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目的探讨胎儿动脉导管血流频谱与右心系统梗阻性疾病胎儿肺血管发育情况的关系。方法在4 006例胎儿的检查中选取胎儿超声心动图诊断为肺动脉狭窄或肺动脉闭锁的胎儿75例为病例组,并根据动脉导管血流频谱形态分为正向灌注组(病例组1)和逆向灌注组(病例组2),另选取与之孕周匹配的正常对照组胎儿100例,两组胎儿分别计算其肺血管相关参数,包括肺动脉/主动脉瓣环径(PA/AO)、McGoon指数及动脉导管/降主动脉(DA/DAO),进行组间比较分析。结果病例组(组1和组2)PA/AO均低于正常对照组,差异有统计学意义。病例组1的McGoon比值与正常对照组接近,差异无统计学意义;病例组2的McGoon比值明显低于组1和正常对照组,差异有统计学意义;病例组(组1和组2)和正常对照组DA/DAO无明显差异。结论胎儿超声心动图诊断动脉导管血流逆向灌注提示右心严重畸形和肺血管发育不良,预后不良。
Objective To investigate the relationship between fetal arterial catheter blood flow spectrum and fetal pulmonary vascular development in patients with right heart obstructive disease. Methods Totally 75 fetuses diagnosed as pulmonary stenosis or pulmonary atresia by fetal echocardiography were enrolled in the study of 4 006 fetuses and were divided into two groups according to the arterial blood flow pattern: positive perfusion group (case group 1) and reverse 100 cases of fetus matched with the gestational week and the normal control group were enrolled in this study. The pulmonary vascular parameters (PA / AO, McGoon index And ductus / descending aorta (DA / DAO) were compared between groups. Results PA / AO in case group (group 1 and group 2) were lower than that in normal control group, the difference was statistically significant. The McGoon ratio of case group 1 was similar to that of the normal control group, and the difference was not statistically significant. The McGoon ratio of case group 2 was significantly lower than that of group 1 and the normal control group. There was significant difference between the case group (group 1 and group 2) Normal control group DA / DAO no significant difference. Conclusions Fetal echocardiography diagnosis of patent ductus arteriosus retrograde perfusion suggests severe right deformity and pulmonary vascular dysplasia with poor prognosis.