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目的探讨孕晚期正常胎儿产前产后主动脉弓峡部血流量参数的正常值。方法对120例孕晚期胎儿分别于产前、产后1~90d、产后91~180d三个不同时期进行超声心动图检查,获取主动脉各段、肺动脉瓣环内径(D)及左心室排血量(QAO)、右心室排血量(QPA)、联合心输出量(QAO+QPA)。比较不同时期内径及流量参数的变化。结果不同时期QAO、QPA、QAO+QPA随年龄呈递增趋势;QAO-A/QAO、QAO-A/(QAO+QPA)随年龄增长均呈递增趋势,流量参数有统计学意义。产后主动脉弓各段内径随年龄增长呈增加趋势,差异有统计学意义;产后主动脉弓各段与升主动脉内径比值、主动脉弓峡部与相邻降主动脉内径的比值变化不明显,差异无统计学意义。结论流量参数对于评估产前产后主动脉弓形态演变较内径参数灵敏度高。相应正常参考值的建立有助于对早期主动脉峡部血流量异常可能造成的继发形态学异常起到更有效的预警提示作用。
Objective To investigate the normal values of isthmic aortic arch isthmus blood flow parameters in prenatal and postnatal normal fetuses. Methods 120 cases of third trimester fetuses were examined by echocardiography at prenatal, postnatal days 1 ~ 90, postnatal 91 ~ 180d respectively, and the aortic segments, the diameter of the pulmonary valve annulus (D), and the left ventricular mass QAO, QPA and QAO + QPA. Compare the changes of inner diameter and flow parameters in different periods. Results The QAO, QPA and QAO + QPA showed an increasing trend with age. The QAO-A / QAO and QAO-A / QAO-QPA showed an increasing trend with age, and the flow parameters were statistically significant. The diameter of each segment of postpartum aortic arch increased with age, the difference was statistically significant; the ratio of postpartum aortic arch segments and ascending aorta ratio, the ratio of aortic arch isthmus to the adjacent descending aorta diameter had no significant difference, the difference was not statistically significant. Conclusion The flow parameters are more sensitive than the inner diameter parameters in assessing the morphological changes of the aortic arch before and after delivery. The establishment of the corresponding normal reference value will help the early aortic isthmus blood flow abnormalities may cause secondary morphological abnormalities play a more effective early warning role.