Z-评分产前评估胎儿肺动脉狭窄的临床价值  

The Clinical Value of Z-scores in Assessing of Fetal Pulmonary Stenosis

作　　者：郭河清[1] 袁华[1] 解左平[1] Guo Heqing;Yuan Hua;Xie Zuoping(Department of Ultrasound,Women&Children Hospital of Shaoxing,Shaoxing 100030,China)

机构地区：[1]绍兴市妇幼保健院,浙江省绍兴市100030

出　　处：《中国超声医学杂志》2020年第12期1105-1108,共4页Chinese Journal of Ultrasound in Medicine

基　　金：绍兴市科技计划项(No.2018C30037);浙江省基础公益研究项目(No.LGF18H180015)。

摘　　要：目的探讨胎儿肺动脉狭窄(PS)的狭窄程度与生物学生长参数的变化规律。方法选取接受两次及以上胎儿超声心动图的胎儿进行分析,根据产后随访结果分为三组:肺动脉狭窄组、肺动脉瓣狭窄组、正常组。运用Z-评分的公式,计算各组胎儿前后两次主动脉内径(AO)、肺动脉内径(PA)的Z-评分及PA/AO比值,比较前后两次的差异。结果肺动脉狭窄组胎儿前后两次检查的AO-Z-评分、PA-Z-评分及PA/AO比值结果比较,差异均有统计学意义(P<0.05);肺动脉瓣狭窄组胎儿前后两次检查结果比较,只有AO-Z-评分差异有统计学意义(P<0.05);健康对照组胎儿前后2次检查结果比较,差异均无统计学意义(均P>0.05)。结论Z-评分与PA/AO比值相结合在PS的诊断及动态随访中具有重要的临床价值,能更准确地定量评估PS胎儿心脏结构的生长发育过程。Objective To explore the dynamic changes of the degree of pulmonary stenosis(PS)and the growth of the biological parameters in fetuses with PS.Methods A retrospective study of fetal echocardiograms were undertook from who underwent twice echocardiographic examinations.According to the postpartum follow-up results,the patients were divided into three groups:pulmonary stenosis group,pulmonary valve stenosis group and normal group.The AO and PA Z-scores were obtained by using equation of Z-score,and PA/AO ratios were subsequently calculated.The differences of AO and PA Z-scores and PA/AO ratios between two examinations were compared.Results Compared with the first fetal echocardiographic examination,AO and PA Z-scores and PA/AO ratios from the second one were found statistically different in PS fetuses.Only AO Z-scores was found statistically different in PVS fetuses.While AO and PA Z-scores and PA/AO ratios were none found statistically different in the normal fetuses.Conclusions The combination of Z score and PA/AO ratio has important clinical value in the diagnosis and dynamic follow-up of PS,which can more accurately and quantitatively evaluate the growth and development process of the fetal cardiovascular parameters of PS.

关 键 词：胎儿超声心动图 肺动脉狭窄 肺动脉瓣狭窄 Z-评分 PA/AO 

分 类 号：R714.5[医药卫生—妇产科学]