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投稿时间：2021-10-30 网络发布日期：2022-03-20
投稿时间：2021-10-30 网络发布日期：2022-03-20
中文摘要: 目的 分析中晚孕期胎儿在左、右室流出道切面和三血管切面测量主动脉与肺动脉内径获得参数之间的关系与差异，探讨大动脉定量评估的最佳测量方法。 方法 选取2019年9月至2020年9月南京医科大学附属妇产医院常规行胎儿超声心动图检查的孕周24~30周的980名孕妇，行胎儿生长指标测量。分别于左、右室流出道切面测量胎儿主动脉内径(AO)、肺动脉内径(PA)，三血管切面测量主动脉内径(AO′)，肺动脉内径(PA′)。在标准四腔心切面于心室舒张末期分别测量左心室横径(LVW)、左心室纵径(LVL)、右心室横径(RVW)、右心室纵径(RVL)。比较不同切面测量获得的主动脉内径(AO与AO′)、主肺动脉内径(PA与PA′)、大动脉内径比值(AO/PA与AO′/PA′)。分析上述各变量间的规律性，各变量与心室径线间的相关性。对两种不同切面测量大动脉内径所获得参数进行对比分析。 结果 （1）流出道切面和三血管切面测得的AO、PA、AO′、PA′均与孕周呈线性正相关(r=0.858、0.821、0.803、0.070，P＜0.01)，AO/PA、AO′/PA′与孕周无相关性（P＞0.05）。（2）流出道切面、三血管切面测得的AO［（4.44±0.27）mm vs (4.54±0.36)mm,P＜0.01］、PA［（5.24±0.30）mm vs (5.34±0.45)mm,P＜0.01］差异有统计学意义，AO/PA差异无统计学意义(0.84±0.35 vs 0.85±0.12,P＞0.05)。（3）AO与LVW及LVL呈正相关(r=0.330、0.247,P<0.01)，AO′与LVW与LVL呈正相关(r=0.191、0.156,P＜0.01)，AO与LVW及LVL的相关性更高。PA与RVW及RVL呈正相关(r=0.262、0.181,P＜0.01)，PA′与RVW及RVL呈正相关(r=0.114、0.164,P＜0.01)，PA与RVW及RVL的相关性更高。 结论 流出道切面可作为测量大动脉内径的常规切面，三血管切面可作为测量大动脉内径的辅助切面。两种测量方法联合运用可准确评估心室及大动脉的发育情况。
Abstract:Objective To analyze the relationship and differences of the inner diameters of aorta and pulmonary artery measured by left and right ventricular outflow view and the three-vessels view echocardiography in normal fetuses during the second and late trimesters to explore the best measurement method for quantitative evaluation of the great arteries. Methods From September 2019 to September 2020, 980 pregnant women who received routine fetal echocardiography at 24-30 gestational weeks in Women's Hospital of Nanjing Medical University were selected for fetal growth index measurement. Fetal aortic (AO) diameter and pulmonary artery (PA) diameter were measured by left and right ventricular outflow tract view(AO,PA) and three-vessel view(AO′,PA′), respectively. Left ventricular width (LVW), left ventricular-length(LVL), right ventricular width (RVW) and right ventricular-length(RVL)were measured at the end of ventricular diastole by the standard four-chamber view. The values of AO and AO′, PA and PA′, AO/PA and AO′/PA′ measured in different view were compared. The regularity of the above variables and the correlation between the variables and ventricular diameter were analyzed. The parameters obtained by measuring the diameter of large artery in two different view were compared and analyzed. Results The values of AO, PA, AO′ and PA′ measured in outflow tract view and three vessel view were linearly and positively correlated with gestational weeks(r=0.858, 0.821, 0.803, 0.070, P＜0.01), while AO/PA and AO′/PA′ were not correlated with gestational weeks(P＞0.05). There were significant differences in AO［(4.44±0.27) mm vs (4.54±0.36) mm］ and PA［(5.24±0.30) mm vs (5.34±0.45) mm］ measured in outflow tract view and three vessel view (P<0.01), but there was no significant difference in AO/PA (0.84±0.35 vs 0.85±0.12, P>0.05). AO and AO′ were positively correlated with LVW(r=0.330, 0.247,P＜0.01) and LVL(r=0.191,0.156, P<0.01). PA and PA′ were positively correlated with RVW(r=0.262, 0.181,P＜0.01) and RVL (r=0.114, 0.164, P<0.01). AO and PA had higher correlation with LVW,LVL, RVW and RVL. Conclusion Ventricular outflow tract view in echocardiography can be used as a routine view in measuring the inner diameter of cardiac arteries of fetuses, with the three-vessels view as an auxiliary method. Combined application of the different view helps to evaluate the normal development of ventricle and great artery in fetuses.
keywords: Echocardiography Fetus Aortic diameter Pulmonary artery diameterl Ventricular outflow tract view Three-vessels view
文章编号： 中图分类号：R714.5,R540.45 文献标志码：B
基金项目:南京市卫生科技发展专项资金项目（YKK18155）
引用文本：
周婷，吴云，杨玲，叶夏慧.超声心动图不同切面测量正常胎儿大动脉内径的对比[J].中国临床研究,2022,35(3):360-363.
周婷，吴云，杨玲，叶夏慧.超声心动图不同切面测量正常胎儿大动脉内径的对比[J].中国临床研究,2022,35(3):360-363.