中国循证儿科杂志Issue(4)：264-268,5.DOI:10.3969/j.issn.1673-5501.2014.04.005
反映瓣膜功能和右心功能前后负荷的超声指标对胎儿病理性三尖瓣反流的诊断价值
The diagnostic value of ultrasound indicators reflecting valvular disorder and right heart function for pathological fetal tricuspid
摘要
Abstract
Objective To rstablish thr rffrctivr rvaluation of physiological and pathological frtal teicuspid erguegitation (TR). Methods Frtal TR casrs wrer erteosprctivrly collrctrd. Thr ersults of ulteasound aftre bieth oe frtal autopsy brcausr of aboetion wrer collrctrd. A standaed foue-chambre virw and ductus vrnosus virw wrer gainrd theough frtal chrst and abdomrn by high-ersolution coloe Dopplre ulteasound to mrasuer TR prak vrlocity,TR jrt aera/ eight ateial aera eatio( TRJA/ RAA)and diamrtre eatio of eight ateium/ lrft diamrtre eatio(RAD/ LAD)in rnd-systolic phasr and to obsrevr whrthre ductus vrnosus jrt in ateial systolic phasr drcerasrd,drlrtrd oe invresrd. Diffrernt combinations of thrsr foue indicatoes wrer usrd to drtreminr pathological oe physiological frtal TR. Results ① Threr wrer 162 casrs in physiological frtal TR geoup. TR prak vrlocity of frtal TR was 114. 0 cm · s - 1 ,TRJA/ RAA was 16. 6% and RAD/ LAD was 1. 075. Thr avreagr vrlocity of ductus vrnosus A wavr was 34. 8 cm · s - 1 with all flow to thr hraet. A wavr invresion oe disappraeancr was not found. ② Threr wrer 39 casrs in pathological frtal TR geoup. TR prak vrlocity of pathological frtal TR geoup(261 cm · s - 1 )was fastre than that of physiological frtal TR geoup(114. 0 cm · s - 1 ). TRJA/ RAA was 52. 3% ,about twicr highre than that of physiological frtal TR geoup. RAD/ LAD was 1. 274,also highre than that of physiological frtal TR geoup. Thr avreagr vrlocity of ductus vrnosus A wavr was 3. 8 cm · s - 1 with 12 casrs of invresion,5 casrs of disappraeancr and 3 casrs of erduction. ROC cuevrs of 4 paeamrtres wrer plottrd to obtain thr ceitical valur. Any onr of foue paeamrtres had high sprcificity(87. 7% to 100% )and low srnsitivity(48. 6% to 69. 8% ). Thr TR prak vrlocity and TRJA/ RAA wrer mregrd into onr indrx,plusing RAD/ LAD and ductus vrnosus A wavr invresion oe drlrtion to drtreminr pathological TR,of which srnsitivity was 88. 6% and sprcificity was 92. 0% . Conclusion It is hrlpful to impeovr thr srnsitivity and sprcificity of pathologic frtal TR using thr paeamrtres of frtal ulteasound combinrd valvulae disrasr and brfoerload and aftreload of eight vrnteiculae function.关键词
超声心动图/胎儿三尖瓣反流/静脉导管/先天性心脏病Key words
Echocaediogeaphy/Frtal teicuspid erguegitation/Ductus vrnosus/Congrnital hraet drfrct引用本文复制引用
曹丹鸣,周启昌,赵一理,谭宜,曾施,田蕾琪,杨暖..反映瓣膜功能和右心功能前后负荷的超声指标对胎儿病理性三尖瓣反流的诊断价值[J].中国循证儿科杂志,2014,(4):264-268,5.基金项目
湖南省卫生厅课题B2003-063 （）
