摘要
目的探讨11~13^(+6)w产前超声筛查软指标与胎儿心脏结构异常的关系。方法选取2014年2月至2015年6月在我院进行妊娠早期超声检查的孕妇1486例,经腹超声检查,记录NT值、三尖瓣反流(TR)及静脉导管血流a波(DV a波)倒置等超声软指标情况,计算早孕期超声诊断心脏畸形的准确度、各项软指标诊断的灵敏度与特异度。结果 1486例胎儿共诊断胎儿心脏畸形42例,其中严重心脏畸形31例;NT厚度为95~99百分位胎儿61例(4.10%,61/1486),7例产前诊断为严重心脏畸形,其中5例在早孕期诊断,2例在中孕期诊断,诊断灵敏度为22.58%(7/31),特异度为3.63%(54/1486)。NT厚度>第99百分位胎儿15例(1.01%,15/1486),13例产前诊断为严重心脏畸形,其中10例为早期诊断,3例为中孕期诊断,诊断灵敏度为41.94%(13/31),特异度为0.13%(2/1486)。TR 17例(1.14%),DV a波倒置35例(2.35%),而在31例产前诊断严重心脏畸形胎儿中,有11例合并TR,诊断敏感度为35.48%(11/31),特异度为0.40%(6/1486);10例合并DV a波倒置,诊断敏感度为32.26%(10/31),特异度为1.68%(25/1486)。结论 NT增厚、TR和DV a波倒置能检出大部分严重心脏畸形,可以为临床更早诊断先天性心脏病提供依据。
Objective：To research correlations of 11~13^＋6 weeks ultrasonic soft data with cardiac structural abnormalities in early pregnancy fetal. Methods：1486 pregnant women were collected in our hospital from February 2014 to June 2015,and underwent examination through abdominal ultrasound. NT value,tricuspid regurgitation（TR）and venous catheter bloodstream（DV）wave inversion were recorded,and cardiac abnormalities,the sensitivity and specific degrees of various soft data diagnosis in pregnancy ultrasound were calculated.42 cases of 1486 fetus were diagnosed to be cardiac abnormalities,including 31 cases were diagnosed to be severe cardiac abnormalities;NT thickness within 95 ~ 99 percentile fetal included 61 cases（4.10%,61/1486）,7 cases were diagnosed to be severe cardiac abnormalities,including 5 cases diagnosed in the first trimester,2 cases diagnosed in the second trimester,the diagnostic sensitivity was 22.58%（7/31）,and the specificity was 3.63%（54/1486）.15cases（1.01%,15/1486）with NT thickness 〉99 th percentile fetal showed 13 cases of severe cardiac abnormalities,including 10 cases diagnosed in the first trimester,3 cases diagnosed in the second trimester,the diagnosis sensitivity was 41.94%（13/31）,and the specificity was 0.13%（2/1486）.17 cases（1.14%）of TR,and 35 cases（2.35%）of DV a wave inversion were observed,11 cases of combined TR were observed in 31 severe cardiac abnormalities,and the diagnostic sensitivity was 35.48%（11/31）,the specificity was 0.40%（6/1486）;10 cases of merger DV a wave inversion were observed in 31 severe cardiac abnormalities,the diagnostic sensitivity and specificity was respectively 32.26%（10/31）and 1.68%（25/1486）.Discussion：NT thickening,TR and DV a wave inversion can check out the most severe cardiac abnormalities,and could be applied to be the basis for clinical diagnosis of congenital heart disease earlier.
作者
王颖金
安培莉
侯小霞
张喻
WANG Ying-jin AN Pei-li HOU Xiao-xia ZHANG Yu.(Northwest Women and Children Hospital, Ultrasonic Center, 710061)
出处
《中国优生与遗传杂志》
2016年第12期117-119,F0003,共4页
Chinese Journal of Birth Health & Heredity
