胎儿左心室小的超声特征及预后  

Ultrasonic Features and Prognosis of Fetal Small Left Ventricle

作　　者：胡圆榘 吴娟[1] 朱姿琪 栗河舟[1] 齐欣欣 HU Yuanju;WU Juan;ZHU Ziqi;LI Hezhou;QI Xinxin(Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院超声科,河南郑州450052

出　　处：《河南医学研究》2022年第1期64-67,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(2018020208);2020年郑州大学医学科学院研究生教育改革研究及课程建设项目。

摘　　要：目的探讨胎儿左心室小的超声特征及其预后。方法回顾性分析2018年1月至2020年12月于郑州大学第三附属医院经超声检查提示为左心室小的54例胎儿的临床资料。按照病因将左心室小的胎儿分为A组(11例)、B组(26例)和C组(17例)。A组胎儿为左心发育不良综合征,B组胎儿为主动脉缩窄及完全型肺静脉异位引流,C组胎儿为永存左上腔静脉、房间隔膨出瘤及卵圆孔血流受限。选取同期于该院经超声检查结果正常的60例妊娠胎儿纳入正常组。测量并比较各组胎儿的左室横径、左房横径、右室横径、右房横径、主动脉内径,计算左室横径/右室横径、左房横径/右房横径比值。随访并了解所有病例的妊娠结局及新生儿情况。结果B组和C组的左室横径、左房横径、主动脉内径、左室横径/右室横径、左房横径/右房横径比正常组小,右室横径、右房横径较正常组大(P<0.05)。B组和C组的左室横径/右室横径、左房横径/右房横径大于A组(P<0.05)。对22例左心室小胎儿进行了产前染色体检查,检出3例染色体异常(13.64%,3/22),均引产。11例左心发育不良综合征胎儿中10例引产,1例出生后死亡。结论主动脉缩窄、完全型肺静脉异位引流、永存左上腔静脉、房间隔膨出瘤、卵圆孔血流受限引起的左心室小未达到左心发育不良综合征的程度,与左心发育不良综合征相比具有显著差异。在左心室小胎儿中,左心发育不良综合征、合并染色体异常等胎儿的预后差。Objective To explore the ultrasonic features and prognosis of fetal small left ventricle.Methods The clinical data of 54 fetuses with small left ventricle which were examined by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 were studied retrospectively.Fetuses with small left ventricle were divided into group A(11 cases),group B(26 cases)and group C(17 cases)according to the etiology.The fetuses in group A were hypoplastic left heart syndrome.The fetuses in group B were coarctation of aorta and total anomalous pulmonary venous connection.The fetuses in group C were persistent left superior vena cava,fatal atrial septal aneurysm and restrictive foramen ovale.During the same period,a total of 60 normal pregnant fetuses who underwent ultrasound examination in this hospital were included in normal group.The transverse diameters of left ventricle,left atrium,right ventricle,right atrium and aorta were measured and compared in each group.The ratios of left ventricular transverse diameter to right ventricular transverse diameter and left atrial transverse diameter to right atrial transverse diameter were calculated.All cases of pregnancy outcomes and neonatal conditions were followed up.Results The transverse diameters of left ventricle,left atrium and aorta,and the ratios of left ventricular transverse diameter to right ventricular transverse diameter and left atrial transverse diameter to right atrial transverse diameter in group B and group C were smaller than those in normal group,while the transverse diameters of right ventricle and right atrium were larger than those in normal group(P<0.05).The ratios of left ventricular transverse diameter to right ventricular transverse diameter and left atrial transverse diameter to right atrial transverse diameter in group B and group C were larger than those in group A(P<0.05).Prenatal chromosome examination was performed in 22 fetuses with small left ventricle and chromosomal abnormality was found in 3 cases(13.64

关 键 词：左心发育不良综合征 超声检查 产前诊断 心室 预后 

分 类 号：R541[医药卫生—心血管疾病]