Nomura Roseli Mieko Yamamoto, Brizot Maria de Lourdes, Liao Adolfo Wenjaw, Nishie Estela Naomi, Zugaib Marcelo
Department of Obstetrics and Gynecology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
J Matern Fetal Neonatal Med. 2013 Feb;26(3):246-9. doi: 10.3109/14767058.2012.733746. Epub 2012 Oct 18.
To study the effect of fetal anemia on fetal cardiac troponin T (cTnT) in pregnancies complicated by RhD alloimmunization.
Twenty pregnant women complicated by RhD alloimmunization who underwent intrauterine transfusion (IUT) for treatment of fetal anemia were studied. Immediately before IUT, fetal blood was obtained for hemoglobin and cTnT measurements.
Complete measurements of hemoglobin and cTnT before IUT were obtained in 49 procedures, of which 20 were first-time. The regression analysis between hemoglobin z-score and cTnT values in 49 procedures showed significant negative correlation (r = -0.43, p = 0.002, Regression equation Log(cTnT) = -1.5057 + -0.07563 Hb z-score). Cardiac TnT values before first IUT were significantly associated with perinatal death. In the group with elevated cTnT (n = 7), fetal or neonatal death was more frequent (2 IUD and 2 NND) when compared to normal cTnT group (n = 13, 1 IUD) (57.1 vs. 7.7%, p = 0.031, Fisher's exact test).
Fetal blood concentration of cTnT before IUT was negatively correlated to hemoglobin z-score, and levels of cTnT help to manage the pregnancies complicated by RhD alloimmunization.
研究胎儿贫血对RhD血型同种免疫妊娠中胎儿心肌肌钙蛋白T（cTnT）的影响。
研究20例因RhD血型同种免疫而接受宫内输血（IUT）治疗胎儿贫血的孕妇。在IUT前即刻获取胎儿血液用于血红蛋白和cTnT测量。
在49次操作中获得了IUT前血红蛋白和cTnT的完整测量值，其中20次为首次测量。49次操作中血红蛋白z评分与cTnT值之间的回归分析显示出显著的负相关（r = -0.43，p = 0.002，回归方程Log(cTnT) = -1.5057 + -0.07563 Hb z评分）。首次IUT前的心肌肌钙蛋白T值与围产期死亡显著相关。在cTnT升高组（n = 7）中，与正常cTnT组（n = 13，1例宫内死亡）相比，胎儿或新生儿死亡更为频繁（2例宫内死亡和2例新生儿死亡）（57.1%对7.7%，p = 0.031，Fisher精确检验）。
IUT前胎儿血液中cTnT浓度与血红蛋白z评分呈负相关，cTnT水平有助于管理RhD血型同种免疫的妊娠。
