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目的探讨超声软指标评估早孕期胎儿心脏结构的价值。方法选择2011年1月-2014年12月间来该院进行围产期保健的行非整倍体染色体异常筛查及胎儿结构筛查的孕妇2 648例,观察期非整倍体染色体异常核型及胎儿心脏结构,并在其孕中、孕末期进行随访其妊娠结局。结果早孕期诊断先天性心脏病的胎儿共计为10例,其中左心室发育不全3例,完全型心内膜垫缺损2例,三尖瓣反流1例,单腔心2例,右心发育不良2例。其中4例异常核型,6例正常。单个软指标和多个软指标联合筛查异常核型发生率比较,χ~2=8.227,P<0.05,差异具有统计学意义;单个软指标和多个软指标联合筛查非整倍体发生率比较,χ~2=6.393,P<0.05,差异具有统计学意义。NT厚度≥3.0 mm的敏感度为50%,TR的诊断敏感度为30%,DVa波倒置的诊断敏感度为50%。NT厚度≥3.0 mm的特异度为3.97%,TR的诊断特异度为2.95%,DVa波倒置的诊断特异度为2.15%。结论超声软指标可用于早孕期胎儿心脏结构异常的初筛,且多个指标联合应用可提高敏感度和特异度。
Objective To investigate the value of ultrasound soft index in assessing fetal cardiac structure in early pregnancy. Methods A total of 2 648 pregnant women with aneuploidy and aneuploidy from January 2011 to December 2014 were enrolled in this study. The aneuploidy of aneuploidy Type and fetal heart structure, and in their pregnancy, the end of pregnancy to follow-up of their pregnancy outcome. Results The number of fetuses diagnosed as congenital heart disease during the first trimester was 10 cases, including 3 cases of left ventricular hypoplasia, 2 cases of complete endocardial cushion defect, 1 case of tricuspid regurgitation, 2 cases of single heart cavity and 2 cases of right heart development Bad 2 cases. 4 cases of abnormal karyotype, 6 cases were normal. A single soft index and a number of soft indicators combined screening of abnormal karyotype comparison rate, χ ~ 2 = 8.227, P <0.05, the difference was statistically significant; a single soft index and a number of soft indicators combined screening for aneuploidy Rates, χ ~ 2 = 6.393, P <0.05, the difference was statistically significant. The NT sensitivity of 50% was ≥3.0 mm, the diagnostic sensitivity of TR was 30%, and the diagnostic sensitivity of DVa wave inversion was 50%. The specificity of NT ≥3.0 mm was 3.97%, the diagnostic specificity of TR was 2.95%, and the specificity of DVa inversion was 2.15%. Conclusion Ultrasound soft index can be used to screen the fetal heart structure abnormalities in early pregnancy, and the combination of multiple indexes can improve the sensitivity and specificity.