摘要
目的 探讨多个超声指标用于产前诊断胎儿肺发育不良的临床价值。方法 应用彩色多普勒超声诊断仪，检查271例正常胎儿，建立5个超声指标（肺面积、肺面积与胎儿质量比、胸围与腹围比、肺面积与胸廓面积比、肺面积与头围比）的正常值范围，以低于正常范围二倍标准差为肺发育不良胎儿判断标准。通过对30例肺发育不良高危胎儿的研究，并与尸体解剖及追踪结果对照，比较各超声指标的临床价值。结果 肺面积及肺面积与头围比随孕周增加而增加，肺面积与胎儿质量比随孕周增加而减少，胸围与腹围比、肺面积与胸廓面积比随孕周增加变化较小。肺面积、肺面积与胎儿质量比、胸围与腹围比、肺面积与胸廓面积比、肺面积与头围比用于产前诊断胎儿肺发育不良的准确率分别为83％、97％、50％、70％、87％。肺面积与胎儿质量比诊断准确率最高，灵敏度为95％（20／21），特异度为9／9，阳性预测值为100％（20／20）。结论 肺面积与胎儿质量比能较好地预测致死性肺发育不良，具有临床实用性。
Objective To evaluate the clinic value of five different ultrasonographic fetal parameters for prenatal diagnosis of pulmonary hypoplasia. Methods Two hundred and seventy-one normal singleton pregnancies with well-established dates between 20 and 40 weeks of gestation were studied to establish normal reference range of five different ultrasonographic fetal parameters. The five parameters, which could reflect fetal lung mass, were as follows： lung area/body weight ratio, lung area, thoracic circumference/ abdominal circumference ratio, lung area/thoracic area ratio and lung area/head circumference. Thirty pregnancies with risk factors for pulmonary hyperplasia were studied for the usefulness of five parameters. Two or more standard deviations below the mean control group measurement were considered abnormal. The prenatal ultrasonic diagnoses of pulmonary hyperplasia were confirmed at neonatal follow-up examinations, on autopsy and by pathologic findings. Results Lung area and lung area/head circumference increased with gestational age, lung area/body weight ratio decreased with gestational age. The relationships among the two ratios（thoracic circumference/abdominal circumference ratio, lung area/thoracic area ratio） and gestational age were relatively constant. Abnormal lung area/body weight ratio had a higher diagnostic accuracy than other parameters. Sensitivity of the parameters, including lung area, lung area/body weight ratio, thoracic circumference/abdominal circumference ratio, lung area/thoracic area ratio and lung area/head circumference were 83% ,97% ,50% ,70% and 87%, respectively. Sensitivity of the lung area/body weight ratio was 95% （ 20/21 fetuses ） ; specificity, 9/9 fetuses; positive predictive value, 100% （ 20/20 fetuses） ; negative predictive value, 9/10; and accuracy 97% （29/30 fetuses）. Conclusion Lung area/ body weight ratio is a good predictor of pulmonary hypoplasia.
出处
《中华妇产科杂志》
CAS
CSCD
北大核心
2008年第5期332-335,共4页
Chinese Journal of Obstetrics and Gynecology
关键词
超声检查
产前
支气管肺发育不良
Ultrasonography,prenatal
Bronchopulmonary dysplasia
