胎儿动脉导管血流频谱与右室梗阻性疾病肺动脉发育相关分析

发布时间：2018-11-25 14:19

【摘要】：目的探讨胎儿动脉导管血流频谱与右心系统梗阻性疾病胎儿肺血管发育情况的关系。方法在4 006例胎儿的检查中选取胎儿超声心动图诊断为肺动脉狭窄或肺动脉闭锁的胎儿75例为病例组,并根据动脉导管血流频谱形态分为正向灌注组(病例组1)和逆向灌注组(病例组2),另选取与之孕周匹配的正常对照组胎儿100例,两组胎儿分别计算其肺血管相关参数,包括肺动脉/主动脉瓣环径(PA/AO)、McGoon指数及动脉导管/降主动脉(DA/DAO),进行组间比较分析。结果病例组(组1和组2)PA/AO均低于正常对照组,差异有统计学意义。病例组1的McGoon比值与正常对照组接近,差异无统计学意义;病例组2的McGoon比值明显低于组1和正常对照组,差异有统计学意义;病例组(组1和组2)和正常对照组DA/DAO无明显差异。结论胎儿超声心动图诊断动脉导管血流逆向灌注提示右心严重畸形和肺血管发育不良,预后不良。
[Abstract]:Objective to investigate the relationship between the blood flow spectrum of fetal ductus arteriosus and the development of fetal pulmonary vessels in obstructive diseases of right heart system. Methods 75 fetuses with pulmonary artery stenosis or pulmonary atresia diagnosed by fetal echocardiography were selected as the group of 4 006 fetuses. According to the blood flow spectrum of arterial ducts, they were divided into two groups: positive perfusion group (case group 1) and reverse perfusion group (case group 2). Pulmonary artery / aortic annulus diameter (PA/AO), McGoon index) and ductus arteriosus / descending aorta (DA/DAO) were compared. Results the PA/AO of the case group (group 1 and group 2) was lower than that of the normal control group (P < 0.05). The McGoon ratio of case group 1 was similar to that of normal control group, but the McGoon ratio of case group 2 was significantly lower than that of group 1 and normal control group (P < 0.05). There was no significant difference in DA/DAO between case group (group 1 and group 2) and normal control group. Conclusion Fetal echocardiographic diagnosis of adverse perfusion of arterial ducts suggests severe malformation of right heart and poor pulmonary vascular development, with poor prognosis.
【作者单位】：首都医科大学附属安贞医院母胎医学会诊中心;首都医科大学附属安贞医院超声心动二部;
【基金】：北京市自然科学基金(No.7122059)
【分类号】：R714.5;R540.45

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