摘要目的:探讨超声胎儿颈项透明层(NT)、静脉导管a波(DVa波)及三尖瓣反流(TR)预测胎儿先天性心脏病(CHD)的临床价值。方法:抽取2018年3月至2020年3月在郑州人民医院行超声检查的孕妇19 600例，根据其胎儿有无CHD分为无CHD组( n＝19 502)与CHD组( n＝98)。比较两组胎儿NT≥3.5 mm、TR、DVa波倒置比率，采用Spearman相关分析方法分析NT≥3.5 mm、DVa波倒置、TR与胎儿CHD的相关性，采用Logistic回归分析方法分析胎儿CHD的危险因素，采用受试者工作特征曲线(ROC)分析NT≥3.5 mm、DVa波倒置、TR对胎儿CHD的预测价值。 结果:CHD组NT≥3.5 mm、DVa波倒置、TR比率高于无CHD组( P<0.05)。NT≥3.5 mm、DVa波倒置、TR与胎儿CHD呈正相关( P<0.05)。NT≥3.5 mm、DVa波倒置、TR是胎儿CHD的危险因素( P<0.05)。TR预测胎儿CHD的价值优于DVa波倒置( P<0.05)，NT≥3.5 mm预测胎儿CHD的价值优于TR( P<0.05)；NT≥3.5 mm、DVa波倒置、TR联合预测胎儿CHD的价值优于各项单独检查( P<0.05)。 结论:超声NT≥3.5 mm、DVa波倒置、TR联合预测胎儿先天性心脏病的价值较高。

abstractsObjective:To investigate the clinical value of ultrasound nuchal thickness (NT), ductus venous A wave (DVa wave) and tricuspid regurgitation (TR) in predicting fetal congenital heart disease (CHD).Methods:A total of 19 600 pregnant women underwent ultrasound examination in Zhengzhou People’s Hospital from March 2018 to March 2020 were selected, and they were divided into non-CHD group ( n=19 502) and CHD group ( n=98) according to whether the fetus had CHD or not. The proportions of NT thickness≥3.5 mm, TR and DVa wave inversion were compared between the two groups. Correlations of NT thickness≥3.5 mm, TR, DVa wave inversion with CHD were analyzed by spearman analysis. The risk factors of CHD were analyzed by Logistic regression analysis. And the predictive value of NT thickness≥3.5 mm, TR and DVa wave inversion for CHD was also verified by receiver operating characteristic curve (ROC). Results:The proportions of NT thickness≥3.5 mm, TR and DVa wave inversion were higher in CHD group than those in non-CHD group ( P<0.05). NT thickness≥3.5 mm, TR and DVa wave inversion were positively correlated with CHD ( P<0.05). NT thickness≥3.5 mm, TR and DVa wave inversion were risk factors for CHD ( P<0.05). NT thickness≥3.5 mm had the highest predict value, followed by TR and DVa wave inversion, with significant difference ( P<0.05). The combined detection of NT thickness≥3.5 mm, TR and DVa wave inversion had higher predictive value than single detections ( P<0.05). Conclusions:NT thickness≥3.5 mm, TR and DVa wave inversion have high predictive value for CHD.