摘要目的 探讨正常中晚孕期胎儿肺动脉瓣至肺动脉分叉处的距离(DPVB)与胎儿生物学生长参数的相关性.方法 随机成功选取进行胎儿超声心动图检查的419例孕周(GA)为20~35+周正常单胎进行测量,获得胎儿的双顶径(BPD)、股骨长径(FL)和孕周(GA)等生物学生长参数.在胎儿大动脉短轴切面或右室流出道-肺动脉长轴切面测量DPVB(DPVBs:心室收缩末期距离;DPVBd:心室舒张末期距离);收缩末期测量肺动脉瓣环内径(PA).以GA、BPD、FL及PA作为自变量,以预测的DPVBs及DPVBd为因变量,建立DPVBs及DPVBd的正常参考值范围.结果 正常 20~35+周胎儿DPVBs值(1.14±0.24)cm,95%区间范围(0.67,1.61)cm;DPVBd值(0.93±0.20)cm,95%区间范围(0.53,1.33)cm.统计分析显示,DPVB与GA、BPD、FL、PA均呈显著线性相关,DPVBs与GA、BPD、FL、PA的r值分别为 0.827、0.798、0.793、0.769(均P<0.001);直线回归方程为Y=0.054×GA-0.369、Y=0.184×BPD-0.179、Y=0.217×FL+0.011;Y=1.602×PA+0.156.DPVBd与GA、BPD、FL、PA的r值分别为 0.802、0.764、0.773、0.771(均P<0.001),直线回归方程分别为Y=0.045×GA-0.330、Y=0.152×BPD-0.157、Y=0.182×FL-0.018;Y=1.380×PA+0.080.结论 正常胎儿的DPVBs与DPVBd随着GA增加而增加,其与GA、BPD、FL、PA有良好的相关性,DPVBs及DPVBd正常范围的确定可作为正常胎儿心脏评估的一项新的参考标准,在胎儿相关先天性心脏畸形诊断方面具有潜在的参考应用价值.

abstractsObjective To quantitatively study the correlation of the distance of pulmonary valve to pulmonary artery bifurcation (DPVB) of normal fetuses in second and late trimester with the fetal biometric parameters using fetal echocardiography.Methods The distances of pulmonary valve to pulmonary artery bifurcation in end-systole (DPVBs) and in end-diastole (DPVBd) were measured in a standard short axis view or right ventricular outflow tract view using fetal echocardiography on 419 normal fetuses.The gestation ages ranged from 20 to 35+ weeks.Fetal non-cardiac biometric parameters including biparietal diameter (BPD),femoral length (FL) and gestation age (GA) based on menstrual age,pulmonary valve annulus diameters (PA) at end-systole were measured.The correlation between DPVBs,DPVBd and non-cardiac biometric parameters were analyzed.Results In normal fetuses,the DPVBs was (1.14±0.24)cm with a range of 0.67 to 1.61 cm,the DPVBd was (0.93±0.20)cm with a range of 0.53 to 1.33 cm.The DPVBs and DPVBd were increased with the growth of GA,and were positively correlated with GA,BPD,FL and PA (r=0.827,0.798,0.793,0.769;0.802,0.764,0.773 and 0.771,respectively,all P<0.001).The linear regression equations between DPVBs,DPVBd and GA,BPD,FL,PA were:Y=0.054×GA-0.369,Y=0.184×BPD-0.179,Y=0.217×FL+0.011,Y=1.602×PA+0.156,Y=0.045×GA-0.330,Y=0.152×BPD-0.157,Y=0.182×FL-0.018,Y=1.380×PA+0.080.Conclusions In normal fetuses,the DPVBs and DPVBd increase with the growth of GA,and have good correlation with GA,BPD,FL and PA,respectively.Normal reference ranges of DPVBs and DPVBd have been provided.These normative data may become a new tool for assessment of fetal heart,especially has potential applications in screening of complex congenital heart defects.