolated fetus with perinatal pregnancy and to analyze the relationship between Tei index and gestational age and to evaluate its clinical value. Methods Fifty-three pregnant women (abnormal group) with pericardial effusion, no structural abnormalities and abnormal heart rhythm were selected by prenatal color Doppler sonography. The fetuses were all isolated pericardial effusion (fetus 53 cases, male 28 cases , Female 25 cases, gestational age 18 ~ 23 (20.3 ± 0.4) weeks]. Fetal echocardiography was performed in <23, ≥23 ~ <27, ≥27 ~ <31, ≥31 ~ <35, ≥35 gestational weeks, respectively. Tei index of left ventricle was also measured by tissue Doppler imaging. Normal control group for comparison. Results The levels of ICT + IRT and Tei index in a large number of groups of <23 gestational weeks were significantly higher than those in the normal control group (all P <0.05) (P <0.05). The ICT + IRT values of the large and medium dose groups of ≥23 ~ <27, ≥27 ~ <31, ≥31 ~ <35, ≥35 gestational weeks were significantly higher than those of the normal control group, (All P <0.05). The ICT + IRT and Tei index of the middle-term group were significantly lower than those of the large group (all P <0.05) The Tei index values of ≥ 27 gestational weeks <27, ≥27 ~ <31, ≥31 ~ <35, ≥35 gestational weeks were significantly higher than those of the normal control group and the minor ones (all P <0.05) Tei index of 35 gestational weeks were significantly higher than the normal control group, a small number of groups (P <0.05). Conclusions There is a small amount of solitary pericardial effusion in the second and third trimester of pregnancy, and the overall function of the left ventricle is normal. The isolated pericardial effusion of the fetus is moderate and large in quantity, and the overall function of the left ventricle is reduced. Tei index measurement method is simple, fast and reliable, Tei index is an ideal indicator to evaluate fetal cardiac function and prognosis of gestational pericardial effusion.