超声软指标NT、DVa波及TR对胎儿先天性心脏病的预测价值  

Predictive value of ultrasound NT,DVa wave and TR for fetal congenital heart disease

作　　者：薛洁[1] 王岩青[1] 王晓静[1] 耿献辉 Xue Jie;Wang Yanqing;Wang Xiaojing;Geng Xianhui(Department of Ultrasound Medicine,Zhengzhou People’s Hospital,Zhengzhou 450003,China;Department of Gastroenterology,the 988th Hospital of Joint Logistics Support Unit of the Chinese People’s Liberation Army,Zhengzhou 450042,China)

机构地区：[1]郑州人民医院超声医学科,450003 [2]中国人民解放军联勤保障部队第九八八医院消化内科,郑州450042

出　　处：《中国实用医刊》2020年第17期23-26,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨超声胎儿颈项透明层(NT)、静脉导管a波(DVa波)及三尖瓣反流(TR)预测胎儿先天性心脏病(CHD)的临床价值。方法抽取2018年3月至2020年3月在郑州人民医院行超声检查的孕妇19600例,根据其胎儿有无CHD分为无CHD组(n=19502)与CHD组(n=98)。比较两组胎儿NT≥3.5 mm、TR、DVa波倒置比率,采用Spearman相关分析方法分析NT≥3.5 mm、DVa波倒置、TR与胎儿CHD的相关性,采用Logistic回归分析方法分析胎儿CHD的危险因素,采用受试者工作特征曲线(ROC)分析NT≥3.5 mm、DVa波倒置、TR对胎儿CHD的预测价值。结果CHD组NT≥3.5 mm、DVa波倒置、TR比率高于无CHD组(P<0.05)。NT≥3.5 mm、DVa波倒置、TR与胎儿CHD呈正相关(P<0.05)。NT≥3.5 mm、DVa波倒置、TR是胎儿CHD的危险因素(P<0.05)。TR预测胎儿CHD的价值优于DVa波倒置(P<0.05),NT≥3.5 mm预测胎儿CHD的价值优于TR(P<0.05);NT≥3.5 mm、DVa波倒置、TR联合预测胎儿CHD的价值优于各项单独检查(P<0.05)。结论超声NT≥3.5 mm、DVa波倒置、TR联合预测胎儿先天性心脏病的价值较高。Objective To investigate the clinical value of ultrasound nuchal thickness(NT),ductus venous A wave(DVa wave)and tricuspid regurgitation(TR)in predicting fetal congenital heart disease(CHD).Methods A total of 19600 pregnant women underwent ultrasound examination in Zhengzhou People’s Hospital from March 2018 to March 2020 were selected,and they were divided into non-CHD group(n=19502)and CHD group(n=98)according to whether the fetus had CHD or not.The proportions of NT thickness≥3.5 mm,TR and DVa wave inversion were compared between the two groups.Correlations of NT thickness≥3.5 mm,TR,DVa wave inversion with CHD were analyzed by spearman analysis.The risk factors of CHD were analyzed by Logistic regression analysis.And the predictive value of NT thickness≥3.5 mm,TR and DVa wave inversion for CHD was also verified by receiver operating characteristic curve(ROC).Results The proportions of NT thickness≥3.5 mm,TR and DVa wave inversion were higher in CHD group than those in non-CHD group(P<0.05).NT thickness≥3.5 mm,TR and DVa wave inversion were positively correlated with CHD(P<0.05).NT thickness≥3.5 mm,TR and DVa wave inversion were risk factors for CHD(P<0.05).NT thickness≥3.5 mm had the highest predict value,followed by TR and DVa wave inversion,with significant difference(P<0.05).The combined detection of NT thickness≥3.5 mm,TR and DVa wave inversion had higher predictive value than single detections(P<0.05).Conclusions NT thickness≥3.5 mm,TR and DVa wave inversion have high predictive value for CHD.

关 键 词：颈项透明层 静脉导管a波 三尖瓣反流 胎儿 先天性心脏病 预测价值 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]