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目的建立胎儿二尖瓣环位移(MAPSE)Z评分正常值参考范围,定量评估胎儿左心室功能。方法应用超声心动图对1 012例孕龄为19~41周的胎儿进行检测,根据停经史计算胎儿的孕周(GA),测量胎儿的双顶径(BPD)、股骨长径(FL),并通过解剖M型超声测量MAPSE。以GA、BPD及FL作为自变量,MAPSE作为因变量建立最佳模型,并校正标准差(SD),通过统计分析运用公式计算得到Z评分的参考范围。结果统计分析显示,直线回归方程能够很好地反映胎儿非心血管参数BPD、FL、GA与MAPSE之间的相关性。运用绝对残差的加权回归消除SD的异方差性,建立直线回归模型,最后根据方程即可得出不同参数的MAPSE的Z评分值。结论运用统计学方法,建立了通过胎儿GA、BPD、FL计算MAPSE的Z评分的正常参考范围,为胎儿左心室功能评估供了更加精准的参考范围。
Objective To establish the reference range of normal infant Z-score of mitral annulus (MAPSE) and evaluate fetal left ventricular function quantitatively. Methods A total of 1 012 fetuses of gestational age from 19 to 41 weeks were measured by echocardiography. The gestational age (GA) was calculated according to the history of menopause. The BPD and the length of the femur were measured. MAPSE was measured by anatomic M-mode ultrasound. Taking GA, BPD and FL as independent variables, MAPSE as the dependent variable to establish the best model, and standard deviation (SD) were corrected, and the reference range of Z score was calculated by using statistical analysis. Results of statistical analysis showed that the linear regression equation can well reflect the fetal non-cardiovascular parameters BPD, FL, GA and MAPSE correlation between. The absolute residuals were used to eliminate the heteroscedasticity of SD and the linear regression model was established. Finally, the Z scores of MAPSE with different parameters were obtained according to the equations. Conclusions The normal reference range of Z score of MAPSE was calculated by using GA, BPD and FL, and a more accurate reference range of fetal left ventricular function assessment was established by using statistical methods.