FETAL DOPPLER ECHOCARDIOGRAPHIC ASSESSMENT OF CARDIAC BLOOD FLOW VELOCITY IN NORMAL FETUSES AND IN THOSE WITH CONGENITAL HEART DISEASE
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概要
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妊娠16週より40週までの正常胎児72例および先天性心疾患5例 (肺動脈弁狭窄2例, 肺動脈弁閉鎖1例, ファロー四徴症1例, 心内膜床欠損1例) を対象とし, のべ90回の超音波ドプラ法を施行した。ドプラビームを左室, 右室, 大動脈, 肺動脈の長軸にそれぞれ平行に設定し, 血流速度波形を記録した。それぞれの血流速度波形より, 僧帽弁を通過する最高血流速度 (MVMax), 三尖弁を通過する最高血流速度 (TVMax), 大動脈弁を通過する最高血流速度 (AVMax), 肺動脈弁を通過する最高血流速度 (PVMax) を求め, その比を計算した。1) 正常胎児において, MVMax, TVMax, AVMax, PVMaxの描出率は, それぞれ69.4%, 68.2%, 77.6%, 43.5%であった。2) 正常胎児においては, MVMax, TVMax, AVMax, PVMaxは, それぞれ妊娠週数とよい相関を示した。3) 正常胎児において, MVMax, TVMax, AVMax, PVMaxは, それぞれ心拍数との間に相関は認められなかった。4) 正常胎児でTVMax/MVMaxの比が1以上を示した症例は55例中53例 (96.4%) であり, PVMax/AVMaxの比が1以上を示した症例は25例中11例 (44%) であった。5) 肺動脈弁狭窄ではTVMaxが比較的低値を示し, PVMaxが著明な高値を示した。また, TVMax/MVMaxの比が1例で0.8, 他の1例で1.0であった。ファロー四徴症の1例ではAVMaxが著明に低値を示し, 心内膜床欠損の1例でも明らかに低い値を示した。以上の結果より, 超音波ドプラ法は正常胎児および先天性心疾患児の子宮内循環動態を解析するうえで有用な検査法であると思われる。
- 社団法人日本産科婦人科学会の論文
- 1989-02-01
著者
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HATA Toshiyuki
Department of Perinatology and Gynecology, Kagawa University School of Medicine
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Hata Toshiyuki
Department Of Obstetrics And Gynecology Shimane Medical University
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KITAO Manabu
Department of Obstetrics and Gynecology, Shimane Medical University
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Kitao Manabu
Department Of Obstetrics And Gynecology Shimane Medical University
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高宮 収
島根医科大学医学部産科婦人科学教室
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高宮 収
Department of Obstetrics and Gynecology, Shimane Medical University
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HATA Toshiyuki
Department of Obstetrics and Gynecology, Shimane Medical University
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