CAJ | 학술논문

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。
목적：탐토인동초성심동도주동맥근부내경Z치계산적방법급기영향인소。방법선취2012년3지10월재심수시인동의원취의적105례인동，중위년령19개월。경이유초성심동도측량적주동맥판배급주동맥두내경，분별채용중국심수인동의원（C법）여Pettersen등（P법）2개불동적정상삼고치회귀방정식화균방오，계산주동맥판배급주동맥두내경Z치；재종합이상2충방법，채용C법적정상삼고치회귀방정식여P법적체표면적（BSA）공식，계산주동맥판배급주동맥두내경적Z치（간칭ZH법）。비교분석C법、P법급ZH법계산득출적주동맥판배、주동맥두내경Z치대소급기개솔분포적정태성。결과채용C법계산적주동맥판배、주동맥두내경적Z치균정정태분포（P치분별위0.067화0.650）。채용P법계산적주동맥판배、주동맥두내경적Z치역균정정태분포（P치분별위0.208화0.970）。채용ZH법계산적주동맥판배내경Z치정편태분포（P=0.027），이주동맥두내경적Z치정정태분포（P=0.430）。C법、P법、ZH법계산득출적주동맥판배내경Z치분별위0.41±0.89、0.23±0.85화0.36±0.94，차이무통계학의의（F=1.117，P=0.309）；3충방법계산득출적주동맥두내경Z치분별위0.38±0.89、0.58±0.71화0.36±0.84，차이유통계학의의（F=5.443， P=0.005）。C법여P법계산초성심동도주동맥판배내경、주동맥두내경적Z치결과고도정상관，주동맥판배내경、주동맥두내경Z치적상관계수분별위0.917（P=0.000）、0.900（P=0.000），상관방정분별위Y=0.917X-0.126、Y=0.900X-0.217。결론인동초성심동도주동맥근부내경적Z치계산중， BSA공식화정상삼고치적회귀방정식시영향Z치대소적주요영향인소。응우선채용괄합우중국인동적정상삼고치。
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.