超声心动图检测正常和主动脉缩窄胎儿主动脉及其意义

Diagnostic value of echocardiographic detection in the differentiation of normal and coarctation of the aorta in fetuses

目的探讨中晚孕期胎儿主动脉各段及分支内径的正常参考值范围，研究主动脉缩窄胎儿相应值的变化。方法检测234例14～41孕周正常胎儿主动脉矢状断面上主动脉根部、升主动脉、主动脉横部、主动脉峡部、降主动脉、头臂干、左颈总动脉、左锁骨下动脉内径，并建立孕周与各项检测指标的直线相关方程。计算正常组与病例组主动脉各段与升主动脉的比值并比较。结果主动脉各段及分支内径随孕周的增加而增加（P〈0．01）。主动脉缩窄组胎儿主动脉峡部／升主动脉及降主动脉／升主动脉比值与对照组比较明显降低（P〈0．01）。结论监测中晚孕期胎儿主动脉峡部／升主动脉及降主动脉／升主动脉比值可作为主动脉缩窄的产前诊断筛查指标。

Objective To establish normal reference indexes of aorta during gestation and cut-points for detection of fetuses with coarctation of aorta. Methods From long-axis views of the aortic arch, the internal diameter of the aortic root,ascending aorta, transverse aortic arch, aortic isthmus, descending aorta, anonyma, left common carotid artery, left subclavian artery were measured in 234 normal fetuses at different time ranging from 14 to 41 weeks during gestation. Reference values of each aortic segment were constructed by linear regression analysis. The ratio of each aortic segment to the ascending aorta were calculated. Results The internal diameter in each aortic segments increased as pregnancy progressed （P 〈 0.01 ）. In the prenatal diagnosis of fetus with coarctation of the aorta,the ratio of the aortic isthmus to the ascending aorta and descending aorta to the ascending aorta were significantly lower than the normal fetuses（all P 〈0.01 ）. Conclusions The ratio of the aortic isthmus to the ascending aorta and ratio of descending aorta to the ascending aorta detected by echocardiography may be helpful in the prenatal diagnosis of coarctation of aorta.