全自动胎儿肺部超声分析预测妊娠晚期胎儿肺成熟度的研究

Prediction of fetal lung maturity in late pregnancy by automatic ultrasound analysis of the fetal lung

目的探讨全自动胎儿肺部超声分析预测妊娠晚期胎儿肺成熟度的应用价值。方法选取在我院分娩的80例单胎孕妇,给予全自动胎儿肺部超声分析,比较新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)和非NRDS肺部超声参数差异。结果80例新生儿中,有34例发生NRDS;NRDS新生儿左肺容积(left lung volume,LLV)、右肺容积(right lung volume,RLV)、总肺容积(total lung volume,TLV)和TLV/体质量比值(fetal lung to body weight ratio,FLB)分别为(33.03±3.75)cm^(3)、(44.07±3.16)cm^(3)、(75.57±4.69)cm^(3)和(0.25±0.04)cm^(3)/10 g,明显低于非NRDS新生儿(35.12±2.84)cm^(3)、(46.68±3.19)cm^(3)、(81.95±6.03)cm^(3)和(0.28±0.05)cm^(3)/10 g。(P<0.05)。NRDS新生儿肺动脉血流参数搏动指数(pulsatile index,PI)和阻力指数(resistance index,RI)分别为(2.14±0.29)和(0.92±0.12),明显高于非NRDS新生儿(2.00±0.28)和(0.83±0.08)(P<0.05)。PI、RI与LLV、RLV、TLV无明显相关性(P>0.05),而PI、RI与FLB呈负相关(r=-0.485,-0.401,P<0.05)。全自动胎儿肺部超声预测胎儿肺成熟的敏感度、特异度、准确度、阳性预测值和阴性预测值分别为91.18%、91.30%、91.25%、88.57%和93.33%。结论全自动胎儿肺部超声分析能有效预测妊娠晚期胎儿肺成熟度,值得临床使用。

Objective To explore the application value of automatic ultrasound analysis of the fetal lung in predicting fetal lung maturity in late pregnancy.Methods A total of 80 singleton pregnant women delivered in our hospital were given automatic ultrasound analysis of the fetal lung to compare the differences of pulmonary ultrasound parameters between neonatal respiratory distress syndrome(NRDS)and non-NRDS.Results Among 80 newborns,34 cases developed NRDS.The left lung volume(LLV),right lung volume(RLV),total lung volume(TLV)and fetal lung to body weight ratio(FLB)of NRDS newborns were(33.03±3.50)cm 3,(44.07±3.16)cm 3,(75.57±4.69)cm 3and(0.25±0.04)cm 3/10 g,respectively,which were significantly lower than those of non NRDS newborns[(35.12±2.84)cm 3,(46.68±3.19)cm 3,(81.95±6.03)cm 3 and(0.28±0.05)cm 3/10 g,respectively].(P<0.05).The pulsatile index(PI)and resistance index(RI)of pulmonary artery blood flow parameters in NRDS newborns were(2.14±0.29)and(0.92±0.12)respectively,which were significantly higher than those in non-NRDS newborns[(2.00±0.28)and(0.83±0.08)](P<0.05).There was no significant correlation between PI,RI and LLV,RLV and TLV(P>0.05),but there was a negative correlation between PI,RI and FLB(r=-0.485 and-0.401,P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of automatic ultrasound of the fetal lung in predicting fetal lung maturity were 91.18%,91.30%,91.25%,88.57%and 93.33%,respectively.Conclusion Automatic ultrasound analysis of the fetal lung can effectively predict fetal lung maturity in late pregnancy,which is worthy of clinical use.