标题:静脉导管多普勒血流检测诊断胎儿先天性心脏病的价值
作者:艾先梅,陈晓园,邓享雄,杨洪伟,陈莉莉
(中山市古镇人民医院功能科,广东 中山 528421)
卷次:
2015年26卷13期
【摘要】 目的 探讨静脉导管多普勒血流检测对诊断胎儿先天性心脏病的临床价值。方法 对本院2010
年9月至2014年8月接诊的3 600例孕11~14周的单胎孕妇行静脉导管血流频谱(DV)及颈项透明层(NT)检测,行
超声心动图检查所有NT增厚及DV异常的胎儿,行超声心动图系统筛查孕18~20周和中孕期的胎儿,系统筛查
所有NT及DV正常的孕22~24周胎儿,并进一步行超声心动图检查疑为先天性心脏病(CHD)的胎儿,对所有胎
儿(出生后1周内)行超声心动图检查,引产者进行尸解,对数据进行评价。结果 3 600例胎儿中,与NT正常的胎
儿比较,NT增厚胎儿的先天性心脏病发生率显著升高(P<0.01),阳性预测值为32.73%、敏感性为53.73%、特异性
为 98.87%;与DV正常的胎儿比较,DV异常的胎儿先天性心脏病发生率显著升高(P<0.01),阳性预测值为
25.81%、敏感性为57.14%、特异性为96.74%;与NT及DV均正常的胎儿比较,NT异常合并DV异常的胎儿的先
天性心脏病发生率显著升高(P<0.01),阳性预测值为62.00%、敏感性为46.27%、特异性为99.84%。结论 胎儿静
脉导管多普勒血流检测对胎儿先天性心脏病的诊断有较高的特异度和灵敏度,可对胎儿先天性心脏病做出有效
的产前诊断,值得在临床上推广。
【关键词】 先天性心脏病;静脉导管;颈项透明层
【中图分类号】 R714.55 【文献标识码】 A 【文章编号】 1003—6350(2015)13—1929—03
Value of Doppler flow waveform of dutcus venosus in early screening of fetal congenital heart defects.
AI Xian-mei,
CHEN Xiao-yuan, DENG Xiang-xiong, YANG Hong-wei, CHEN Li-li. Department of Function, Zhongshan Guzhen
People's Hospital, Zhongshan 528421, Guangdong, CHINA
【Abstract】 Objective To investigate the clinical value of Doppler flow waveform of dutcus venosus in early
screening of fetal congenital heart disease (CHD). Methods A total of 3 600 pregnant woman with single fetus of 11~
14 weeks’gestation in our hospital from September 2010 to August 2014 received ductus venosus (DV) flow spec-
trum and nuchal translucency (NT). Echocardiography was used to test all the fetuses with NT thickening and DV ab-
normity, which was also applied to test the fetuses at 18~20 weeks' gestation and during the second trimester of preg-
nancy, all the fetuses of 22~24 weeks' gestation with normal NT and DV, as well as the fetuses suspected of CHD. One
week after birth, all the fetuses received echocardiography examination and those with abortion suffered autopsy. The
data was collected and statistically analyzed. Results Compared with the fetuses with normal NT, the fetuses with
NT thickening had significantly higher incidence of CHD (P<0.01), with the positive predictive value of 32.73%, the
sensitivity of 53.73%, and the specificity of 98.87%. Compared with fetuses with normal DV, the fetuses with DV ab-
normity had significantly higher incidence of CHD (P<0.01), with the positive predictive value of 25.81%, the sensi-
tivity of 57.14% and the specificity of 96.74%. Compared with fetuses with normal DV and NT, the fetuses with abnor-
mal DV and NT had significantly higher incidence of CHD (P<0.01), with the positive predictive value of 62.00%, the
sensitivity of 46.27%, and the specificity of 99.84%. Conclusion Doppler flow waveform of dutcus venosus shows
high specificity and sensitivity in the detection of CHD, which can make an effective prenatal diagnosis of CHD in
clinical practice. It is worthy of clinical promotion.
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