目的 分析免疫相关性胎儿心脏病的产前超声心动图特点,提高其产前诊断率.方法 回顾性分析我院确诊的22例自身免疫性疾病孕妇胎儿的超声心动图检查资料,对终止妊娠者行病理学检查.结果 22例自身免疫性疾病孕妇中5例胎儿心脏出现异常表现,4例均有房室传导阻滞,其中2例Ⅱ度房室传导阻滞,2例Ⅲ度房室传导阻滞;5例均有三尖瓣反流;3例表现为心室内膜面回声增强、增厚、毛糙,以右室壁为著,其中1例伴有左房壁及原发房间隔回声增强;2例有心包积液.其余17例胎儿超声心动图检查未见异常.结论 先天性心脏传导阻滞、瓣膜及心内膜病变是免疫相关性胎儿心脏病的主要表现,心脏传导系统损害是其最常见表现.产前筛查能提高其早期诊断率,及早干预,有助于获得良好妊娠结局,有非常重要的临床价值.%Objective To analyze the ultrasonographic features of immune associated fetal heart disease,to im prove the prenatal diagnosis rate.Methods Retrospective analysis of the echocardiographic data of the 22 cases of fetuses whose mother suffered from autoimmune diseases diagnosed in Peking University People's Hospital from.Autopsy was performed for fetuses who underwent termination of pregnancy.Results Five among the 22 cases showed abnormal ultrasonic appearance of fetal heart whose mother suffered autoimmune diseases.4 cases were atrioventricular block,2 cases were Ⅱ degree and 2 cases were Ⅲ degree atrioventricular block;5 cases had tricuspid regurgitation;3 cases showed the echo enhancement,thickened and rough of the ventricular endocardial,especially the right ventricular wall,1 case associate with the echo enhancement of left atrial wall and primary atrial septum.2 cases associated with pericardial effusion.The other 17 fetuses showed no abnormality by echocardiography.Conclusions Congenital heart conduct block and the echo change of valvular and endocardial are the main manifestations of immune related congenital heart disease.The damage of the heart conduction system is the most common manifestation.The regurgitation of the heart valves occur in all fetuses.Prenatal echocardiographic screening is helpful for improving the early diagnosis rate.Early intervention obtains a good pregnancy outcome and a very important clinical value.
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