妊娠中晚期胎儿肺动脉超声参数分析

Analysis of Ultrasonic Parameters of the Fetal Pulmonary Artery during the Second and Third Trimesters of Pregnancy

目的 建立正常妊娠中晚期胎儿肺动脉内径和收缩期加速时间(AT)与射血时间(ET)比值的参考值范围,探讨肺动脉发育与孕周的关系,为临床预判胎肺成熟度提供参考。方法 选择孕22~40周正常单胎孕妇1 800例,根据孕周分组,共18组,统一采取胎儿心脏三血管气管切面或右心室流出道主动脉分叉切面,测量主肺动脉、左右肺动脉内径及主肺动脉中段AT/ET值,分析各参数与孕周的关系;以孕37周以上判断为胎肺完全成熟,分析各参数的变化规律。结果 1 800例正常胎儿主肺动脉、左右肺动脉内径及主肺动脉中段AT/ET指标随着孕周增长而增加,肺动脉内径与AT/ET呈正相关(r分别为0.907、0.878、0.884、0.893,P均<0.001);孕37周以上胎儿主肺动脉、左右肺动脉内径及主肺动脉中段AT/ET最小值分别为7.72 mm、3.3 mm、3.63 mm和0.206。结论 建立不同孕周胎儿主肺动脉、左右肺动脉内径及主肺动脉中段AT/ET参考值,发现随孕周增加肺动脉内径增宽;此结果为临床评估胎儿肺动脉发育以及胎肺成熟度提供参考。

Objective To establish reference values for fetal pulmonary artery diameter and systolic acceleration time(AT)-to-ejection time(ET)ratio in normal fetal development during the second and third trimesters,to determine the relationship between the development of the pulmonary artery and gestational age,and to provide a reference for clinical evaluation of fetal lung maturity.Methods The study included 1 800 fetuses with normal gestational ages(22-40 gestational weeks),divided into 18 groups.A unified fetal heart view was used,and the internal diameter and AT/ET ratio of the pulmonary artery were measured.The relationship between gestational age and the pulmonary artery parameters,and the changes in the parameters were analyzed.Results The normal fetal pulmonary artery and the AT/ET ratio of the middle pulmonary artery were measured,and the measured values increased with the increase in gestational age,showing a positive correlation(r=0.907,0.878,0.884,and 0.893;P<0.001).The minimum internal diameter and AT/ET ratio of the middle pulmonary artery at>37 weeks of gestation were 3.3 mm,7.72 mm,and 3.63 mm,and 0.206,respectively.Conclusion Reference values of the internal diameter and AT/ET ratio of the middle pulmonary artery at different gestational weeks were established.The results indicated that the pulmonary artery diameter increased with gestational age.The data presented provide a reference for evaluating fetal pulmonary maturity indirectly.