正常胎儿脑沟深度Z-评分模型的研究

Z-score analysis of brain fissure depth in normal fetuses

目的建立正常胎儿脑沟深度的Z-评分模型。方法随机选取2018年1-8月于湘雅二医院行产前超声检查的孕妇487例,胎儿(18~38周)发育均正常,测量其大脑外侧裂、顶枕沟、距状沟深度,并将其作为因变量,将孕周、顶径及股骨长作为自变量,统计分析后得到具体参数及其标准差的最佳拟合方程,并根据拟合方程得出Z-评分,建立Z-评分模型。两名观察者间隔2 h随机测量50例受试孕妇胎儿的脑沟深度以进行重复性检验。结果本研究成功建立了妊娠18~38周的正常胎儿脑沟深度相对于孕龄的Z-评分模型,胎儿的大脑外侧裂、距状沟、顶枕沟深度与孕周、双顶径及股骨长呈明显的正相关。结论Z-评分能直观地反映脑沟深度变化,可作为传统百分位数法的有力补充。

Objective To construct the Z-score models for normal fetal brain fissures.Methods Four hundred and eighty-seven pregnant woman who underwent prenatal ultrasonography from January to August 2018 in the Second Xiangya Hospital of Central South University were collected randomly for analysis,and all the fetuses(18-38 weeks)were healthy.The calacarine fissure,pariet-ooccipital fissure,sylvian fissure of the fetuses were measured and they were chosed as the dependent variables,while the independent variable were the gestational age and biparietal diamete,as well as femur length.The regression analyses of the mean(M)and the standard deviation(SD)for each parameter were performed separately.Two observers randomly measured the brain fissures depth two hours apart to evaluate the interobserver repeatability.Results The brain fissure depth in normal fetuses during geatational age between 18 to 38 weeks can be evaluated by Z-score model.Positive correlations were found between the depth of calacarine fissure,pariet-ooccipital fissure,sylvian fissure and gestational age,biparietal diameter and femur length.Conclusions Z-score can intuitively reflect the development of brain fissure more accurate,and is valuable,and can be used as a powerful supplement to the traditional method.