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目的应用胎儿超声心动图短轴观评价中孕中期胎儿肺动脉、主动脉内径,通过测量不同孕周胎儿肺动脉、主动脉内径及两者比值,建立中孕中期胎儿心脏短轴观的肺动脉/主动脉内径比值的相应统计参数,并进行统计分析。方法 2008年9月—2010年10月,在非选择性的普通人群中选取6～763例常规产前检查并随访至入院分娩后3 d内接受新生儿超声心动图检查的单胎妊娠孕妇。在18～23孕周胎儿超声心动图短轴观获得肺动脉、主动脉内径,计算得出两者比值。结果 6 763例胎儿的心脏肺动脉主动脉内径比值测量值为0.18～1.80,平均值1.10±0.08,95%的参考值为1.00～1.27。其中6 699例胎儿产后超声心动图证实未见结构性异常。正常胎儿肺动脉、主动脉内径与孕周高度相关。以孕周和肺动脉、主动脉内径分别作为自变量和因变量,得到线性回归方程:Y[肺动脉内径(cm)]=-1.916+0.25 6X(孕周)(r=0.35 7,P<0.000 1);Y[主动脉内径(cm)]=-1.865+0.238X(孕周)(r=0.373,P<0.000 1)。回归方程的残差满足正态分布及方差齐性。结论在心脏短轴观上测量肺动脉、主动脉内径大小及两者比值,为产前筛查胎儿心脏流出道畸形提供了一定的参考依据。
Objective To evaluate the pulmonary artery and aorta diameter in the second trimester of fetuses by using the short axis view of fetal echocardiography and to establish the pulmonary artery / aorta of the mid-second trimester fetus by measuring the ratio of the pulmonary artery and the aorta in different gestational weeks Diameter ratio of the corresponding statistical parameters, and statistical analysis. Methods From September 2008 to October 2010, 6 to 763 routine antenatal examinations were performed among non-selective general population and followed up to singleton pregnant women who were examined by neonatal echocardiography within 3 days after delivery. In 18 to 23 gestational weeks fetus fetal epicardial short axis view of the pulmonary artery, aortic diameter, calculate the ratio between the two. Results 6 763 fetuses had a measured pulmonary artery aortic internal diameter ratio of 0.18 to 1.80 with an average of 1.10 ± 0.08 and a 95% reference value of 1.00 to 1.27. Among 6 699 fetuses, postnatal echocardiography confirmed no structural abnormalities. Normal fetal pulmonary artery, aortic diameter and gestational age are highly correlated. The linear regression equation was derived from gestational age, pulmonary artery, and aortic internal diameter as independent and dependent variables, respectively: Y [internal diameter of pulmonary artery (cm)] = - 1.916 + 0.25 6X (gestational age) ); Y [aortic diameter (cm)] = -1.865 + 0.238X (gestational age) (r = 0.373, P <0.0001). The residuals of the regression equation satisfy the normal distribution and the homogeneity of the variance. Conclusion Measurement of pulmonary artery, aortic internal diameter and the ratio between the two in short axis view of heart provide a reference for prenatal screening of fetal cardiac outflow tract deformity.