胎儿轻、中度单纯性侧脑室增宽的变化规律及其与出生后神经系统发育情况的相关性  

The natural course of mild to moderate isolated fetal ventriculomegaly and its correlation with the postnatal neurodevelopment

作　　者：夏青青 雷婷[2] 尚建红[2] 林美芳[2] XIA Qing-qing;LEI Ting;SHANG Jian-hong;LIN Mei-fang(Department of Ultrasound,the Eighth Affiliated Hospital of Sun Yat-sen University,Shenzhen 518033,Guangdong,China;不详)

机构地区：[1]中山大学附属第八医院超声科,广东深圳518033 [2]中山大学附属第一医院超声科,广东广州510080

出　　处：《广东医学》2024年第1期77-82,共6页Guangdong Medical Journal

基　　金：国家自然科学基金资助项目(81801705);中国超声医师科技新星计划课题(KJXX2019004)。

摘　　要：目的探讨胎儿轻、中度单纯性侧脑室增宽(isolated ventriculomegaly,IVM)病例其侧脑室宽度随孕期进展的变化规律以及不同的变化规律与出生后神经系统发育异常的关系。方法回顾性收集产前超声诊断为单纯性轻、中度侧脑室增宽,且染色体微阵列分析(chromosome microarray analysis,CMA)结果正常的病例,记录产前胎儿侧脑室增宽的超声特征,追踪出生后神经系统发育情况。对于孕期内有2次及以上检查的病例,比较不同孕期侧脑室宽度变化情况,以分析各孕期侧脑室宽度的变化规律及不同变化规律与神经系统发育异常的关系。结果研究期间,共纳入133例病例,其中随访出生后神经系统发育正常126例(94.7%),神经发育异常7例(5.26%)。神经系统异常组病例其产前侧脑室宽度未恢复率为85.7%(6/7),高于正常组的28.6%(36/126,P<0.05);而两组间的侧脑室增宽的侧别及增宽程度的差异无统计学意义(P>0.05)。比较3个孕期的侧脑室宽度的变化,发现胎儿期侧脑室宽度的总体变化规律是随着孕期的进展而逐渐缩小(中孕期、晚孕早期与晚孕晚期侧脑室宽度两两比较,P均<0.0167);进一步亚组分析发现单、双侧IVM或轻度IVM或神经发育正常IVM其侧脑室宽度的变化均符合上述规律,但中度IVM侧脑室增宽恢复较晚,自晚孕早期才开始逐渐缩小(晚孕早期vs.晚孕晚期,P=0.001;而中孕期vs.晚孕早期,P=0.043);而出生后神经系统发育障碍组其侧脑室宽度整个孕期无明显变化(P>0.0167)。结论轻、中度的IVM病例5.26%出生后发生神经系统发育异常;神经发育异常者胎儿期侧脑室宽度随着孕期的进展无明显变化,其产前IVM未恢复率明显高于正常组;而发育正常胎儿其侧脑室宽度的总体变化规律是随着孕期的进展自中孕期开始逐渐缩小,其中中度IVM其侧脑室宽度缩小时间较轻度IVM晚,自晚孕早期才开始。为此,通过对侧脑室宽度的变化规Objective To explore the changing patterns of lateral ventricle width in cases of mild to moderate isolated ventriculomegaly(IVM)during pregnancy and their correlation with postnatal neurological development.Methods We retrospectively collected cases diagnosed prenatally with isolated mild to moderate ventriculomegaly,and confirmed normal results from chromosome microarray analysis(CMA).We recorded the ultrasound characteristics of fetal ventriculomegaly and tracked postnatal neurological development.For cases with two or more examinations during pregnancy,we compared the changes in lateral ventricle width at different gestational ages to analyze the changing patterns and their relationship with abnormal neurological development.Results During the study period,a total of 133 cases were included.Among them,126 cases(94.7%)had normal postnatal neurological development,and 7 cases(5.26%)had neurological abnormalities.The rate of non-recovery of prenatal ventriculomegaly in the neurological abnormality group was 85.71%(6/7),significantly higher than the 28.57%(36/126)in the normal group(P<0.05).However,there was no statistically significant difference in the laterality and degree of ventriculomegaly between the two groups.Comparing the changes in lateral ventricle width at three gestational ages,we found that the overall changing pattern of fetal ventricular width gradually decreased with the progression of pregnancy(comparisons between mid-pregnancy,early late pregnancy,and late pregnancy,P<0.0167).Subgroup analysis further revealed that the changes in lateral ventricle width in cases of single or bilateral IVM,or mild IVM,or normal neurological development all followed the above pattern.However,in cases of moderate IVM,the reduction in lateral ventricle width occurred later,starting from early late pregnancy(early late pregnancy vs.late pregnancy,P=0.001;mid-pregnancy vs.early late pregnancy,P=0.043).In the group with postnatal neurological developmental disorders,there was no significant change in lateral ventricl

关 键 词：胎儿侧脑室增宽 产前超声检查 变化规律 神经发育 

分 类 号：R715.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]