目的 分析正常孕11～14周子宫动脉及螺旋动脉的多普勒超声的特征.方法 选取410名正常孕11～14周孕妇,根据孕周分为Ⅰ组(≥11周且＜12周)、Ⅱ组(≥12周且＜13周)和Ⅲ组(13周～14周),按胎盘位置分为居中胎盘组、左侧胎盘组和右侧胎盘组；根据阻力指数(RI)分为＜0.60组、0.60～0.69组、0.70～0.74组、0.75～0.79组及≥0.80组；分析不同孕周、不同胎盘位置的子宫动脉和螺旋动脉的多普勒超声参数特征,以及子宫动脉不同RI值舒张早期存在α切迹的情况.结果 Ⅲ组子宫动脉平均RI值低于Ⅰ组(P＜0.05)；Ⅲ组平均搏动指数(PI)值低于其他两组(P均＜0.05).居中胎盘组右侧子宫动脉PI低于左侧胎盘组(P＜0.05),左、右侧胎盘组子宫动脉收缩期最大血流速度/舒张末期血流速度(S/D)及RI差异无统计学意义(P均＞0.05).左侧胎盘组左侧子宫动脉S/D、RI及PI均低于右侧胎盘组(P均＜0.01)；右侧胎盘组右侧子宫动脉S/D、RI及PI均低于左侧胎盘组(P均＜0.01).在子宫动脉RI≥0.75的孕妇中,右侧α切迹发生率79.49％(31/39),左侧89.80％(44/49).螺旋动脉各项多普勒超声参数在不同孕周、不同胎盘位置孕妇间差异均无统计学意义(P均＞0.05).结论 正常孕11～14周子宫动脉、螺旋动脉多普勒参数及胎盘位置存在一定特征,可为临床早期诊疗提供参考.%Objective To analyze characteristics of Doppler ultrasound of uterine and spiral artery at 11-14 weeks normal gestation. Methods A total of 410 pregnant women were divided into 3 groups according to gestational week, I. E. I group (≥11 weeks and <12 weeks), Ⅱ group (≥12 weeks and <13 weeks) and II group (13-14 weeks). They were also divided into 3 groups according to the location of placenta, I. E. Central placenta group, placenta on the left side and on the right side. Then the pregnant women were divided into 5 groups according to resistance index (RI) : RI<0. 60 group, 0. 60 - 0. 69 group, 0. 70 - 0. 74 group, 0. 75 - 0. 79 group and ≥0. 80 group. Doppler ultrasound parameters of uterine and spiral artery were measured in different gestational ages and different location of the placenta, while α-notch of RI index values in early diastolic of uterine artery were observed. Results The mean RI value of uterine artery in Ⅲ group was less than that in Ⅰ group (P<0. 05). The mean pulsatility index (PI) of uterine artery in Ⅲ group was less than that in the other two groups (both P<0. 05). PI index value of right uterine artery was lower than that of the left placenta group in central placenta group (P<0. 05). Systolic-to-diastolic ratio (S/D) and RI index value were not different among central, left and right placenta groups (both P>0. 05). In left placenta group, S/D, RI and PI index value of left uterine artery were all lower than those of the right (both P<0. 01). In right placenta group, S/D, RI and PI index value of right uterine artery were all lower than those of the left (both P<0. 01). Incidence rate of a-notch detected in the right and left uterine artery (RI≥0. 75) was 79. 49% (31/39) and 89. 80% (44/49) , respectively. There was no significant difference among different gestational weeks and location of the placenta in parameters of spiral artery (all P>0. 05). Conclusion There are certain relationship between Doppler ultrasound parameters of uterine artery, spiral artery and the location of placenta at 11-14 weeks gestation, which may provide references for clinical diagnosis and treatment.
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