Basic research of new modality for assessment of fetal condition using blood flow pattern in inferior vena cava

下腔静脉血流模式评估胎儿状况新模式的基础研究

• 批准号: 13671711
• 负责人: KANZAKI Toru
• 金额: $ 2.3万
• 依托单位: Osaka University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2001
• 资助国家: 日本
• 起止时间: 2001 至 2002
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13671711/
• 关键词: Fetal cardiac failure; Fetal central venous pressure; Fetal IVC blood flow; 胎児下大静脈血液; 下大静脈血流波形

Objective : In the fetal hydrops hypoxemia or acidemia are not always present, but the fetal jeopardy resulting in the death actually exists. This is the reason why the assessment of fetal circulation is imperative to evaluate the fetal wellbeing. In the fetus cardiac impairment seems to be manifested by right heart failure, thus the investigation of venous circulation is particularly important. The purpose of this study is to elucidate the usefulness of inferior vena caval (IVC) blood flow measurement for the evaluation of the fetal wellbeing and to confirm the pathophysiology which influence the blood flow of IVC using animal modelMethods : The new index named preload index (PLI) was defined to evaluate the reverse flow of the IVC. Among several fetal diseases including IUGR, the PLI values were compared. In the chronically prepared pregnant sheep animal model, the effect of the transfusion on the fetus was studiedResults : The mean of PLI is almost constant after 24 gestational weeks and the cut off value is set at 0.4 throughout this period. The PLI value was high in the case of endometrial fibroelastosis of the heart with hydrops, which represents the typical fetal heart failure. In the IUGR the elevation of PLI indicated the poor neonatal outcome. In the animal model, the correlation between the fetal central venous pressure and the blood flow pattern was confirmedConclusion : The usefulness of the IVC blood flow analysis for the assessment of the fetal condition was confirmed

目的：胎儿水肿并不一定存在低氧血症或酸血症，但导致胎儿死亡的危险是存在的。这就是为什么胎儿循环的评估对于评估胎儿健康至关重要的原因。胎儿心脏损害似乎表现为右心衰竭，因此静脉循环的检查尤为重要。本研究的目的是阐明下腔静脉（IVC）血流测量在胎儿健康评估中的应用价值，并通过动物模型证实影响IVC血流的病理生理机制。方法：定义了一个新的指标--前负荷指数（PLI）来评价IVC的反向血流。比较几种胎儿疾病（包括IUGR）的PLI值。结果：妊娠24周后PLI均值基本不变，以0.4为界值。PLI值高的情况下，子宫内膜弹力纤维增生症的心脏水肿，这代表了典型的胎儿心力衰竭。IUGR中PLI升高提示新生儿预后不良。结论：IVC血流分析对胎儿健康状况的评估是有效的

项目成果

Satoh S., T Kanzaki., et al.: "Chronologic change in Doppler indices in the umbilical and middle cerebral arteries in the Japanese fetus : JSUM standardization committee for fetal measurements."J Med Ultrasound. 9. 73-78 (2001)

Satoh S.、T Kanzaki. 等人：“日本胎儿脐动脉和大脑中动脉多普勒指数的时间变化：JSUM 胎儿测量标准化委员会。”J Med Ultrasound。

神崎 徹: "下大静脈血流波形による胎児循環動態の評価"日本産科婦人科学会雑誌. 54. 1139-1151 (2002)

Toru Kanzaki：“使用下腔静脉血流波形评估胎儿血流动力学”日本妇产科学会杂志 54. 1139-1151 (2002)。

J.Mu, T.Kanzaki, T.Tomimatsu, H.Fukuda, E.Fujii, S.Fuke, K.Wasada, H.Takeuchi, Y.Murata: "A comparative study of intraplacental vinous arteries by latex cast model in vitro and color Doppler flow imaging in vivo"J Obstet Gynaecol Res. 27. 297-303 (2001)

J.Mu、T.Kanzaki、T.Tomimatsu、H.Fukuda、E.Fujii、S.Fuke、K.Wasada、H.Takeuchi、Y.Murata：“体外乳胶模型对胎盘内静脉动脉的比较研究

神崎 徹: "下大静脈血液波形による胎児循環動態の評価"日本産婦人科雑誌. 54. 1139-1157 (2002)

Toru Kanzaki：“使用下腔静脉血液波形评估胎儿血流动力学”日本妇产科杂志 54. 1139-1157 (2002)。

M, J.Kanzaki, T.Tomimatsu, T.Fukuda, H.Fujii, E.Murata, Y: "Investigation of intraplacental villous arteries by Doppler flow imaging in growth-restricted fetuses"Am J Obstet Gynecol. 186. 297-302 (2001)

M、J.Kanzaki、T.Tomimatsu、T.Fukuda、H.Fujii、E.Murata、Y：“通过多普勒血流成像对生长受限胎儿的胎盘内绒毛动脉进行研究”Am J Obstet Gynecol。