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胎儿肺动脉加速时间/射血时间比值与左侧先天性膈疝存活患儿生后吸入一氧化氮需求的相关性

Association Between Fetal Pulmonary Artery Acceleration Time/Ejection Time Ratio and Postnatal Inhaled Nitric Oxide Requirement in Surviving Infants With Left-Sided Congenital Diaphragmatic Hernia.
PubMed 文献 · Prenat Diagn · 2026-05-14

该回顾性单中心研究纳入2016至2024年出生的左侧先天性膈疝胎儿，评估胎儿肺动脉多普勒参数（如AT/ET比值）是否预测存活新生儿生后吸入一氧化氮（iNO）的使用。27例胎儿中3例死亡，23例存活无结构异常者中，iNO组胎儿对侧肺动脉AT/ET比值显著更低（p=0.019），且与iNO持续时间负相关（r=-0.57）；AT/ET截断值0.17预测iNO使用的敏感性63%、特异性100%。

要点

  • 左侧先天性膈疝胎儿对侧肺动脉AT/ET比值在生后需iNO的存活患儿中显著更低（p=0.019）。
  • 胎儿AT/ET比值与iNO持续时间呈负相关（r=-0.57）。
  • AT/ET截断值0.17预测iNO使用：敏感性63%，特异性100%。

核心结论

  • 胎儿肺动脉AT/ET比值与左侧先天性膈疝存活患儿生后iNO使用相关，可能有助于风险分层和产前父母咨询。

研究设计与样本

  • 回顾性单中心研究，纳入2016至2024年出生的左侧先天性膈疝胎儿，分析胎儿超声心动图肺动脉多普勒参数与新生儿iNO使用的关系。

主要发现

  • 27例左侧先天性膈疝胎儿中3例死亡，23例存活无结构异常者纳入分析。
  • iNO组胎儿对侧肺动脉AT/ET比值显著低于非iNO组（p=0.019）。
  • 胎儿对侧肺动脉AT/ET比值与iNO持续时间呈负相关（r=-0.57）。

关键数值与推荐

  • AT/ET截断值0.17预测iNO使用：敏感性63%，特异性100%。

临床怎么用

  • 胎儿肺动脉AT/ET比值可无创测量，或可用于左侧先天性膈疝患儿生后呼吸支持需求的风险分层及产前父母咨询。

以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。

原文

OBJECTIVE: To evaluate whether fetal pulmonary artery (PA) measurements and PA Doppler parameters such as acceleration time/ejection time (AT/ET) ratio predict respiratory outcomes in surviving neonates with left-sided congenital diaphragmatic hernia (CDH). METHODS: This retrospective single-center study included fetuses with left-sided CDH born between 2016 and 2024. Fetal echocardiography assessed PA Doppler parameters, including the AT/ET ratio, peak early diastolic reverse flow, and pulsatility index. Neonatal morbidity using the use of inhaled nitric oxide (iNO) was analyzed in relation to prenatal ultrasound parameters. RESULTS: 27 fetuses with left-sided CDH were analyzed, and 3 neonates died. Among 23 survivors without structural abnormalities, the fetal contralateral PA AT/ET ratio was significantly lower in the iNO group (p = 0.019) and negatively correlated with iNO duration (r = -0.57). ROC analysis showed that an AT/ET cut-off of 0.17 predicted iNO use with 63% sensitivity and 100% specificity. CONCLUSION: In this study, the AT/ET ratio correlated with postnatal iNO use in fetuses with left-sided CDH. It can be measured non-invasively, and may be useful for risk stratification and prenatal parental counseling.

来源：Prenat Diagn，查看原文。版权归原作者所有。

引用

  1. Namimatsu K, Yamamoto Y, Seyama R, et al. Association Between Fetal Pulmonary Artery Acceleration Time/Ejection Time Ratio and Postnatal Inhaled Nitric Oxide Requirement in Surviving Infants With Left-Sided Congenital Diaphragmatic Hernia. Prenat Diagn. 2026. PMID: 42132403. doi:10.1002/pd.70176
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供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。