正常胎儿心脏发育与孕周增长关系的初步探讨

Preliminary study of relationship between heart growth and increased gestational weeks in normal fetus

目的初步探讨二维超声心动图在研究胎儿心脏发育与孕周增长关系中的应用价值。方法回顾分析386例正常胎儿超声心动图测值,统计胎儿心脏横径、左右房室横径、主动脉内径、主动脉及肺动脉流速、动脉导管舒张期和收缩期流速,以及心率随孕周变化增长的关系,分析正常胎儿心脏发育趋势;比较胎儿左右房室大小。结果①胎儿心脏横径、左右房室横径、主动脉内径、主动脉及肺动脉流速、动脉导管舒张期和收缩期流速与孕周之间均呈线性相关关系,随孕周增长而增长,心脏横径与孕周间的线性相关性最大,动脉导管舒张期流速受孕周影响最小;胎心率与孕周无明显线性相关;②有心系统横径大于左心系统横径,右心房横径与左心房横径,右心室横径与左心室横径间比较差异有统计学意义;③心脏横径/孕周比值及心脏横径/胸廓横径比值均呈正态分布,前者均数为0.95,接近1.0;后者均数0.44,小于0.5。结论二维超声心动图可作为评估胎儿心脏发育的检测方法。

Objective To primarily explore the application value of two - dimensional echocardiography in researching normal fetal heart growth. Methods The echocardiographie measurement data from 386 normal fetus were analyzed retrospectively. The transverse diameter of heart , left ventricle （ LV ）, right ventricle （ RV ） , aortic diameter, flow velocity of aorta, pulmonary artery and diastolic phase and systolic phase of arterial duct, and the relationship between heart rate and increased gestational weeks in fetus was measured. Then the growing tendency of normal fetal heart was analyzed, the diameter of left and right heart was compared. Results There was linear correlation between gestational week and transverse diameter of heart, left ventricle （ LV ）, right ventricle （ RV ）, aortic diameter, flow velocity of aorta, pulmonary artery, diastolic phase and systolic phase of arterial duct. The echocardiographic measurement data were increased with the increase of gestational weeks. The most notable linear correlation was between transverse diameter of heart and gestational weeks, while the most feeble linear correlation was between flow velocity of arterial duct in diastolic phase and gestational weeks, and no obvious linear correlation was between fetal heart rate and gestational weeks. The transverse diametre of right heart system was larger than that of left heart system, there was significant difference of transverse diameter between left antrum （ LA ） and right antrum （ RA ）, left ventricle （LV） with right ventricle （RV）. The ratioes of heart diameter/pregnant weeks and heart diameter/thorax diameter showed normal distribution, the former mean was 0. 95, near 1 ; the latter mean was 0.47, smaller than 0.5. Conclusion Two - dimensional echoeardiography could be an important method to assess the growth of fetal heart .