临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (7): 662-.doi: 10.3969 j.issn.1000-3606.2015.07.015

• 文献综述 • 上一篇    下一篇

胎儿免疫性房室传导阻滞研究进展

严华林1,2,李一飞1,2 综述 周开宇1,3 ,华益民1,3 审校   

  1. 1. 四川大学华西第二医院儿科,2. 四川大学华西临床医学院,3. 妇儿疾病与出生缺陷教育部重点实验室( 四川成都 610041)
  • 收稿日期:2015-07-15 出版日期:2015-07-15 发布日期:2015-07-15
  • 基金资助:
    国家自然科学基金资助项目(No.81070136、81270226);四川省科技支撑计划项目(No.2014SZ0009);成都市科技项目 (No.2014-HM01-00006-SF)

Advances in fetal immune mediated atrioventricular block

Reviewer: YAN Hualin 1,2, LI Yifei 1,2, Reviser: ZHOU Kaiyu 1,3,HUA Yimin 1,3   

  1. 1. Department of Pediatrics, West China Second University Hospital, Sichuan University, 2. West China Medical School of Sichuan University, 3.Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610041, Sichuan, China
  • Received:2015-07-15 Online:2015-07-15 Published:2015-07-15

摘要: 胎儿房室传导阻滞属于胎儿缓慢性心律失常。当母体血清抗-SSA/Ro、抗-SSB/La抗体阳性时,胎儿完全性房室传导阻滞发病率和相关围生期胎儿/新生儿死亡率显著升高。母体血清自身抗体可经胎盘转运进入胎儿体内,可能导致胎儿心脏传导系统免疫损伤,从而引起房室传导阻滞发生。如果能进行胎儿免疫性房室传导阻滞的早期诊断和及时干预,可能阻止病情进展,改善免疫性房室传导阻滞胎儿的预后并提高其生存率。文章综述胎儿免疫性房室传导阻滞的发病机制、危险因素、产前诊断、胎儿期干预及预后等。

Abstract:  Fetal atrioventricular block (AVB) is a type of fetal bradyarrhythmias. The reported incidence of fetal complete atrioventricular block (CAVB) and mortality of perinatal fetuses and neonates are significantly higher in pregnancies of anti-SSA/Ro-positive mothers than that of anti-SSA/Ro-negative mothers. The auto-antibodies in maternal serum that can be transported into fetal circulation through placenta may damage fetal cardiac conductive system and eventually result in fetal AVB. There are evidences that early diagnosis and proper treatment can improve the prognosis and survival rate of affected fetuses. In this article, the pathogenesis, risk factors, prenatal diagnosis, treatment and prognosis of fetal immune mediated AVB is reviewed.