国人正常妊娠系列孕周胎儿大血管径线的超声测量

Great arteries dimensions determined by cross-sectional echocardiography in normal Chinese fetuses

目的评价国人正常妊娠系列孕周(16～40周)正常胎儿大血管径线的变化规律.方法选择常规产科超声检查、系统胎儿心脏超声检查以及产后随访无异常的胎儿757例,按孕周分为12组,超声分别测量升主动脉(AsAo)、主动脉弓(ArAo)、主动脉峡部(IsAo)、肺动脉(PA)和动脉导管(DA)径线大小(分别测量3次取平均值),并将各测量值与孕周行直线回归相关分析.结果同一分组中PA与AsAo径线比较,除16～18周外,其余差异均有非常显著性(P＜0.01),PA内径大于AsAo内径;IsAo与AsAo、ArAo径线比较差异均有非常显著性(P＜0.01),IsAo内径小于AsAo、ArAo内径.对各径线测值与孕周行直线回归分析显示,各径线测值均随孕周增加而增大,且与孕周呈显著相关性,AsAo、ArAo、IsAo、PA、DA与孕周相关系数分别为r=0.779、r=0.706、r=0.664、r=0.804、r=0.636,P均＜0.01;PA与AsAo内径比值(PA/AsAo)与孕周行相关分析显示,r=0.032,P＞0.05.结论胎儿大血管各部位径线与孕周呈明显相关性,胎儿心脏发育以右心占优势,IsAo内径较主动脉各部位内径均小.

Objective To evaluate the regular changes of the great arteries in the normal Chinese fetuses of the normal gestations from 16 to 40 weeks. Methods Dimensions of ascending aorta （AsAo） , arch of aorta （ ArAo ） , isthmus of aorta （ IsAo ）, pulmonary artery （ PA ） and ductus artery （ DA ） were measured in 757 singleton normal fetuses with two-dimentional ultrasound. Dividing the different gestational weeks into 12 groups, we calculated the mean values of the great arteries in each group and made a regression and correlation analysis with gestational weeks. Results Every dimension of the great arteries in normal fetuses was of remarkable correlation with gestation age （P 〈 0.01 ）. The dimension of PA was significantly bigger than that of the ascending aorta （ P 〈 0.01 ）. The dimension of the aortic isthmus was significantly smaller than that of every position of the aorta calculated （ P 〈 0.01 ）. Condusions Every dimension of the great arteries in the normal fetuses is of remarkable correlation with gestational age. The right heart is predominant in the fetal heart. The dimension of the aortic isthmus is significantly smaller than those of other positions of the aorta calculated.