胎儿动脉导管迂曲与孕周的相关性研究

Study on Relationship between Fetal Arterial Duct Tortuosity and Gestational Weeks

目的分析胎儿动脉导管(DA)迂曲发生率与孕周的相关性。方法回顾性分析2018年11月至2019年3月河南中医药大学第一附属医院行胎儿超声心动图检查的709例孕妇的超声资料,共入组671例患者。首先常规测量生物学参数以确定孕周大小,然后进行胎儿超声心动图检查,利用三血管气管切面和导管弓切面观察胎儿DA的走行及形态。根据孕周分为A(孕周20~25周,192例)、B(孕周26~31周,180例)、C(孕周32~36周,177例)、D组(孕周37~40周,122例),统计每组动脉导管迂曲及各种形态导管迂曲所占比例,并分析动脉导管迂曲与孕周的相关性。结果A组DA正常188例,占97.92%,DA迂曲4例,占2.08%;B组DA正常164例,占91.11%,DA迂曲16例,占8.88%;C组DA正常133例,占75.14%,DA迂曲44例,占24.86%;D组DA正常79例,占64.75%,DA迂曲43例,占35.25%。各组DA迂曲率比较差异有统计学意义(P<0.01)。Pearson相关分析结果显示,DA迂曲发生率与孕周呈显著正相关(r=0.832,P<0.01)。随着孕周的增大,L形及C形导管迂曲所占比例逐渐下降,S形及不规则形导管迂曲所占比例逐渐增加。结论随着孕周的增大,胎儿DA走行正常所占比例逐渐下降,而走行迂曲所占比例逐渐上升,且动脉导管迂曲的程度逐渐加重。随孕周增大DA迂曲发生率明显升高,胎儿DA迂曲发生率与孕周呈显著正相关。

Objective To analyze the correlation between the incidence of tortuousness of fetal ductus arteriosus(DA)and gestational weeks.Methods A retrospective analysis of 709 cases of gravida ultrasound data from the first Affiliated Hospital of the Chinese University of Traditional Chinese Medicine from Nov.2018 to Mar.2019 was done.The data of 671 patients were enrolled.Firstly,biological parameters were routinely measured to determine the size of gestational weeks,and the direction and morphology of fetal DA were observed by using three-vessel trachea section and catheter arch section.Accordingly,they were divided into group A(between 20 and 25 weeks of gestation,192 cases),B(between 26 and31 weeks of gestation,180 cases),C(between 32 and 36 weeks of gestation,177 cases)and D(between 37 and40 weeks of gestation,122 cases),and the proportion of ductus tortuousness in each group and the proportions of various forms of ductus tortuousness were calculated,and the correlation between ductus tortuousness and gestational weeks was statistically analyzed.Results Group A:DA normal 188 cases,accounting for 97.92%,DA tortuousness in 4 cases,accounting for 2.08%;group B:DA normal 164 cases,accounting for 91.11%,DA tortuousness 16 cases,accounting for 8.88%;group C:DA normal 133 cases,accounting for 75.14%,DA tortuousness 44 cases,accounting for 24.86%;group D:DA normal in 79 cases,accounting for 64.75%,DA tortuousness 43 cases,accounting for 35.25%.There was statistical difference in the incidence of DA tortuousness among four groups(P<0.01).The results of Pearson correlation analysis showed that the incidence of DA tortuousness was positively correlated with the gestational weeks(r=0.832,P<0.01).With the increase of gestational weeks,the proportion of L-shaped and C-shaped catheter tortuous gradually decreased,while the proportion of S-shaped and irregularly shaped catheter tortuous gradually increased.Conclusion The normal proportion decreases with the increase of gestational weeks.The proportion of tortuousness increases with gestational weeks,and the degree of ductus tortuousness gradually increases.The incidence of DA tortuousness increases with gestational weeks,and there is a significant positive correlation between the incidence of DA tortuousness and gestational weeks.