胎儿主动脉弓缩窄产前超声特征对产后新生儿结局的预测价值
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R714.5

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Predictive value of prenatal ultrasound characteristics of fetal constriction of the aorta in postpartum neonatal outcomes
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    摘要:

    目的:探讨胎儿主动脉弓缩窄(CoA)产前超声特征对产后新生儿结局的预测价值。方法:选取128例进行规律 产检且产前超声提示胎儿 CoA 孕妇为研究对象,随访至出生后0~2周岁,根据出生后超声心动图诊断、手术证实,将新生儿 结局分为 A 组(明显缩窄)与 B组(轻度缩窄+正常)。比较两组产妇及新生儿一般资料、产前超声检查声像图特征[升主动脉 内径(AAO)、远端主动脉弓狭窄处内径(DTAI)、狭窄处流速]。采用 Logistic回归分析 AAO、DTAI、狭窄处流速与新生儿主 动脉弓明显缩窄的关系,采用 ROC分析 AAO、DTAI、狭窄处流速及其联合预测主动脉弓明显缩窄的价值。结果:128例孕 妇随访正常新生儿11例,轻度缩窄31例,明显缩窄86例。A 组产妇年龄、超声检测孕周、BMI、妊娠糖尿病占比均高于 B组 (P<0.05)。A 组 AAO、DTAI均低于 B组,A 组狭窄处流速高于 B组(P<0.05)。Logistic回归分析校正年龄、超声检测孕 周、BMI、妊娠糖尿病占比影响后,AAO、DTAI值低、狭窄处流速高均是主动脉弓明显缩窄的风险指标(P<0.05)。ROC分析 结果显示,AAO、DTAI、狭窄处流速联合及 DTAI单独预测新生儿主动脉弓明显缩窄的 AUC 均较高,均具有良好的预测价 值。结论:产前 AAO、DTAI及狭窄处流速在预测新生儿主动脉弓明显缩窄中具有重要临床价值,其中 DTAI的预测价值最 高,临床可优先采用 DTAI进行预测,AAO、狭窄处流速作为辅助预测指标。

    Abstract:

    Objective: To explore the predictive value of prenatal ultrasound characteristics of fetal constriction of the aorta (CoA) in postpartum neonatal outcomes. Methods: A total of 128 pregnant women with fetal CoA indicated by prenatal ultrasound who underwent regular prenatal examinations were enrolled, and all were followed up till 0~2 years old after fetal birth. According to echocardiographic diagnosis and surgical confirmation after birth, neonatal outcomes were divided into group A (significant constriction) and group B (mild constriction + normal). The maternal and neonatal general data and prenatal ultrasonogram characteristics [ascending aortic diameter (AAO), distal transverse aortic arch (DTAA), flow velocity at the stenosis site] in the two groups were compared. The relationship between AAO, DTAA, flow velocity at the stenosis site and significant CoA was analyzed by Logistic regression analysis, and predictive value of AAO, DTAA, flow velocity at the stenosis site and combined detection in significant CoA was analyzed by ROC curves. Results: Among 128 pregnant women after follow-up, there were 11 cases with normal neonates, 31 cases with mild constriction and 86 cases with significant constriction. The age of puerperae, gestational weeks detected by ultrasound, BMI and proportion of gestational diabetes mellitus in group A were higher than those in group B(P<0.05). AAO and DTAA in group A were lower than those in group B, and flow velocity at the stenosis site was faster than that in group B(P<0.05). After correcting the influences of age, gestational age detected by ultrasound, BMI and the proportion of gestational diabetes mellitus, Logistic regression analysis showed that low AAO, low DTAA and high flow velocity at the stenosis site were risk factors of significant CoA (P<0.05). The results of ROC curves analysis showed that AUC values of AAO combined with DTAA and flow velocity at the stenosis site, and DTAA alone for predicting significant CoA were greater, showed good predictive value. Conclusion: Prenatal AAO, DTAA and flow velocity at the stenosis site have significant clinical predictive value in CoA. Among them, DTAA has the highest predictive value. In clinical practice, DTAA can be the first choice for prediction, while AAO and flow velocity at the stenosis site can be applied as auxiliary predictive indexes

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唐玉英;白艳;赵婧;何冠南;马丽琼;袁桃;柏禹竹;李钱梅.胎儿主动脉弓缩窄产前超声特征对产后新生儿结局的预测价值[J].川北医学院学报,2026,41(6):743-746.

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  • 在线发布日期: 2026-06-12
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