摘要
目的 评估产前超声心动图在诊断胎儿卵圆孔血流受限(FOR)中的价值,以提高早期检测的准确度和预防并发症.方法 回顾性分析诊断为FOR的62例胎儿及60例正常胎儿的资料,对比心胸比、RV/LV、RA/LA、VMPA/VAO和MPA/AO等指标,使用Logistic回归和ROC曲线评估诊断效果.结果 观察组胎儿的心胸比、RV/LV、RA/LA、MPA/AO及VMPA/VAO均显著高于对照组(P＜0.001).Logistic回归分析表明,心胸比、RA/LA比值、RV/LV比值、VMPA/VAO比值和MPA/AO比值为胎儿FOR的独立危险因素.ROC曲线分析显示,心胸比、RA/LA、RV/LV、MPA/AO 及 VMPA/VAO 的 AUC 分别为 0.832、0.817、0.752、0.746 和 0.707,联合预测 AUC 为0.954(P＜0.05),显示了良好的诊断效能.结论 心胸比、RV/LV、RA/LA、MPA/AO及VMPA/VAO是评估FOR的可靠指标,建议在临床中使用这些指标进行早期识别和评估,尽早干预以预防相关并发症.
Abstract
Objective To evaluate the diagnostic value of prenatal echocardiography in fetal foramen ovale re-striction to improve the accuracy of early detection and intervention and prevent the occurrence of related complica-tions.Methods Sixty normal fetuses and sixty-two fetuses diagnosed with foramen ovale restriction were retrospec-tively analyzed.Cardiothoracic ratio,RV/LV,RA/LA,VMPA/VAO and MPA/AO were compared,and the diagnostic effect was evaluated by Logistic regression and ROC curve.Results The fetal cardiothoracic ratio,RV/LV,RA/LA,MPA/AO and VMPA/VAO in observation group were significantly higher than those in control group(P＜0.001).Multivariate Logistic regression analysis showed that cardiothoracic ratio,RA/LA ratio,RV/LV ratio,VMPA/VAO ratio and MPA/AO ratio were independent risk factors for fetal foramen ovale restriction.ROC analysis showed that the AUC values of cardiothoracic ratio,RA/LA,RV/LV,MPA/AO and VMPA/VAO were 0.832,0.817,0.752,0.746 and 0.707,respectively,and the combined prediction AUC was 0.954(P＜0.05),indicating good diagnostic efficiency.Conclusions Cardiothoracic ratio,RV/LV,RA/LA,MPA/AO and VMPA/VAO are re-liable indicators for evaluating foramen ovale restriction.It is recommended to use these indicators for early identifica-tion and evaluation,and for early intervention to prevent related complications.
NETL
NSTL
万方数据