目的研究颈部透明层厚度(NT)、心脏三尖瓣反流(TR)和静脉导管血流(DV)联合胎儿心脏测量参数Z评分对胎儿先天性心脏病的诊断效能。方法采用2015年1月至2020年2月在内蒙古医学院附属医院进行孕早期新生儿筛查的6217例孕妇作为研究对象,根...目的研究颈部透明层厚度(NT)、心脏三尖瓣反流(TR)和静脉导管血流(DV)联合胎儿心脏测量参数Z评分对胎儿先天性心脏病的诊断效能。方法采用2015年1月至2020年2月在内蒙古医学院附属医院进行孕早期新生儿筛查的6217例孕妇作为研究对象,根据引产与分娩共确证胎儿患有先心病分为观察组和对照组,分别对两组胎儿的NT、TR、DV以及心脏测量参数Z评分进行比较。分析NT、TR、DV与Z评分的联合对胎儿先天性心脏病的诊断效能。结果观察组胎儿的NT、TR、DV异常率均高于对照组(χ^(2)=1953.577、1805.085、1339.066,均P<0.001)。在以双顶径的预测中,观察组胎儿的主动脉Z评分低于对照组(0.012±0.001 vs 0.023±0.002,t=84.259,P<0.001),肺动脉Z评分高于对照组(0.035±0.002 vs 0.025±0.003,t=38.623,P=0.000);在以股骨长的预测中,观察组胎儿的主动脉Z评分(0.022±0.003 vs 0.037±0.004,t=38.172,P<0.001)以及肺动脉Z评分(0.031±0.005 vs 0.039±0.003,t=12.474,P<0.001)低于对照组;在以实际孕周的预测中,观察组胎儿的主动脉Z评分(0.013±0.001 vs 0.022±0.002,t=68.939,P<0.001)以及肺动脉Z评分(0.014±0.002 vs 0.019±0.003,t=19.312,P<0.001)低于对照组。NT、TR、DV与Z评分联合诊断胎儿先天性心脏病的灵敏度为93.44%,显著优于单独诊断;NT、TR、DV与Z评分联合诊断胎儿先天性心脏病的受试者工作特征曲线下面积为0.892,显著高于单独检测(95%CI:0.654~0.912,P<0.001)。结论NT、TR、DV联合胎儿心脏测量参数Z评分对胎儿先天性心脏病具有积极的诊断意义。展开更多
AIM： To evaluate the association between gastroesophageal reflux diseases （GERD） and coronary heart diseases. METHODS： One thousand nine hundred and seventy consecutive patients who attended our hospital were enro...AIM： To evaluate the association between gastroesophageal reflux diseases （GERD） and coronary heart diseases. METHODS： One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography （ECG） was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as ST- segment depression based on the Minnesota code. RESULTS： Among 712 patients （36%） with GERD, ECG was performed in 171 （24%）, and ischemic changes were detected in eight （5%）. Four （50%） of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients （0.6%; 4/712） were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 （7%） had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% （8/1970 patients）.CONCLUSION： The present study suggested that ischemic heart disease might be found although a patient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms.展开更多
文摘目的研究颈部透明层厚度(NT)、心脏三尖瓣反流(TR)和静脉导管血流(DV)联合胎儿心脏测量参数Z评分对胎儿先天性心脏病的诊断效能。方法采用2015年1月至2020年2月在内蒙古医学院附属医院进行孕早期新生儿筛查的6217例孕妇作为研究对象,根据引产与分娩共确证胎儿患有先心病分为观察组和对照组,分别对两组胎儿的NT、TR、DV以及心脏测量参数Z评分进行比较。分析NT、TR、DV与Z评分的联合对胎儿先天性心脏病的诊断效能。结果观察组胎儿的NT、TR、DV异常率均高于对照组(χ^(2)=1953.577、1805.085、1339.066,均P<0.001)。在以双顶径的预测中,观察组胎儿的主动脉Z评分低于对照组(0.012±0.001 vs 0.023±0.002,t=84.259,P<0.001),肺动脉Z评分高于对照组(0.035±0.002 vs 0.025±0.003,t=38.623,P=0.000);在以股骨长的预测中,观察组胎儿的主动脉Z评分(0.022±0.003 vs 0.037±0.004,t=38.172,P<0.001)以及肺动脉Z评分(0.031±0.005 vs 0.039±0.003,t=12.474,P<0.001)低于对照组;在以实际孕周的预测中,观察组胎儿的主动脉Z评分(0.013±0.001 vs 0.022±0.002,t=68.939,P<0.001)以及肺动脉Z评分(0.014±0.002 vs 0.019±0.003,t=19.312,P<0.001)低于对照组。NT、TR、DV与Z评分联合诊断胎儿先天性心脏病的灵敏度为93.44%,显著优于单独诊断;NT、TR、DV与Z评分联合诊断胎儿先天性心脏病的受试者工作特征曲线下面积为0.892,显著高于单独检测(95%CI:0.654~0.912,P<0.001)。结论NT、TR、DV联合胎儿心脏测量参数Z评分对胎儿先天性心脏病具有积极的诊断意义。
文摘AIM： To evaluate the association between gastroesophageal reflux diseases （GERD） and coronary heart diseases. METHODS： One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography （ECG） was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as ST- segment depression based on the Minnesota code. RESULTS： Among 712 patients （36%） with GERD, ECG was performed in 171 （24%）, and ischemic changes were detected in eight （5%）. Four （50%） of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients （0.6%; 4/712） were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 （7%） had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% （8/1970 patients）.CONCLUSION： The present study suggested that ischemic heart disease might be found although a patient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms.
