CAJ | 학술논문

目的：利用胎儿及新生儿心脏二维彩超图像,探讨围产期新生儿心室生长变化,定量分析胎儿期至出生后心室的形态变化。方法选取2012年3月至2013年8月于武汉市黄陂区人民医院行常规胎儿、新生儿超声检查且结果为正常者为研究对象,按胎龄或出生时间分为A(21~27w)、B(28~32w)、C(33~40w)、D(产后1w内)4组,各65例。 A、B、C组行胎儿常规超声检查留取标准四腔心切面图像,D组新生儿行超声心动图检查留取标准四腔心切面图像。测量并记录各心室横径、长径、侧壁厚度、室间隔厚度及心室心尖角度,利用曲率半径测量软件测量左、右心室侧壁的最小曲率半径( LVCRm、RVCRm )及位置( LVCm%、RVCm%),测量室间隔最大曲率( IVSCm)、位置( IVSCm%),分析、比较各组间上述指标的差异。结果①从A组到D组,LVTD、LVLD及RVLD均呈递增趋势(LVTD、LVLD及RVLD的趋势χ2值分别为5.39、7.69和3.65,均P<0.05)；D组的LVTD/RVTD显著大于A、B、C三组(t值分别为14.52、8.99和9.91,均P<0.05)；②从A组到D组,LVLW、RVLW及IVS呈递增趋势,各组间差异有统计学意义(LVLW、RVLW及IVS的趋势χ2值分别为0.75、0.73和0.78,均P<0.05)；③4组间LVAA比较无明显差异(F=1.10,P>0.05),D组的RVAA小于A、B、C组(t值分别为10.05、13.41和15.63,均P<0.05)；④从A组到D组,LVCRm呈递增趋势(LVCRm的趋势χ2值为2.44,P<0.05)。结论胎儿期右心室占优势,随着胎儿心脏发育,出生后左、右心室比例相当。采用胎儿心脏超声检查技术及超声心动图可了解胎儿、新生儿心脏发育情况。
목적：이용태인급신생인심장이유채초도상,탐토위산기신생인심실생장변화,정량분석태인기지출생후심실적형태변화。방법선취2012년3월지2013년8월우무한시황피구인민의원행상규태인、신생인초성검사차결과위정상자위연구대상,안태령혹출생시간분위A(21~27w)、B(28~32w)、C(33~40w)、D(산후1w내)4조,각65례。 A、B、C조행태인상규초성검사류취표준사강심절면도상,D조신생인행초성심동도검사류취표준사강심절면도상。측량병기록각심실횡경、장경、측벽후도、실간격후도급심실심첨각도,이용곡솔반경측량연건측량좌、우심실측벽적최소곡솔반경( LVCRm、RVCRm )급위치( LVCm%、RVCm%),측량실간격최대곡솔( IVSCm)、위치( IVSCm%),분석、비교각조간상술지표적차이。결과①종A조도D조,LVTD、LVLD급RVLD균정체증추세(LVTD、LVLD급RVLD적추세χ2치분별위5.39、7.69화3.65,균P<0.05)；D조적LVTD/RVTD현저대우A、B、C삼조(t치분별위14.52、8.99화9.91,균P<0.05)；②종A조도D조,LVLW、RVLW급IVS정체증추세,각조간차이유통계학의의(LVLW、RVLW급IVS적추세χ2치분별위0.75、0.73화0.78,균P<0.05)；③4조간LVAA비교무명현차이(F=1.10,P>0.05),D조적RVAA소우A、B、C조(t치분별위10.05、13.41화15.63,균P<0.05)；④종A조도D조,LVCRm정체증추세(LVCRm적추세χ2치위2.44,P<0.05)。결론태인기우심실점우세,수착태인심장발육,출생후좌、우심실비례상당。채용태인심장초성검사기술급초성심동도가료해태인、신생인심장발육정황。
Objective To investigate ventricular morphological changes with the growth of perinatal neonates and quantitatively analyze the morphological changes by echocardiography. Methods During the period of March 2012 to August 2013 fetus and newborns with normal results in routine ultrasound examination in People’s Hospital of Huangpi District of Wuhan were chosen and divided into group A (21-27 weeks), group B (28-32 weeks), group C (33-40 weeks) and group D (newborns within 7 days) according to fetus age and birth time. Each group had 65 cases. Fetus underwent fetal routine ultrasound examination and newborns underwent echocardiography examination. The standard four-chamber view images of fetus in group A, group B and group C and newborns in group D were remained. Left ventricular transverse diameter ( LVTD) and right ventricular transverse diameter ( RVLD) , left ventricular long diameter ( LVLD) , right ventricular long diameter ( RVLD ) , thickness of left ventricular lateral wall ( LVLW ) , thickness of right ventricular lateral wall ( RVLW) , thickness of interventricular septal ( IVS) , left ventricular apex angle ( LVAA) and right ventricular apex angle ( RVAA) were measured and recorded. The minimum left ventricular curvature radius ( LVCRm) , right ventricular curvature radius ( RVCRm) and their location ( LVCm%, RVCm%) , the maximum interventricular septum curvature ( IVSCm) and location ( ( IVSCm%) were measured with curvature radius measurement software. Results From group A to group D, LVTD, LVLD and RVLD showed a trend of increase (χ2 value was 5. 39, 7. 69 and 3. 65, respectively, all P<0. 05). LVTD/RVTD in group D was greater than that of group A, group B and group C (t value was 14. 52, 8. 99 and 9. 91, respectively, all P<0. 05). From group A to group D, LVLW, RVLW and IVS showed a trend of increase with significant difference (χ2 value was 0. 75, 0. 73 and 0. 78 respectively, all P<0. 05). There was no obvious difference in LVAA among four groups (F=1. 10, P>0. 05), while the RVAA of group D was less than that in group A, group B and group C (t value was 10. 05, 13. 41 and 15. 63, respectively, all P<0. 05). From group A to group D, LVCRm showed a trend of increase (χ2 =2. 44, P<0. 05). Conclusion Right ventricular is preponderant in fetal period. With the increase of gestational age, the left and right ventricle increase evenly. The application of fetal cardiac ultrasound technology and echocardiography enable us to understand the situation of growth and development of fetal and neonatal heart.