妊娠晚期胎儿动脉导管内径Z评分诊断动脉导管瘤

目的 应用胎儿超声心动图构建妊娠晚期胎儿动脉导管（DA）内径Z评分模型，观察Z评分诊断胎儿动脉导管瘤（DAA）的价值。方法 纳入128胎DAA胎儿（DAA组）和309胎正常胎儿（对照组），分析孕周（GA）、胎儿双顶径（BPD）及股骨长（FL）与胎儿DA内径之间的关系；构建胎儿DA内径Z评分模型，计算DAA组与对照组DA内径Z评分，观察其诊断DAA的价值。结果 对照组胎儿GA、BPD及FL与胎儿DA内径之间均呈高度线性相关（r均>0.9，P均<0.001）。DAA组胎儿DA内径Z评分各参数均明显高于对照组（P均<0.001）。分别以GA、BPD及FL预测DA内径，DAA组胎儿中，DA内径Z评分>3者各占92.18%、94.53%、98.43%，对照组胎儿中DA内径Z评分>二者各占1.61%、1.94%、1.61%。结论 妊娠晚期胎儿DA内径Z评分模型可定量评估胎儿DA发育情况，有助于诊断DAA并监测病情进展。胎儿DA内径Z评分>2高度提示DAA，>3时可诊断DAA。

Ductus arteriosus internal diameter Z-score for diagnosis offetal ductus arteriosus aneurysm in the third trimester of pregnancy

Objective To observe the value of Z-score model of fetal ductus arteriosus (DA) internal diameter constructed with fetal echocardiography for diagnosis of fetal ductus arteriosus aneurysm (DAA) in the third trimester of pregnancy. Methods Totally 128 fetuses with DAA (DAA group) and 309 normal fetuses (control group) were enrolled. The relationships of gestational age (GA), biparietal diameter (BPD) and femoral length (FL) with internal diameter of fetal DA were analyzed, and the Z-score model was constructed. Then Z-scores of internal diameter of DA were calculated in DAA group and control group, and the diagnostic value of DAA was observed. Results In control group, GA, BPD and FL were significantly linearly correlated with internal diameter of DA (all r>0.9, all P<0.001). The Z-score parameters of internal diameter of DA in DAA group were all significantly higher than those in control group (all P<0.001). Taken GA, BPD and FL to predict Z-score of internal diameter of DA, there were 92.18%, 94.53% and 98.43% fetuses with Z-score>3 in DAA group, while 1.61%, 1.94% and 1.61% fetuses with Z-score>2 in control group, respectively. Conclusion Fetal echocardiography could be used to construct Z-score models for evaluate the internal diameter of fetal DA in the third trimester of pregnancy for quantitatively assess the development of fetal DA, diagnose and monitor the progress of DAA. Z-score of internal diameter of fetal DA >2 highly suspected DAA, while DAA could be diagnosed when Z-score >3.