摘要
目的：探讨超声软指标与早孕期胎儿心脏严重结构异常的意义。方法选取2014年1月至2015年6月在我院进行妊娠早期超声检查的孕妇2972例，经腹或联合阴道超声检查，记录颈部透明层（NT）值、三尖瓣反流（TR）及静脉导管血流a波（DV a波）倒置等软指标情况，计算各项软指标对严重心脏畸形诊断的灵敏度与特异度。结果 2972例胎儿共诊断胎儿心脏畸形42例，包括31例严重心脏畸形，其中早孕期诊断23例，早孕期任意一项超声软指标异常对检出严重心脏畸形的敏感度为74.19%（23/31）；NT厚度为95~99百分位胎儿134例（4.51%，134/2972），7例产前诊断为心脏畸形，其中5例在早孕期诊断，2例在中孕期诊断，诊断灵敏度为22.58%（7/31），特异度为4.27%（127/2972）。NT厚度＆gt;第99百分位胎儿30例（1.01%，30/2972），13例产前诊断为心脏畸形，其中10例为早期诊断，3例为中孕期诊断，诊断灵敏度为41.94%（13/31），特异度为0.57%（17/2972）。TR 34例（1.14%），DV a波倒置70例（2.35%），而在42例产前诊断心脏畸形胎儿中，有11例合并TR，诊断敏感度为35.48%（11/31），特异度为0.77%（23/2972）；10例合并DV a波倒置，诊断敏感度为32.26%（10/31），特异度为2.01%（60/2972）。结论 NT增厚、TR和DV a波倒置对胎儿严重心脏畸形有重要的临床意义，可以为临床更早诊断先天性心脏病提供依据。
Objective To investigate the significance of ultrasonic soft marker on severe fetal cardiac structural abnormalities during the first trimester. Methods A total of 2972 pregnant women,who underwent ultrasound examination at the first trimester between January 2014 and June 2015 in our hospital, were included in the study. After transabdominal and/or transvaginal ultrasound examination,the soft markers of nuchal translucency（NT）value,tricuspid regurgitation（TR）and venous catheter bloodstream a wave（DV a wave）inversion were recorded. The sensitivity and specificity of all soft markers for the diagnosis of severe cardiac abnormalities were calculated. Results Among 2 972 fetus,42 were diagnosed with cardiac abnormalities,including 31 severe cardiac abnormalities,among whom 23 underwent the first trimester diagnosis. The sensitivity of all abnormal soft markers for the diagnosis of severe cardiac abnormalities was 74.19%（23/31）. The NT thickness of 95~99 percentile included 134 fetuses（4.51%,134/2 972）. Seven cases were diagnosed prenatally with cardiac abnormalities,including 5 diagnosed at the first trimester,2 diagnosed at the second trimester,the diagnostic sensitivity was 22.58%（7/31）,and the specificity was 4.27%（127/2 972）. The NT thickness＆gt;99th percentile（1.01%,30/2 972）were found in 30 cases. Thirteen cases were diagnosed prenatally with cardiac abnormalities,including 10 first trimester＆amp;nbsp;diagnosis,3 second trimester diagnosis,the diagnostic sensitivity was 41.94%（13/31）,and the specificity was 0.57%（17/2 972）. There were 34 TR（1.14%）and 70 DV a wave inversion（2.35%）. In 42 cases diagnosed prenatally with cardiac abnormalities,there were 11 cases with TR,the diagnostic sensitivity of 35.48%（11/31）,and the specificity was 0.77%（23/2 972）;10 cases with DV a wave inversion,the diagnostic sensitivity was 32.26%（10/31）,and the specificity was 2.01%（60/2972）. Conclusion NT thickening,TR and DV a wave inversion have clinical significance in severe fetal cardiac abnormalities, which can provide evidence for the clinical diagnosis of congenital heart disease.
出处
《中华生物医学工程杂志》
CAS
2016年第2期150-153,共4页
Chinese Journal of Biomedical Engineering
关键词
超声检查
产前
三尖瓣闭锁不全
心脏缺损
先天性
Ultrasonography,prenatal
Tricuspid valve insufficiency
Heart defects,congenital
