子痫前期孕妇胎儿血流频谱与早产儿脑发育的相关性

目的 观察子痫前期（PE）孕妇胎儿脐动脉（UA）及大脑中动脉（MCA）血流频谱与其所生早产儿颅脑各向异性分数（FA）的相关性。方法 以43例PE孕妇分娩的早产儿为观察组，同期43例孕龄相匹配且无高危围产因素孕妇娩出的早产儿为对照组，分析2组胎儿期血流频谱参数，包括UA收缩期峰值流速/舒张末期流速（UA-S/D）及搏动指数（UA-PI），MCA-S/D、MCA-PI，UA-S/D与MCA-S/D的比值（UA/MCA）-S/D]；比较新生儿期脑各部位FA值；分析血流频谱参数与FA值的相关性。结果 观察组胎儿UA-S/D、UA-PI及（UA/MCA）-S/D高于对照组，而MCA-PI及MCA-S/D低于对照组（P均<0.001）；观察组早产儿颅脑内囊后肢、丘脑、尾状核、额叶白质、顶叶白质、大脑脚及小脑FA值均低于对照组（P均<0.05）。观察组FA均值与UA-S/D、MCA-S/D均呈负相关（r=-0.668、-0.957，P=0.025、0.002）。2组内囊后肢FA值与UA-PI呈负相关（r=-0.220，P=0.021），与MCA-S/D呈正相关（r=0.462，P<0.001）；FA均值与UA-PI呈负相关（r=-0.341，P=0.001），与MCA-PI呈正相关（r=0.206，P=0.049）。结论 胎儿UA及MCA血流频谱参数与FA具有一定相关性，可用于评估PE孕妇所娩早产儿脑发育情况。

Correlation between the fetal blood flow spectrum of pregnant women with Preeclampsia and brain development of premature infants

Objective To explore the correlation of fetal umbilical artery (UA) and middle cerebral artery (MCA) blood flow spectrum of pregnant women with preeclampsia (PE) and neonatal brain fractional anisotropy (FA). Methods Totally 43 premature infants delivered by pregnant women with PE were selected as observation group, while 43 premature infants with matched gestational age but no high-risk perinatal factors were taken as control group. Fetal blood flow spectrum parameters, including peak systolic velocity/end diastolic velocity (S/D) and pulse index (PI) of UA (UA-S/D, UA-PI), MCA-S/D, MCA-PI, and the ratio of UA-S/D to MCA-S/D (UA/MCA]-S/D) were retrospectively analyzed. The FA value of different parts of the brain in neonatal period were compared, and the correlation of blood flow spectrum parameters and FA value were analyzed. Results The fetal UA-S/D, UA-PI and (UA/MCA)-S/D in observation group were higher, while MCA-PI and MCA-S/D in observation group were lower than those in control group (all P<0.001). FA values of posterior limb of internal capsule, thalamus, caudate nucleus, white matter of frontal lobe, white matter of parietal lobe, cerebral peduncle and cerebellum were lower in observation group (all P<0.05). In observation group, FA mean was negatively correlated with UA-S/D and UA-PI (r=-0.668,-0.957; P=0.025, 0.002). Among all 86 premature infants, the FA value of posterior limb of internal capsule was negatively correlated with UA-PI (r=-0.220, P=0.021) and positively correlated with MCA-S/D (r=0.462, P<0.001), FA mean was negatively correlated with UA-PI (r=-0.341, P<0.001) and positively correlated with MCA-PI (r=0.206, P=0.049). Conclusion The blood flow spectrum parameters of fetal UA combined with MCA have certain correlation with FA, which can be used to evaluate the brain development of premature infants delivered by pregnant women with PE.