目的：探讨儿童超声心动图主动脉根部内径Z值计算的方法及其影响因素。方法选取2012年3至10月在深圳市儿童医院就医的105例儿童，中位年龄19个月。经二维超声心动图测量的主动脉瓣环及主动脉窦内径，分别采用中国深圳儿童医院（C法）与Pettersen等（P法）2个不同的正常参考值回归方程式和均方误，计算主动脉瓣环及主动脉窦内径Z值；再综合以上2种方法，采用C法的正常参考值回归方程式与P法的体表面积（BSA）公式，计算主动脉瓣环及主动脉窦内径的Z值（简称ZH法）。比较分析C法、P法及ZH法计算得出的主动脉瓣环、主动脉窦内径Z值大小及其概率分布的正态性。结果采用C法计算的主动脉瓣环、主动脉窦内径的Z值均呈正态分布（P值分别为0.067和0.650）。采用P法计算的主动脉瓣环、主动脉窦内径的Z值亦均呈正态分布（P值分别为0.208和0.970）。采用ZH法计算的主动脉瓣环内径Z值呈偏态分布（P=0.027），而主动脉窦内径的Z值呈正态分布（P=0.430）。C法、P法、ZH法计算得出的主动脉瓣环内径Z值分别为0.41±0.89、0.23±0.85和0.36±0.94，差异无统计学意义（F=1.117，P=0.309）；3种方法计算得出的主动脉窦内径Z值分别为0.38±0.89、0.58±0.71和0.36±0.84，差异有统计学意义（F=5.443， P=0.005）。C法与P法计算超声心动图主动脉瓣环内径、主动脉窦内径的Z值结果高度正相关，主动脉瓣环内径、主动脉窦内径Z值的相关系数分别为0.917（P=0.000）、0.900（P=0.000），相关方程分别为Y=0.917X-0.126、Y=0.900X-0.217。结论儿童超声心动图主动脉根部内径的Z值计算中， BSA公式和正常参考值的回归方程式是影响Z值大小的主要影响因素。应优先采用适合于中国儿童的正常参考值。%Objective To investigate the calculation method and its inlfuencing factors of Z scores in the aortic root diameters measured by echocardiography in children. Methods A total of 105 children with median age 19 months, who came to Shenzhen Children′s Hospital from March 2012 to October 2012 were included. The diameters of aortic ring (ARD) and aortic sinus (ASD) were measured by two dimension echocardiography, Z scores of ARD and ASD were calculated using two different normal reference values regression equation and mean square error derived from Shenzhen children′s hospital (C method) and Pettersen et al (P method). The regression equation from C method and body surface area (BSA) formula from P method were adopted to calculate Z scores of ARD and ASD (ZH method). The Z results of ARD and ASD calculated by those three methods were compared and were analyzed for their normality probability distributions. Results Z scores of ARD and ASD derived from C method were all showed as normal distribution (P=0.067 and 0.650). Z scores of ARD and ASD derived from P method were all showed as normal distribution (P=0.208 and 0.970). Z score of ARD derived from ZH method was showed as non-normal distribution (P=0.027), but Z score of ASD was normal distribution (P=0.430). There were no significant differences in ARD-Z calculated by C method (0.41±0.89), P method (0.23±0.85) and ZH method (0.36±0.94) (F=1.117, P=0.309). There were signiifcant differences in the Z scores of ASD calculated by C method (0.38±0.89), P method (0.58±0.71) and ZH method (0.36±0.84) (F=5.443, P=0.005). Z scores of ARD (r=0.917, P=0.000) and ASD (r=0.900, P=0.000) calculated by C method correlated well with that by P method. Conclusions Calculation method of BSA and normal reference values regression equation were the main influencing factors of Z score value in quantifying children aortic root diameters by echocardiography. For the clinical applications. The normal reference value should be used which is suitable for the Chinese children.
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