目的 探讨正常孕晚期胎儿产前和产后肺动脉血流多普勒频谱的变化情况, 为早期发现新生儿疾病提供依据。方法 将265例受检者分为3组, 孕晚期(32～40周)为A组, 生后1 d为B组, 生后28 d为C组, 分别测量各组胎儿及新生儿主肺动脉加速时间(accelerating time, AT)、主肺动脉峰值流速(the main pulmonary artery peak velocity, VMPA)及右肺动脉峰值流速(the right pulmonary artery peak velocity, VRPA), 并进行统计学对比分析。结果 AT值正常孕晚期胎儿(0.059±0.012) s、生后1 d新生儿(0.072±0.010) s及生后28 d新生儿(0.085±0.010) s比较, 差异有统计学意义(P＜0.05);正常孕晚期胎儿、生后1 d新生儿、生后28 d新生儿VMPA及VRPA比较, 差异均有统计学意义(P＜0.05)。但生后1 d新生儿与生后28 d新生儿VMPA及VRPA差异均无统计学意义。结论 AT不随年龄增长, 需警惕病理性肺动脉高压;VMPA及VRPA持续增快, 需警惕病理性肺动脉狭窄及右心容量负荷增重等疾病。

Objective To study the changes of the pulmonary arterial Doppler spectrum from the third trimester to neonatal period, and consider possible basis for early detection and identification of neonatal disease. Methods 265 patients were divided into three groups: the third trimester(32-40 weeks)for group A, one day after birth for group B, 28 days after birth for group C. We recorded the accelerating time (AT), the main pulmonary artery peak velocity (VMPA), the right pulmonary artery peak velocity (VRPA) for each group, and made statistical analysis. Results The AT values in the third trimester, one day after birth and 28 days after birth were (0.059±0.012) s, (0.072±0.010) s, and (0.085±0.010) s. The differences had statistical significance(P<0.05). The differences between the three groups of VMPA, VRPA had statistical significance(P<0.05). But the difference between one day after birth and 28 days after birth of VMPA and VRPA had no statistical significance. Conclusions We should think highly of pathological pulmonary hypertension if the AT do not grow with the age; and pay attention to pulmonary stenosis and disease of right ventricular volume overload if the VMPA and VRPA increase normally.