2025 年第 2 期 第 20 卷

不同亚型房室间隔缺损胎儿的超声心动图定量参数分析

Quantitative parameters analysis of fetal echocardiography in different subtypes of atrioventricular septal defects

作者：周小雪阮燕萍张烨韩建成谷孝艳赵映何怡华

英文作者：Zhou Xiaoxue Ruan Yanping Zhang Ye Han Jiancheng Gu Xiaoyan Zhao Ying He Yihua

单位：首都医科大学附属北京安贞医院心脏超声医学中心胎儿心脏病母胎医学会诊中心，北京100029

英文单位：Cardiac Ultrasound Medical Center Beijing Anzhen Hospital Capital Medical University Maternal-Fetal Medicine Consultation Center on Fetal Heart Disease Beijing 100029 China

关键词：房室间隔缺损；胎儿；定量参数；筛查

英文关键词：

• 摘要：

• 目的 分析胎儿超声心动图（FE）定量参数在房室间隔缺损（AVSD）不同亚型中的产前筛查效果。方法 回顾性分析2016年1月1日至2021年12月31日于首都医科大学附属北京安贞医院诊断的49例完全型AVSD胎儿、20例过渡型（或中间型）AVSD胎儿及27例部分型AVSD胎儿和370例正常胎儿的6个FE定量参数，包括舒张末期房室长度比值、舒张末期房室长度比值的Q值、收缩末期房室长度比值、收缩末期房室长度比值的Q值、舒张末期心室长度及舒张末期心室长度的Q值。根据受试者工作特征曲线下面积（AUC），分析6个定量参数对不同AVSD亚型的筛查效果。结果 6个定量参数在完全型AVSD筛查中的AUC均较高，依次为0.992、0.992、0.938、0.976、0.913和0.950；在过渡型（或中间型）中，除了舒张末期房室长度比值及舒张末期房室长度比值的Q值的AUC分别为0.924和0.930外，其余4个参数AUC均小于0.9；而在部分型中，舒张末期房室长度比值及舒张末期房室长度比值的Q值的AUC分别为0.848和0.842，其余4个参数AUC均小于0.8。结论 6个FE参数在完全型中筛查效果最好，在部分型中最差，在不同AVSD亚型中筛查效能最好的是舒张末期房室长度比值及其Q值。

• Objective To analyze the effect of quantitative parameters of fetal echocardiography (FE) in prenatal screening the different subtypes of atrioventricular septal defect (AVSD). Methods Six quantitative parameters of FE were retrospectively analyzed for 49 complete AVSD fetuses, 20 transitional (or intermediate) AVSD fetuses, 27 partial AVSD fetuses and 370 normal fetuses diagnosed in Beijing Anzhen Hospital, Capital Medical University from January 1, 2016 to December 31, 2021, including the end-diastolic atrioventricular length ratio, the Q score of the end-diastolic atrioventricular length ratio, the ratio of the end-systolic atrioventricular length, the Q score of the end-systolic atrioventricular length ratio, the end-diastolic ventricular length and Q score of the end-diastolic ventricular length. According to the area under the receiver operating characteristic curve (AUC), the screening effect of six quantitative parameters in different AVSD subtypes was analyzed. Results The AUC of the six quantitative parameters in complete AVSD was 0.992, 0.992, 0.938, 0.976, 0.913 and 0.950. In the transitional (or intermediate) type, except for the end-diastolic atrioventricular length ratio and its Q score, which the AUC were 0.924 and 0.930, the AUC of the other four parameters were less than 0.9. For the partial type, the AUC of the end-diastolic atrioventricular length ratio and its Q score were the largest, which were 0.848 and 0.842, respectively. Conclusion The screening effect of the six FE parameters was the best for the complete AVSD and the worst for the partial. Among the six parameters, the best screening performance for the different AVSD subtypes were the end-diastolic atrioventricular length ratio and its Q score.