正常中晚孕期胎儿肺动脉瓣至肺动脉分叉处的距离与胎儿生物学生长参数的相关性研究

Correlation between the Distance from Fetal Pulmonary Valve to Pulmonary Bifurcation during Normal Mid-late Pregnancy and Fetal Biological Growth Parameters

目的探讨正常中晚期孕期胎儿生物学生长参数和胎儿肺动脉分叉处至肺动脉瓣的距离的相关性。方法方便选择2017年4月—2018年4月孕中晚期妊娠女性420例,行胎儿超声心动图检查,测量胎儿股骨长径(FL)、双顶径(BPD),右心室舒张末期径(DPVBd)、心室收缩末期径(DPVBs),自变量为孕周、股骨长径、双顶径、肺动脉瓣环内径(收缩末期)(PA),因变量为心室舒张末期径、肺动脉分叉处至肺动脉瓣的距离,建立心室舒张末期径(DPVBd)和心室收缩末期径(DPVBs)的正常参考范围。结果得到不同心动周期的心室舒张、收缩末期肺动脉分叉至肺动脉瓣距离,20~35孕周健康胎儿的95%区间范围分别为(0.54,1.34)、(0.66,1.59),心室舒张、收缩末期肺动脉分叉至肺动脉瓣距离分别为(0.92±0.19)cm、(1.15±0.25)cm;孕周、股骨长径、双顶径、肺动脉收缩末期环内径与心室、收缩舒张末期肺动脉分叉至肺动脉瓣距离呈较强相关性,相关性最强者为孕周,随孕周增加,心室收缩末期肺动脉分叉至肺动脉瓣之间的距离也显著增长。结论DPVBd和DPVBs随孕周增加,与PA、FL、BPD、GA具有较佳的相关性。DPVBd和DPVBs可用于评估先天性胎儿心脏畸形的诊断。

Objective To investigate the correlation between the biological growth parameters of fetal in normal middle and late pregnancy and the distance from fetal bifurcation to pulmonary valve.Methods A total of convenient election 420 pregnant women in the second trimester of pregnancy from April 2017 to April 2018 were enrolled.Fetal echocardiography was performed to measure fetal femur long diameter(FL),double top diameter(BPD),and right ventricular end diastolic diameter(DPVBd),the ventricular end-systolic diameter(DPVBs),independent variables were gestational age,femoral long diameter,biparietal diameter,pulmonary valve annulus(end-systolic)(PA),dependent variable ventricular end-diastolic diameter,pulmonary bifurcation to pulmonary valve distance,to establish a normal reference range for ventricular end-diastolic diameter(DPVBd)and ventricular end-systolic diameter(DPVBs).Results The ventricular diastolic and end-systolic pulmonary bifurcation to pulmonary valve distance were obtained in different cardiac cycles.The 95%interval range of healthy fetuses at 20-35 weeks was(0.54,1.34),(0.66,1.59),ventricular diastolic,end-systolic distance from the pulmonary artery bifurcation to the pulmonary valve was(0.92±0.19)cm,(1.15±0.25)cm;gestational age,femur long diameter,biparietal diameter,pulmonary artery end-systolic ring diameter and ventricle,systolic end-diastolic pulmonary artery bifurcation to pulmonary artery distance between the petals was strongly correlated.The most relevant one was gestational age,which increased with the gestational age.The distance between the pulmonary artery bifurcation and the pulmonary valve was also significantly increased.Conclusion DPVBd and DPVBs increase with gestational age and have a better correlation with PA,FL,BPD and GA.DPVBd and DPVBs can be used to assess the diagnosis of congenital fetal heart malformations。