心脏圆锥动脉干畸形患儿产前超声心动图特征及染色体核型分析  

Prenatal echocardiographic characteristics and chromosomal karyotype analysis of children with cardiac conus trunk malformation

作　　者：谭瑶[1] 何庆兰 曾红英[1] 张松 TAN Yao;HE Qing-lan;ZENG Hong-ying(Department of Ultrasound,Jianyang People's Hospital,Jianyang Sichuan 641400,China)

机构地区：[1]简阳市人民医院超声科,四川简阳641400 [2]遂宁市中心医院超声科,四川遂宁629000

出　　处：《临床和实验医学杂志》2023年第21期2342-2346,共5页Journal of Clinical and Experimental Medicine

基　　金：四川省卫生和计划生育委员会科研课题项目(编号:20PJ525)。

摘　　要：目的探讨产前超声心动图诊断心脏圆锥动脉干畸形(CTD)的价值及其与染色体异常的关系。方法回顾性选取2011年1月至2021年12月进行染色体检查的CTD患儿227例,并选取同期健康婴幼儿60名作为对照组,均在产前行超声心动图检查。分析超声心动图对不同类型CTD的诊断情况及圆锥形态,比较不同类型CTD和对照组在不同剖视面的圆锥隔偏转角度、最大圆锥隔偏移距离、圆锥隔偏移面积,并分析新生儿心脏CTD染色体异常情况及与产前超声心动图的关系。结果超声心动图诊断CTD的准确性为91.63%(208/227)。永存动脉干(PTA)、肺动脉闭锁伴室间隔缺损(PA-VSD)无圆锥形态。法洛四联症(TOF)、大动脉转位(D-TGA)、右室双出口(DORV)上下剖视面的圆锥隔偏转角度明显低于对照组,差异有统计学意义(P<0.05);前后剖视面的圆锥隔偏转角度,上下、前后、左右剖视面的最大圆锥隔偏移距离,前后、左右剖视面的圆锥隔偏移面积比较:D-TGA>TOF>DORV>对照组,差异有统计学意义(P<0.05);D-TGA左右剖视面的圆锥隔偏转角度明显高于TOF、DORV、对照组,TOF左右剖视面的圆锥隔偏转角度明显高于DORV、对照组,D-TGA上下剖视面的圆锥隔偏移面积明显高于DORV、对照组,差异均有统计学意义(P<0.05)。227例CTD患儿中发生染色体异常22例(9.69%)。结论产前超声心动图检查在CTD的诊断中具有较高的诊断准确性,染色体异常是部分CTD患儿的致病原因。Objective To explore the value of prenatal echocardiography in the diagnosis of cardiac conic trunk malformation(CTD)and its relationship with chromosomal abnormalities.Methods A total of 227 children with CTD who underwent an infection examination in Jianyang People's Hospital from January 2011 to December 2021 were retrospectively selected,and 60 normal newborns during the same period were selected as the control group.All of them underwent prenatal echocardiography.The diagnosis of different types of CTD and cone morphology was analyzed by echocardiography,the deflection angle of the conical septum,the maximum deviation distance of the conical septum,and the area of the conical septum at different cross-sectional planes of the different types of CTD and the control group was compared,and the neonatal heart CTD chromosomal abnormalities and their relationship with prenatal echocardiogram was analyzed.Results The accuracy of CTD diagnosis by echocardiography was 91.63%(208/227).Persistent truncus arteriosus(PTA)and pulmonary atresia with ventricular septal defect(PA-VSD)had no conical shape.The deflection angle of the conical septum in the top and bottom section planes of tetralogy of fallot(TOF),transposition of the great arteries(D-TGA),and double outlet of right ventricle(DORV)was significantly lower than that of the control group,the difference was statistically significant(P<0.05);the deflection angle of the conical septum in the front and rear section planes,and the maximum deflection angle of the conical septum in the top and bottom section,front and rear,and left and right sections shift distance,comparison of the offset area of the conical septum in the front and rear,left and right cross-sectional planes:D-TGA>TOF>DORV>control group,the difference was statistically significant(P<0.05);the deflection of the conical septum in the left and right cross-sectional planes of D-TGA was significantly higher than that of TOF,DORV,and the control group,the deflection angle of the conical septum on the left and ri

关 键 词：圆锥动脉干畸形 产前超声心动图检查 诊断价值 染色体异常 

分 类 号：R725.4[医药卫生—儿科]