超声心动图诊断胎儿先心病及危险因素分析

doi:10.7517/issn.1674-0475.210729

摘要/Abstract

摘要： 本研究探讨超声心动图在胎儿先心病诊断中的价值以及影响先心病发病的危险因素。采用回顾性研究方法，选取孕产妇18987例，均进行系统的彩色多普勒超声检查，同时问卷调查胎儿先心病家庭65例（病例组）及130例正常胎儿家庭（对照组）的病史等情况。结果显示，先心病发病率为0.43%，疾病类型中：以单纯性室间隔缺损、心内膜垫缺损和右心室双出口为主；Logistic回归分析结果显示：产妇年龄、孕期有致畸物接触史、产妇糖尿病、产妇结缔病、不良妊娠史、染色体异常、胎儿早期NT值、先心病家族史是先心病发生的影响因素（P<0.05）。从上述结果可知，超声心动图在胎儿先心病诊断中有较好的价值，先心病发病受产妇年龄、致畸物接触史等因素的影响。

关键词: 超声心动图, 胎儿, 先心病, 诊断价值, 危险因素

Abstract: This study explored the value of echocardiography in the diagnosis of fetal congenital heart disease and the risk factors affecting the onset of congenital heart disease. A retrospective study was conducted, 18987 pregnant women underwent prenatal examination were selected, and 65 families with fetal congenital heart disease (case group) and 130 families with normal fetus (control group) were investigated by questionnaire. The incidence rate of congenital heart disease was 0.43%, the disease types were simple ventricular septal defect, endocardial cushion defect and double outlet of right ventricle; Logistic regression analysis showed that maternal age, history of teratogen exposure during pregnancy, maternal diabetes mellitus, maternal connective disease, adverse pregnancy history, chromosomal abnormalities, early fetal NT value and family history of congenital heart disease were the influencing factors of congenital heart disease (P<0.05). It is concluded that echocardiography has good value in the diagnosis of fetal congenital heart disease, and the incidence of congenital heart disease is affected by maternal age, teratogenic exposure history and other factors.

Key words: echocardiography, fetus, congenital heart disease, diagnostic value, risk factors

余婵, 王蓓, 杨园, 狄敏. 超声心动图诊断胎儿先心病及危险因素分析[J]. 影像科学与光化学, 2022, 40(1): 156-160.

YU Chan, WANG Bei, YANG Yuan, DI Min. Value and Risk Factors of Echocardiography in the Diagnosis of Fetal Congenital Heart Disease[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(1): 156-160.

参考文献

[1] 陈奕男, 秦将均, 覃英梅, 等. 四维超声时间空间相关成像和超声断层显像(STIC-TUI)技术对胎儿先天性心脏病筛查的应用价值[J]. 海南医学院学报, 2019, 25(12):948-950, 956.
[2] 左镕宇, 骆志玲. 超声心动图诊断胎儿卵圆孔血流受限或提前闭合的相关研究[J]. 心血管病学进展, 2019, 40(1):84-88.
[3] 卢文岳, 梁小勤, 王宏婵. 断层超声显像技术联合2DE在胎儿心脏大动脉畸形诊断中的应用价值[J]. 内蒙古医科大学学报, 2019, 41(2):187-189.
[4] 杨伟, 王峥. 超声心动检查联合孕妇血清miRNA-19b、AFP测定对胎儿先天性心脏病的诊断价值分析[J]. 中国优生与遗传杂志, 2020, 28(5):618-621.
[5] 颜雪萍, 李雪娇, 陈昌钊, 等. 超声心动图Tei指数在妊娠期糖尿病孕妇胎儿心脏功能评价中的应用[J]. 中国超声医学杂志, 2020, 36(2):153-156.
[6] 刘吉庆, 苏静, 孟秋霞. 四维超声心动图联合二维彩超在胎儿先天性心脏畸形筛查中的应用[J]. 中国妇幼保健, 2019, 34(19):4574-4576.
[7] Joshi A, Shrestha R, Shrestha P S. Indications of fetal echocardiography and detection of congenital heart disease prenatally in tertiary care hospital[J]. Kathmandu University Medical Journal, 2019, 17(67):195-200.
[8] 泮思林, 罗刚. 医学人工智能在胎儿超声心动图中的应用前景[J]. 中国实用儿科杂志, 2020, 35(11):850-853.
[9] 余燕成, 赵博文, 戴丽雅, 等. 基于容积超声的胎儿心脏计算机辅助诊断技术获取胎儿超声心动图基本诊断切面的应用价值[J]. 中华超声影像学杂志, 2020, 29(4):314-320.
[10] 李兰, 谢海蓉, 饶静, 等. 超声心动图在妊娠中晚期胎儿复杂性先天性心脏畸形筛查中的作用[J]. 中国医药导报, 2019, 16(1):138-140, 144.
[11] 宋筱玉, 唐中锋, 孙庆梅, 等. 早孕期胎儿超声心脏筛查联合胎儿心脏测量参数Z-评分在胎儿先天性心脏病产前诊断中的应用价值[J]. 中国妇幼保健, 2019, 34(11):2643-2645.
[12] 李玉杰, 吴琳. 产前超声心动图在先天性心脏病临床诊治中的应用价值[J]. 临床超声医学杂志, 2020, 22(11):850-852.
[13] 张俊, 邓学东, 潘琦, 等. 早孕期超声心动图在胎儿严重先心病中的应用[J]. 中国临床医学影像杂志, 2019, 30(1):28-31.
[14] 杨军, 张梅. 三维超声心动图在结构性心脏病中的应用[J]. 中国医学影像技术, 2019, 35(9):1285-1286.
[15] 闫景彬, 闫秀梅, 杨建享, 等. 产前超声筛查胎儿先天性心脏病的临床意义及高危因素分析[J]. 中华全科医学, 2016, 14(1):114-115.