Z评分评价正常中晚孕期胎儿主动脉和肺动脉内径增长

摘要

Objective To explore the application value of Z-scores in evaluating growth of aorta (AO) and pulmonary artery (PA) diameter.Methods AO and PA diameters in 332 normal fetuses were measured twice using fetal echocardiography.Z-scores of AO and PA were obtained based on a simple linear equation using gestational age (GA),biparietal diameter (BPD) and femur length (FL) as independent variables.The difference of Z-scores calculated by twice examinations was evaluated.Results The gestation ages of the first and the second examinations of fetal echocardiography were (25.82± 2.27) weeks (range 18-35 weeks) and (30.61± 2.28) weeks (range 23-39 weeks).There were statistical significant differences of AO and PA diameters between the first and the second examinations (both P＜0.05).AO and PA diameters increased with the growth of GA in all fetuses obtained using two examinations,whereas there was no obvious change of Zscores of AO and PA with increasing GA,BPD and FL in individual pregnant woman.No statistical significant difference was found for Z-scores of AO and PA between the first and the second examinations (both P＞0.05).Conclusion The growth of AO and PA diameters are positively correlated with the growth of biological parameters in normal fetuses,while Z-scores of AO and PA remain constant in second and late trimesters.%目的 探讨Z评分对评价正常中晚孕期胎儿主动脉(AO)、肺动脉(PA)内径增长的应用价值.方法 通过前后2次产前超声心动图测量332胎正常胎儿的AO内径及PA内径.以AO内径、PA内径为应变量,胎儿双顶径(BPD)、胎儿股骨长径(FL)、孕周(GA)为自变量,建立回归方程,基于此计算AO、PA的Z评分.比较前后2次超声心动图检查Z评分的差异.结果 首次胎儿超声心动图检查时GA为(25.82±2.27)周(18～35周),第2次检查时GA为(30.61±2.28)周(23～39周).前后2次胎儿超声心动图检查所测胎儿AO内径、PA内径差异均有统计学意义(P均＜0.05).2次超声心动图检查的AO内径及PA内径均随GA、BPD及FL的增长而增长.同一孕妇胎儿AO及PA的Z评分随GA、BPD及FL的增长而相对稳定.前后2次产前超声心动图检查胎儿AO、PA的Z评分的差异均无统计学意义(P均＞0.05).结论 正常胎儿AO和PA内径的增长与生物学参数的增长呈正相关,但Z-评分在中晚孕期相对保持恒定.