胎儿心率或能预测长QT综合征

2012-11-16 范伟伟译 医学论坛网

     近期一项针对胎儿长QT综合征(LQTS)的研究表明,对于正常和患有LQTS的胎儿,胎心率(FHR)随着胎龄(GA)发生变化。对于FHR≤GA第三百分位区间的患儿,新生儿出生后的评价可能会提高LQTS胎儿,新生儿和未确诊家庭成员的确诊。研究于2012年11月2日在线发表于《循环》(Circulation)杂志。   胎儿长QT综合征(LQTS)与复杂的心律失常,包括尖端扭转型室性心动过

  胎心率

  近期一项针对胎儿长QT综合征(LQTS)的研究表明,对于正常和患有LQTS的胎儿,胎心率(FHR)随着胎龄(GA)发生变化。对于FHR≤GA第三百分位区间的患儿,新生儿出生后的评价可能会提高LQTS胎儿,新生儿和未确诊家庭成员的确诊。研究于2012年11月2日在线发表于《循环》(Circulation)杂志。

  胎儿长QT综合征(LQTS)与复杂的心律失常,包括尖端扭转型室性心动过速和二度房室(AV)传导阻滞相关。此外,胎儿LQTS还与窦性心动过缓相关,但这种节律表现尚不明确。该研究旨在评价LQTS胎儿的心率(FHR)/胎龄(GA)特征。

  研究通过家族史(第1组)或胎儿心律失常医疗处置(第2组)确诊LQTS胎儿。比较LQTS受试胎儿与正常胎儿的FHR。为确定LQTS的FHR预测因素,研究者计算了“心动过缓指数”,即LQTS的FHR记录百分率≤110 bpm(产科标准)或≤GA的第三百分位区间。在42例LQTS受试胎儿中,有26例在第1组,16例在第2组,共有536例正常胎儿。胎心率≤110次的胎儿心动过缓指数只有15%,而在FHR≤GA第三百分位区间者为66%。其中,10例患有复杂性心律失常的胎儿在整个妊娠期同时患有严重和持续的窦性心动过缓。在第2组中,因识别胎儿先证而导致LQTS诊断者发生在6个家庭的9例意料之外的患儿。

 

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