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目的:通过对胎儿大脑中动脉血流峰值速度(middle cerebral artery peak systolic velocity MCA-PSV)和胎儿血红蛋白关系的研究,评估胎儿MCA-PSV在预测胎儿贫血中的临床应用价值,为临床提供一种无创伤的检测胎儿贫血的新方法。方法:采用前瞻性对照研究,正常单胎组85例,正常双胎22例,胎儿贫血高危组50例,所有病例均查脐血血常规测血红蛋白含量。脐穿前1周内做MCA-PSV检测,分析胎儿MCA-PSV和胎儿血红蛋白的关系。评估胎儿MCA-PSV预测胎儿贫血的准确性。结果:①以相应孕周正常值的中位数的倍数MOM值为单位,胎儿MCA-PSV与Hb浓度呈负相关(P<0.001)。②MCA-PSV预测轻度贫血灵敏度25%,特异度98%,预测重度贫血的敏感性及特异性均为100%。③重度贫血胎儿MCA-PSV升高早于二维超声异常表现。④正常双胎与单胎MCA-PSV与Hb浓度无显著差异。结论:胎儿大脑中动脉血流峰值速度预测胎儿贫血无创伤,发现早,准确性高,可作为临床胎儿贫血尤其是重度贫血的预测指标。
OBJECTIVE: To evaluate the clinical value of fetus MCA-PSV in predicting fetal anemia through the study of the relationship between fetal cerebral artery systolic velocity velocity (MCA-PSV) and fetal hemoglobin, to provide a Noninvasive method to detect fetal anemia. Methods: In a prospective controlled study, 85 normal singletons, 22 normal twins and 50 high-risk fetal anemia patients were recruited. All cases were examined for cord blood hemoglobin. MCA-PSV test was performed within 1 week before umbilical cord penetration to analyze the relationship between fetal MCA-PSV and fetal hemoglobin. Evaluate the accuracy of fetal MCA-PSV in predicting fetal anemia. Results: ① The fetal MCA-PSV had a negative correlation with Hb concentration (P <0.001), based on the multiple MOM of the median of normal gestational weeks. ②MCA-PSV predicts mild anemia with a sensitivity of 25% and a specificity of 98%. The sensitivity and specificity of predicting severe anemia are both 100%. ③ severe anemia fetus MCA-PSV increased earlier than two-dimensional ultrasound abnormalities. ④ normal twin and singleton MCA-PSV and Hb concentration no significant difference. Conclusion: The peak velocity of fetal middle cerebral artery blood flow predicts noninvasive fetal anemia, which is found early and accurate. It can be used as a predictor of clinical anemia, especially for severe anemia.