产前部分上臂容积测量与新生儿出生体质量的相关性  

Correlation between prenatal fractional upper arm volume and neonatal birth weight

作　　者：张卿 吴桂花[1] 朱国燕[1] Zhang Qing;Wu Guihua;Zhu Guoyan(Department of Ultrasonography,Suzhou Wuzhong People's Hospital,Suzhou 125128,China)

机构地区：[1]苏州市吴中人民医院超声科,江苏苏州215128

出　　处：《中华医学超声杂志（电子版）》2022年第1期23-30,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的:探讨三维超声5D Limb技术测量正常孕晚期临产前7 d内胎儿部分上臂容积(AVol)在新生儿估算出生体质量(EFW)中的应用价值。方法:选取2018年7月至2019年6月期间在苏州市吴中人民医院超声科进行产检的临产前7 d内的115例胎儿作为研究对象,运用二维、三维超声技术为孕妇产检,并记录相关测量值,主要包括双顶径、股骨长度、头围、腹围、AVol。采用单因素和多因素线性回归分析各参数与新生儿BW之间的相关性,并建立回归方程产生新的BW估算公式。以新生儿BW为金标准,Hadlock经典公式为对照,运用χ2检验比较Hadlock经典公式与新公式的估算符合率(绝对误差和相对误差)的差异。再将胎儿按照BW分为低BW组、正常BW组和巨大儿组,运用配对t检验比较2种公式估算3组胎儿BW的相对误差(系统误差±随机误差)的差异。结果:单因素相关分析显示,BW与双顶径、头围、腹围、股骨长度、AVol均具有相关性(r=0.477、0.515、0.506、0.404、0.827,P均<0.001);多因素回归分析显示,腹围、AVol为新生儿BW估算的独立影响因素(P=0.007、<0.001);基于双顶径、头围、腹围、股骨长度、AVol构建回归方程EFW(AVol)=-2470.985+56.547×双顶径+33.225×头围+50.142×腹围+169.806×股骨+47.203×AVol。EFW(AVol)公式估算BW的绝对误差符合率和相对误差符合率均高于Hadlock经典公式(65.2%vs 48.7%;84.3%vs 64.3%),差异具有统计学意义(P=0.011、<0.001)。EFW(AVol)公式和Hadlock经典公式估算低BW组、正常BW组和巨大儿组胎儿BW的相对误差分别为(19.5%±7.2%vs 44.8%±29.6%)、(5.5%±4.3%vs 7.8%±5.5%)、(5.3%±3.4%vs 8.5%±4.5%),2种公式对正常BW组胎儿BW估算的相对误差比较,差异具有统计学意义(P<0.001)。结论:AVol与BW相关性显著,可作为新参数应用于估算新生儿BW的临床实践中。Objective To explore the application value of fetal fractional upper arm volume(AVol)measured by three-dimensional ultrasound 5D Limb technique within 7 days before delivery in the normal third trimester of pregnancy in neonatal birth weight(BW)estimation.Methods From July 2018 to June 2019,115 fetuses within 7 days before delivery at the Ultrasound Department of Wuzhong People's Hospital in Suzhou City were selected as the research subjects.Two-dimensional and three-dimensional ultrasound technology was used for maternity examination.The measured values mainly included double parietal diameter(BPD),femoral length(FL),head circumference(HC),abdominal circumference(AC),and AVol.The correlations between each parameter and newborn BW were analyzed and a multi-factor linear regression equation was established to generate a new weight estimation formula.With BW as the gold standard and Hadlock classic formula as a control,the Chi-square test was used to analyze the absolute error and relative error coincidence rate of the new formula.Then,the fetuses were divided into a low BW group,a normal BW group,and a macrosomia group according to BW.Paired t-test was used to estimate the systematic and random errors of BW of different groups of fetuses.Results BW had significant correlations with BPD,HC,AC,FL,and AVol(r=0.477,P<0.001;r=0.515,P<0.001;r=0.506,P<0.001;r=0.404,P<0.001;r=0.827,P<0.001).The regression equation generated was EFW(AVol)=-2470.985+56.547×BPD+33.225×HC+50.142×AC+169.806×FL+47.203×AVol.The new formula had significantly higher absolute and relative error compliance rates for BW estimation than the Hadlock classical formula(65.2%vs 48.7%,P=0.011;84.3%vs 64.3%,P<0.001).The relative errors of the new formula and the Hadlock classical formula for fetal BW estimation in the low BW group,normal BW group,and macrosomia group were(19.5%±7.2%)vs(44.8%±29.6%),(5.5%±4.3%)vs(7.8%±5.5%),and(5.3%±3.4%)vs(8.5%±4.4%),respectively,with statistically significant differences between the two formulas(P<0.001).Conclus

关 键 词：超声检查 部分上臂容积 新生儿 出生体质量 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]