诊断胎儿心脏畸形的心功能超声指标筛选及其临床价值研究

Study on the Screening and Clinical Value of Ultrasonic Index of Cardiac Function in the Diagnosis of Fetal Heart Malformation

目的:筛选诊断胎儿心脏畸形的心功能超声指标并探讨其临床应用价值。方法:选取2018年7月-2019年9月本院收治的胎儿疑似心脏畸形的孕妇110例作为研究组,并选取同期胎儿无心脏畸形的健康孕妇50例作为对照组,采用彩色多普勒超声诊断仪对所有孕妇进行检查。比较两组心功能指标,并计算各心功能指标对胎儿心脏畸形的诊断效能。结果:研究组LVEF、IFI、TAD、MAD、E/AMV、E/ATV均低于对照组,Tei指数高于对照组,差异均有统计学意义(P<0.05);心功能指标联合检测的准确率、灵敏度、特异度、阳性预测值、阴性预测值分别为94.5%、97.5%、86.7%、95.1%、92.9%,均高于心功能指标单独检测;心功能指标诊断胎儿心脏畸形的一致性比较,Kappa值由高到低分别为心功能指标联合检测、Tei指数、LVEF、IFI、TAD、MAD、E/ATV、E/AMV。结论:超声评估不同的心功能指标对胎儿心脏畸形有不同的诊断效能,联合心功能指标检测有利于提高临床诊断胎儿心脏畸形的准确率,具有较高的临床价值。

Objective:To screen the indexes of heart function in the diagnosis of fetal cardiac malformation and discuss their clinical application value.Method:A total of 110 pregnant women with suspected fetal cardiac malformation in our hospital from July 2018 to September 2019 were selected as the study group,and 50 healthy pregnant women without fetal cardiac malformation in the same period were selected as the control group.All pregnant women were examined by color Doppler ultrasonography.The cardiac function indexes of two groups were compared,and the diagnostic efficiency of each cardiac function index for fetal heart malformation was calculated.Result:The LVEF,IFI,TAD,MAD,E/AMV and E/ATV in the study group were lower than those in the control group(P<0.05),and the Tei index was higher than that in the control group(P<0.05).The accuracy,sensitivity,specificity,positive predictive rate and negative predictive rate of combined detection of cardiac function indicators were 94.5%、97.5%、86.7%、95.1%and 92.9%respectively,which were higher than those of single detection of cardiac function indicators.The consistency of cardiac function indicators in diagnosis of fetal cardiac malformation was compared,the Kappa values from high to low were combined detection of cardiac function indicators,Tei index,LVEF,IFI,TAD,MAD,E/ATV and E/AMV,respectively.Conclusion:Ultrasound evaluation of different cardiac function indexes has different diagnostic efficacy for fetal cardiac malformations.Combined detection of cardiac function indicators is helpful to improve the accuracy of clinical diagnosis of fetal cardiac malformations,and has high clinical value.