主、肺动脉的超声观测诊断胎儿心脏大血管畸形的研究

Study on the chief clue of aorta and pulmonary artery in screening fetal heart and great arteries abnormities by ultrasound.

目的 探讨主、肺动脉的超声观测作为产前筛选胎儿心脏大血管畸形主要线索的诊断价值。方法 对 10 0例 2 0～ 4 0周正常孕妇采用超声心动图测量主、肺动脉内径 ,并计算肺动脉内径和主动脉内径比值 (PA/ AO)。按照 PA/ AO的正常比值对 2 6 83例 2 0周以上孕妇进行胎儿先天性心脏病 (CHD)筛选。结果 (1)不同孕龄的胎儿其 PA、 AO内径随孕龄增加而增大 ,但是其 PA/ AO比值相对较为恒定 ,约为 1.0～ 1.2。 (2 )多种胎儿心脏大血管畸形包括主动脉弓发育不良、主动脉狭窄、肺动脉狭窄、法乐氏四联征、主动脉缩窄等 ,其 PA/ AO比值明显异常。结论 胎儿 PA/ AO作为产前筛选胎儿 CHD指标 ,尤其是胎儿大血管畸形 ,是一项实用的指标。

ObjectiveTo explore the diagnostic value of aorta and pulmonary arterial diameters as the chief clue in screening fetal heart and great arteries abnormities prenatally by ultrasound.Methodsone-hundred pregnacies(gestational ages from 20 weeks to 40 weeks) were studied by fetal echocardiography.The internal diameters of pulmonary artery(PA) and aorta(AO)were measured and the ratio between them was calculated.According to the normal ratio of PA/AO,2683 cases whose gestational ages were no less than 20 weeks were screened for congential heart disease.Result (1)The internal diameter of AO and PA showed a positive correlation with the increasing of gestational age,but the PA/AO ratio remained comparatively steady,which was about 1.0～1.2.(2)The ratio PA/AO was obviously different in a variety of fetal cardiovascular defects,which included hypoplasia of aortie arch,aortie stenosis,pulmonary artery stenosis,Fallot’s tetralogy,coarctation of the aorta.ConclusionsPA/AO ratio is useful in detecting fetal congential heart disease,especially for great artery deformity.