应用双脉冲多普勒技术探讨中晚孕期胎儿主动脉脉搏波传导速度（PWV）与孕龄及心脏各瓣环内径的相关性及宫内发育特点。

前瞻性收集2024年10月至2025年3月在中南大学湘雅二医院超声医学科行胎儿超声检查的中晚孕期（18~39⁺⁶周）正常胎儿。使用双脉冲多普勒技术测量中晚孕期正常胎儿主动脉PWV，获得149例胎儿升主动脉PWV和201例胎儿降主动脉PWV。比较升主动脉与降主动脉PWV；分析升主动脉、降主动脉PWV与孕龄及心脏各瓣环内径[二尖瓣瓣环（MV）、三尖瓣瓣环（TV）、主动脉瓣环（AV）及肺动脉瓣环（PAV）]的相关性；拟合多种回归模型，选出最佳拟合曲线。

中晚孕期正常胎儿升主动脉、降主动脉PWV随孕龄增加而增加（r=0.30、0.38，P均＜0.01），以Sigmoid曲线拟合度最佳。降主动脉PWV在中孕期和晚孕期均明显大于升主动脉PWV，中孕期降主动脉与升主动脉PWV比较[（2.22±0.44）m/s vs（1.03±0.42）m/s]，差异有统计学意义（P＜0.01）；晚孕期降主动脉与升主动脉PWV比较[2.48（2.32，2.66）m/s vs 1.31（1.10，1.47）m/s]，差异有统计学意义（P＜0.01）。中晚孕期正常胎儿升主动脉、降主动脉PWV与各瓣环内径呈正相关（MV：r=0.26、0.34，TV：r=0.24、0.36，AV：r=0.28、0.33，PAV：r=0.28、0.39，P均＜0.01）。

本研究应用双脉冲多普勒技术发现胎儿主动脉PWV随孕龄增加而增加，揭示了胎儿主动脉PWV的节段性分布差异，有助于后期深入探索胎儿主动脉功能，为临床对胎儿主动脉弹性的定量评估提供了新的参考指标。

To investigate the correlation of fetal aortic pulse wave velocity (PWV) with gestational age and cardiac annulus diameters in the second and third trimesters of pregnancy, and to explore the specific characteristics of fetal intrauterine growth and development.

This prospective study included normal fetuses (gestational age: 18 weeks to 39⁺⁶ weeks) undergoing fetal ultrasound at the Second Xiangya Hospital from October 2024 to March 2025. Dual-gate Doppler ultrasound successfully acquired valid measurements for ascending aortic PWV in 149 cases and descending aortic PWV in 201 cases. PWV was compared between the ascending and descending aorta, and the correlation of ascending and descending aortic PWV with gestational age and diameters of cardiac annuli, including the mitral valve annulus (MV), tricuspid valve annulus (TV), aortic valve annulus (AV), and pulmonary valve annulus (PAV), were analyzed. Multiple regression models were constructed to determine the optimal curve fitting.

Both ascending and descending aortic PWV showed a significant positive correlation with gestational age (r=0.30 and 0.38, respectively, both P＜0.01), with a Sigmoid curve showing the best goodness of fit. Descending aortic PWV was significantly higher than ascending aortic PWV in both the second and third trimesters [second trimester: (2.22±0.44) m/s vs (1.03±0.42) m/s, P＜0.01; third trimester: 2.48 (2.32, 2.66) m/s vs 1.31 (1.10, 1.47) m/s, P＜0.01] Additionally, there was a positive correlation between ascending and descending aortic PWV and each cardiac annulus diameter in normal second and third trimester fetuses (MV: r=0.26 and 0.34; TV: r=0.24 and 0.36; AV: r=0.28 and 0.33; PAV: r=0.28 and 0.39; all P＜0.01).

This study adopted the dual-pulse Doppler technique and demonstrated that fetal aortic PWV increases with gestational age, while also revealing segmental distribution differences in fetal aortic PWV. These findings facilitate further investigation of fetal aortic function and provide a novel reference indicator for the clinical quantitative assessment of fetal aortic elasticity.