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[1]田華谷,郭潔,劉敏,等.免疫介導相關胎兒心臟異常的超聲表現(xiàn)及妊娠結局[J].福建醫(yī)藥雜志,2022,44(06):1-5.
　TIAN Huagu,GUO Jie,LIU Min,et al.Ultrasonic presentation and pregnancy outcome of immune-mediated fetal cardiac anomalies[J].FUJIAN MEDICAL JOURNAL,2022,44(06):1-5.
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免疫介導相關胎兒心臟異常的超聲表現(xiàn)及妊娠結局()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
44
期數(shù):
2022年06期
頁碼:
1-5
欄目:
臨床研究
出版日期:
2022-12-15

文章信息/Info

Title:
Ultrasonic presentation and pregnancy outcome of immune-mediated fetal cardiac anomalies
文章編號:
1002-2600（2022）06-0001-05
作者:
田華谷; 郭潔; 劉敏; 吳秋梅; 凌文; 翁宗杰1
福建省婦幼保健院 福建醫(yī)科大學婦兒臨床醫(yī)學院（福州 350003）
Author(s):
TIAN Huagu; GUO Jie; LIU Min; WU Qiumei; LING Wen; WENG Zongjie
Department of Ultrasound，College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics，F(xiàn)ujian Medical University，F(xiàn)ujian Maternity and Child Health Hospital，F(xiàn)uzhou，F(xiàn)ujian 350003，China
關鍵詞:
自身免疫; 超聲心動圖; 房室傳導阻滯; 心內膜彈力纖維增生癥
Keywords:
autoimmune; echocardiogram; atrioventricular block; endocardial elastin fibroplasia
分類號:
R541
文獻標志碼:
A
摘要:
目的 分析免疫介導相關胎兒心臟異常的產前超聲心動圖特征，為妊娠伴自身免疫性疾病的圍產期管理提供依據(jù)。方法 選取我院2016年1月至2021年7月確診系統(tǒng)性自身免疫性疾病穩(wěn)定期孕婦101例為對照組，另選取同期在我院首次發(fā)現(xiàn)胎兒心臟異常且其后檢測母體自身抗體陽性的孕婦11例為暴露組，對以上兩組胎兒進行產前及產后超聲心動圖評估，對比妊娠結局。結果 暴露組11例中7例（7/11，63.64%）出現(xiàn)心臟器質性改變，主要表現(xiàn)為以心房為主的房室壁回聲增強，8例（8/11，72.73%）出現(xiàn)以緩慢型心律失常為主的心臟節(jié)律改變，5例（5/11，45.45%）出現(xiàn)聯(lián)合病變，5例（5/11，45.45%）胎兒活產預后良好。對照組101例均未見明顯心臟結構畸形，8例（8/101，7.92%）出現(xiàn)輕度三尖瓣反流，3例（3/101，2.97%）早產，所有病例預后均良好。暴露組臨床表現(xiàn)及預后均明顯較對照組差，差異具有統(tǒng)計學意義（P＜0.001）。結論 免疫介導相關胎兒心臟異常以心臟房室傳導阻滯、心內膜及瓣膜病變?yōu)橹饕憩F(xiàn)，通過對確診及可疑自身免疫性疾病的孕婦進行超聲心動圖監(jiān)測，尤其是通過對心臟A-V間期監(jiān)測，可早期發(fā)現(xiàn)Ⅰ度房室傳導阻滯并通過及時干預改善胎兒預后。
Abstract:
Objective To analyze the prenatal echocardiographic characteristics of immune-mediated fetal heart abnormalities, and to provide evidence for perinatal management of pregnancy with autoimmune diseases. Methods A total of 101 pregnant women diagnosed with systemic autoimmune diseases at stable stage from January 2016 to July 2021 were selected as the control group. In addition, 11 pregnant women who first detected fetal heart abnormalities in our hospital during the same period and subsequently detected positive maternal autoantibodies were selected as the exposure group. Prenatal and postnatal echocardiography were performed to evaluate the fetal outcomes of the two groups. Results In the exposure group, 7 of 11 cases （7/11, 63. 64%） showed organic changes in the heart, which was mainly manifested as enhanced echo of atrium wall and ventricular wall, with atrium as the main body, 8 cases （8/11, 72. 73%） showed changes in cardiac rhythm mainly in bradyarrhythmia, 5 cases （5/11, 45. 45%） showed combined lesions, and 5 cases （5/11, 45. 45%） fetal prognosis were good during live birth. In the control group, there were no obvious cardiac structural malformations, 8 cases （8/101, 7. 92%） had mild tricuspid regurgitation, and 3 cases （3/101, 2. 97%） were premature. All the cases had good prognosis. The clinical manifestations and prognosis of the exposure group were significantly worse than that of the control group, and the differences were statistically significant（P＜0. 001）. Conclusion The main manifestations of immune-mediated fetal cardiac abnormalities are atrioventricular block, endocardial and valvular lesions. Echocardiographic monitoring of pregnant women with confirmed and suspected autoimmune diseases, especially the A-V interval monitoring of the heart, can detect grade I atrioventricular block early and improve fetal prognosis through timely intervention.

參考文獻/References:

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備注/Memo

備注/Memo:
基金項目：福建省自然科學基金資助項目（2021J1420）
1 通信作者，Email:[email protected]
更新日期/Last Update: 2022-12-15