【作者】 裴秋艳； 张晓红； 李建国； 黄歆；

【Author】 Pei Qiuyan;Zhang Xiaohong;Li Jianguo;Department of Obstetrics Ultrasongraphy,People’s Hospital of Peking University;

【机构】 北京大学人民医院产科超声室； 北京大学人民医院超声科；

【摘要】 目的探讨胎儿颈项透明层(nuchal translucensy,NT)增厚及静脉导管(ductus venosus,DV)多普勒血流频谱异常在早期先天性心脏畸形(congenital heart disease,CHD)筛查中的临床意义。方法 2007年1月~2009年4月期间,常规对在我院产前检查的孕妇于孕11~14周进行胎儿NT测量,同时对NT增厚的胎儿行超声心动图检查和DV血流频谱检测,对可疑CHD的胎儿于孕18~20周再次行超声心动图检查以确诊或除外CHD;对NT正常的胎儿于孕20~24周行胎儿超声心动图检查。所有活产儿于生后1周内行超声心动图检查,引产的胎儿争取尸解。结果 (1)NT增厚胎儿的62例,产前产后证实17例患有CHD,NT正常的胎儿2 046例,产前产后证实18例患有CHD,与NT正常胎儿比较,NT增厚胎儿CHD发病率明显增高,且以复杂型CHD为主;(2)NT增厚的62胎儿中,7例胎儿DV血流频谱异常,产前产后证实其中5例为先天性心脏畸形。结论胎儿NT增厚及DV血流频谱异常可作为胎儿复杂CHD的早期筛查指标。更多还原

【Abstract】 Objective To investigate the clinical significance of fetal increased nuchal translucency(NT) and abnormal Doppler blood flow spectrum of ductus venosus(DV) in the screening of early congenital heart disease(CHD).Methods From January 2007 to April 2009,fetal regular NT measurements were conducted to pregnant women within11~14 gestational weeks in our hospital.Blood flow spectra of DV of fetuses with increased NT were detected using color flow Doppler ultrasound as well as echocardiography.Those fetuses suspected with CHD were re-examined with echocardiography duing 18-20 gestational weeks to obviate congenital heart disease.Echocardiography detections were conducted during 20~24 weeks of gestation to fetuses with normal NT.All fetuses were followed up with echocardiography examination during 1 week after birth,and those abortions accepted autopsy.Fetuses without follow-up were not included in this study.Results(1) A total of 2108 fetuses were included in this study among which 62 cases were with increased NT,17 cases with CHD confirmed before and after birth,2046 cases with normal NT,18 cases with CHD confirmed before and after birth.Compared with fetuses with normal NT,fetuses with increased NT showed significantly higher CHD incidence,mainly complex CHD.(2) Among 62 fetuses with increased NT,7 presented abnormal Doppler blood flow spectrum of DV,5 cases of which with CHD were confirmed before and after birth with or without chromosomal abnormalities,while the other 2 cases showed chromosomal abnormalities without CHD.Conclusions Fetal increased NT and abnormal blood flow spectrum of DV can be used as early screening indicators of complex CHD.更多还原