摘要
目的探讨超声测量正常中晚孕期胎儿四腔心观左心房后壁至降主动脉之间距离（DLD）的参考值及与胎儿生物学生长参数的相关性。方法随机连续选取进行胎儿超声心动图检查的300例孕龄为20~40周的正常单胎进行测量，获得胎儿的双顶径（BPD）、股骨长（FL）和孕龄（GA）等生物学生长参数。在胎儿标准四腔心观测量DLD[心室收缩末期距离（DLDs），心室舒张末期距离（DLDd）]。以GA、BPD及FL作为自变量，以预测的DLDs及DLDd为因变量，建立DLDs及DLDd的正常参考值范围。结果正常胎儿DLDs值为（0．32±0．08）cm，95％正常参考值范围分别为0．19～0．48cm；DLDd值为（0．43±0．10）cm，95％正常参考值范围分别为0．25～0．62cm。统计分析显示，DLDs及DLDd与GA、BPD、FL均呈显著线性相关，DLDs与GA、BPD、FL的r值分别为0．545、0．556、0．574（P〈0．001）；直线回归方程分别为：Y=0．009GA＋0．041，Y=0．038BPD＋0．028，Y=0．044FL＋0．073。DLDd与GA、BPD、FL的r值分别为0．530、0．563、0．576（P〈O．001），直线回归方程分别为：Y=0．011GA＋0．083，Y=0．048BPD＋0．063，Y=0．054FL＋0．124。结论正常胎儿的DLDs与DLDd随着孕周的增加而增加，其与GA、BPD、FL有良好的相关性，DLDs及DLDd正常范围的确定可作为正常胎儿心脏的一项新的参考标准，在胎儿相关先天性心脏畸形，尤其在胎儿全肺静脉异位引流或肺动脉瓣缺如综合征的诊断方面具有潜在的参考应用价值。
Objective To quantitatively study the distance between the left atrial posterior wall and the descending aorta （DLD） in the normal fetal four-chamber view using fetal echocardiography. Methods The distances between the left atrial posterior wall and the descending aorta in end-systole （DLDs） and in end-diastole （DLDd） were measured in a standard apical four-chamber view using fetal echocardiography in 300 normal fetuses. The gestation ages ranged from 20 to 40 weeks. Fetal non-cardiac biometric parameters included femoral length （FL）, biparietal diameter （BPD） and gestation age （GA） based on menstrual age. The correlation between DLDs, DLDd and non-cardiac biometric parameters were analyzed. Results In normal fetuses,the DLDs was （0.32 ± 0.08）cm with a range of 0.19 - 0.48 cm, the DLDd was （0.43 ± 0.10）cm with a range of 0.25 - 0.62 cm. The DLDs and DLDd increased with the growth of GA, and were correlated with GA and BPD and FL significantly （ r = 0.545, 0.556, 0.574, 0.530, 0.563 and 0.576, respectively, all P d0. 001 ）. The linear regression equations between DLDs, DLDd and GA, BPD, FL were： Y = 0.009GA＋ 0.041, Y = 0.038BPD＋ 0.028, Y =0.044 FL＋ 0.073, Y =0.011GA＋ 0.083, Y =0.048 BPD ＋ 0. 063, Y = 0.054FL ＋ 0. 124, respectively. Conclusions In normal fetuses, the DLDs and DLDd increase with the growth of GA, and have good correlation with GA, BPD, and FL respectively. Normal reference ranges of DLDs and DLDd have been provided. These normative data may be a new tool forassessment of fetal heart, especially has potential applications in screening of total anomalous pulmonary venous connection （TPVAC）, absent pulmonary valve syndrome （APVS） or other complex congenital heart defects.
出处
《中华超声影像学杂志》
CSCD
北大核心
2016年第3期203-206,共4页
Chinese Journal of Ultrasonography
