中孕中期胎儿心轴角度的参考值及对心脏畸形诊断的价值  

Value of fetal cardiac axis measured in the fetal echocardiography of the second trimester

作　　者：张蕴[1] 桂永浩[2] 严英榴[1] 赵蔚[1] 黄晓微[1] 姚英[1] 孔凡斌[1] 任芸芸[1] 周毓青[1] 储晨[2] 周霁子[1] 

机构地区：[1]复旦大学附属妇产科医院超声科,上海200011 [2]复旦大学附属儿科医院心血管中心

出　　处：《中华超声影像学杂志》2012年第1期39-41,共3页Chinese Journal of Ultrasonography

基　　金：国家高技术研究发展计划（基金编号2007AA022442）

摘　　要：目的建立中孕中期胎儿心轴角度的相应统计参数，并评价中孕中期测定胎儿心轴角度在产前诊断中的应用价值。方法选择2008年9月至2010年10月复旦大学附属妇产科医院常规产科检查的孕妇6744例，均为单胎。于孕18-23^＋周行中孕中期胎儿畸形筛选超声的同时，进行胎儿心脏超声检查，于四腔心观测量胎儿心轴角度。结果6744例胎儿心轴角度测量值为（37．03±6．10）°，范围9．80。～102．41°。按超过普通人群中胎儿的心轴角度的95％的参考值范围（26．63°～49．40°）为异常心轴。正常组胎儿的心轴平均角度为（36．96±5．91）°，心脏结构异常组的心轴平均角度为（43．12±15．67）°，胸腹腔异常组的心轴平均角度为（51．74±15．97）°，与正常组相比差异有统计学意义（P〈0．01）。结论本地区胎儿心轴角度参数的建立将有助于发现相当一部分的心脏结构畸形或胸腔腹壁病变，可作为常规心脏畸形筛选的补充及某些畸形的诊断标准。Objective To establish the reference ranges for fetal cardiac axis in the mid second trimester and to evaluate the use of fetal cardiac axis in prenatal diagnosis. Methods 6744 unselected singleton pregnancies were enrolled from September 2008 to October 2010. Routine screening scan of second trimester and fetal echocardiography were performed at 18- 23 ±6 weeks gestation. Fetal cardiac axis was measured on the four chamber view of the heart. Results The 6744 fetuses had a mean cardiac axis of （37.03 ± 6.10）°,ranging from 9.80°to 102.41° Using above or below 95% range of population （26.63° - 49.40°） as a cut-off, there were significant difference of cardiac axis between normal group [（36.96 ± 5.91）°, P 〈0.01] and the group with heart defects [（43.12 ± 15.67）°, P 〈0.01],the group with intrathoricic anomalies or abdominal wall defect [（51.74 ± 15.97）°]. Conclusions The reference ranges of fetal cardiac axis for local population in mid-second trimester may helpful for detecting congenital defects. Presence of an abnormal cardiac axis in the fetuses is associated with a substantial risk of congenital heart disease and/or other extra cardiac defects.

关 键 词：超声检查 产前 心轴 心脏缺损 先天性 

分 类 号：R714.5[医药卫生—妇产科学]