超声心动图对正常胎儿心脏结构的定量分析

目的对孕20～40周正常胎儿心脏结构及血流参数进行定量分析,评价其动态变化规律。方法测量2458例胎儿各房室内径、大血管内径及各瓣口血流速度。对其中854例正常胎儿心脏按不同孕周分为5组进行分析。结果在所观察的胎儿心脏各项参数中,其中各房室内径和主、肺动脉内径均与孕周呈直线相关(r值分别为0.69、0.68、0.70、0.68、0.73和0.72),而二尖瓣血流速度(E峰、A峰)、三尖瓣血流速度(E峰、A峰)、肺动脉瓣峰值血流速度和动脉导管血流速度(S峰、D峰)与孕周的相关关系较差(r值分别为0.33、0.06、0.35、0.04、0.22、0.23和0.09);并进行相关系数的显著性检验,均P<0.05。结论胎儿心脏发育以右心占优势;心脏各径线大小与孕周呈明显相关,据此可评价胎儿心脏发育情况,更好地对异常胎心进行筛查。

The quantitative analysis of cardiac construction in normal fetus by echocardiography

Objective To quantitatively analyze the cardiac structure and the blood flow parameters in normal fetus at 20-40 week＇ s gestation, and to evaluate the rules of dynamic changes. Methods The cardiac chambers, great vessel diameters and blood flow rate of each valve orifice were measured in 2458 normal fetuses. Among them, 854 fetus were further divided into 5 groups according to different gestational weeks, and the parameters were analyzed in these groups. Results In the observed parameters of the fetal heart, the size of left ventricle, right ventricle, left atrium, right atrium, inner diameter of aorta and pulmonary artery were linearly correlated with gestational week. r values were 0.69, 0.68, 0.70, 0, 68, 0.73 and 0.72, but the blood flow rate of mitral valve（ E, A） blood flow rate of tricuspid valve （E, A） , the peak blood flow rate of pulmonary artery valve and ductus arteriosus were less closely correlated with gestational week. r values were 0.33, 0. 06, 0.35, 0. 04, 0.22, 0. 23 and 0.09. There was significant difference between the coefficient correlation （P〈0.05）. Conclusion Right heart is predominate in fetus cardiac development. Heart size has a manifest relationship with gestational weeks, According to this we can estimate the cardiac developmental condition of fetus and screen abnormal fetal heart better.