胎儿主动脉偏细的预后分析及与主动脉缩窄的鉴别诊断

目的 探讨胎儿主动脉偏细的临床预后及与主动脉缩窄的超声鉴别诊断。方法 选取笔者医院行胎儿超声心动图检查的胎儿1280例，成功随访超声诊断为单纯性主动脉偏细的胎儿13例，作为病例组，回顾性分析其超声心动图参数，随访出生后情况。选取20例出生28天内诊断为主动脉缩窄的新生儿为对照组，结合分析其超声心动图资料，探讨胎儿主动脉偏细与主动脉缩窄的鉴别点。结果 病例组胎儿出生后无1例诊断为主动脉缩窄。病例组与对照组的主动脉峡部与肺动脉比值差异有统计学意义（P=0.000），两者主动脉与肺动脉比值差异无统计学意义（P=0.817）。20例对照组中14例合并室缺，而13例病例组中仅1例合并室缺。结论 单纯性主动脉偏细胎儿预后良好。胎儿主动脉峡部与肺动脉比值及有无合并室缺对主动脉偏细与主动脉缩窄的鉴别诊断有重要价值。

Postnatal Outcome of the Fetus of Narrow Aorta and the Differentiation with the Coarctation of Aorta

Objective To investigate the clinical outcome of the fetus of narrow aorta, and seek the differentiation between the narrow of aorta and the coarctation of aorta. Methods Thirteen cases of fetuses with isolated narrow aorta selected from the 1280 cases of fetuses, were retrospectively analyzed and followed up after birth. Twenty cases of neonatus diagnosed as the coarctation of aorta in their first 28 days of life, as a control group, were also retrospectively analyzed. Cardiography parameters as the diameters of the aorta isthmus, the aorta and the pulmonary were measured in the two groups, the ratio of aorta to pulmonary and the ratio of aorta isthmus to pulmonary were calculated. Results None of the 13 fetuses with narrow aorta were diagnosed as coarctation of aorta after birth. The ratio of aorta to pulmonary between the two groups had no significant difference(P=0.817), however, the ratio of aorta isthmus to pulmonary had statistical significance(P=0.000). Among the 20 neonatus, 14 cases were complicated with ventricular septal defect, contrasted 1 in 13 in the fetuses. Conclusion The prognosis of the fetuses of narrow aorta were good. The ratio of aorta isthmus to pulmonary and if complicated with ventricular septal defect were important significance indexes in the differential diagnosis of the narrow of aorta and the coarctation of aorta.