孕中期产前超声诊断先天性心脏畸形的Meta分析  

Meta-analysis of Prenatal Ultrasound Diagnosis for Congenital Heart Defect in The Second Trimester of Pregnancy

作　　者：解珺淑[1] 闫亚妮[1] 杨振娟[1] 李云桃[1] 薛小伟 裴秋艳[1] Xie Junshu;Yan Yani;Yang Zhenjuan;Li Yuntao;Xue Xiaowei;Pei Qiuyan(Department of Obstetrics and Gynecology,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院妇产科,北京市100044

出　　处：《中国超声医学杂志》2023年第5期592-595,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的研究先天性心脏畸形(CHD)的孕中期超声产前诊断率(简称产前诊断率)。方法通过相应的文献检索策略和纳入标准,在Pubmed、Web of Science和Embase中检索近5年发表的英文或中文文献并纳入数据库,采用Stata 14.0进行Meta分析,计算不同类型CHD的孕中期产前诊断率及95%CI。结果研究共纳入17篇文献、CHD病例73897例,包含16种类型的CHD。孕中期胎儿CHD产前诊断率为61.0%(95%CI:43.1%~78.8%)。其中诊断率居前三位的为左心室发育不良综合征(84.4%)、单心室(81.0%)、右室双出口(76.7%),均高于75%;居后三位的为主动脉缩窄(47.0%)、室间隔缺损(37.5%)、肺静脉畸形引流(26.7%),均低于50%。结论目前孕中期超声对CHD的产前诊断率较既往明显提高;产前诊断率与CHD的类型及严重程度相关。四腔心切面、左室流出道切面、右室流出道切面和三血管气管切面联合应用,可以有效提高不同类型CHD的诊断率。Objective To investigate the prenatal diagnostic rate of ultrasound in the second trimester of pregnancy for congenital heart defect(CHD).Methods According to the corresponding literature retrieval strategy and inclusion criteria,the English or Chinese literature published were retrieved in Pubmed,Web of Science and Embase in recent 5years.The Meta-analysis was performed using Stata 14.0to calculate the prenatal diagnosis rate and 95%CI of different types of CHD in the second trimester of pregnancy.Results A total of 17articles were identified in the study,including 73897cases of CHD,and 16types of CHD.The prenatal diagnosis rate of fetal CHD in the second trimester was 61.0%(95%CI:43.1%~78.8%).Among them,the top three diagnostic rates were hypoplastic left heart syndrome(84.4%),single ventricle(81.0%)and right ventricular double outlet(76.7%),all of which were more than 75%;The last three were aortic coarctation(47.0%),ventricular septal defect(37.5%)and anomalous pulmonary venous drainage(26.7%),all of which were lower than 50%.Conclusions At present,the prenatal diagnosis rate of CHD by ultrasound in the second trimester of pregnancy is significantly higher than that in the past.The accuracy of prenatal diagnosis is related to the type and severity of CHD.Combined application of four-chamber view,left ventricular outflow tract view,right ventricular outflow tract view and three-vessel trachea view can effectively improve the diagnostic rate of different types of CHD.

关 键 词：先天性心脏畸形 产前诊断 胎儿心脏超声 孕中期超声检查 META分析 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.53[医药卫生—诊断学]