摘要
目的探究胎儿脐动脉血流参数[搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、血流收缩期峰值/舒张末期峰值(systolic peak/diastolic peak,S/D)]对妊娠期高血压患者胎儿生长受限(fetal growth restriction,FGR)的预测价值,以期为临床早期诊断提供有效参考依据。方法纳入85例妊娠期高血压患者,根据其是否发生胎儿生长受限分为发生组(25例)、未发生组(60例)。比较两组及不同病情严重程度患者的胎儿脐动脉血流参数,采用Spearman法分析这些参数与病情严重程度及FGR的相关性,采用ROC曲线分析评估PI、RI及S/D对FGR的预测价值。采用相对危险度(relative risk,RR)分析,探讨不同水平的胎儿脐动脉血流参数对FGR的预警作用。结果发生组PI、RI及S/D值均高于未发生组,差异均有统计学意义(均P<0.01)。不同病情严重程度患者PI、RI、S/D值比较:重度子痫前期>轻度子痫前期>妊娠期高血压,且差异有统计学意义(均P<0.05)。PI、RI及S/D均与病情严重程度、FGR呈正相关(均P<0.01);胎儿脐动脉血流参数联合预测FGR的AUC值为0.885,约登指数为0.770,最佳预测敏感性为92.00%,特异性为85.00%。高水平PI、RI、S/D妊娠期高血压患者发生FGR的RR分别是低水平患者的6.115倍、6.729倍、3.857倍,对FGR发生具有明显预警作用(均P<0.01)。结论胎儿脐动脉血流参数与妊娠期高血压患者病情严重程度和FGR的发生关系密切。各指标联合检测对这类患者的FGR结局有一定预测价值。
Objective To explore the predictive value of fetal umbilical artery blood flow parameters[pulsatility index(PI),resistance index(RI)and systolic peak/diastolic peak(S/D)]for fetal growth restriction(FGR)in patients with gestational hypertension,providing effective references for early clinical diagnosis.Methods A total of 85 patients with gestational hypertension were enrolled,and they were divided into a group with FGR(25 cases)and a group without FGR(60 cases)based on the presence or absence of FGR.The fetal umbilical artery blood flow parameters were compared between the two groups,and among patients with varying severities of illness.The correlation between these parameters and the severity of illness or FGR was analyzed by Spearman's method,while the predictive value of PI,RI and S/D for FGR was assessed by the ROC curve analysis.The early warning effect of different levels of fetal umbilical artery blood flow parameters on FGR was explored by relative risk(RR)analysis.Results The PI,RI,and S/D values in the group with FGR were all higher than those in the group without FGR,and the differences were statistically significant(all P<0.01).The PI,RI and S/D values among patients with varying severities of illness were ranked in order as:severe preeclampsia>mild preeclampsia>gestational hypertension,with statistically significant differences(all P<0.05).PI,RI,and S/D were all positively correlated with the severity of illness and FGR(all P<0.01).The AUC value of the combined prediction of fetal umbilical artery blood flow parameters for FGR was 0.885,with a Youden index of 0.770,the optimal prediction sensitivity of 92.00%,and a specificity of 85.00%.The RR of the occurrence of FGR in gestational hypertension patients with high levels of PI,RI,and S/D was 6.115 times,6.729 times,and 3.857 times of that in patients with low levels,respectively.And these parameters had significant early warning effect on the occurrence of FGR(all P<0.01).Conclusion The blood flow parameters of the fetal umbilical artery are closely related to the severity of disease and the occurrence of FGR among patients with gestational hypertension.The combined detection of each parameter has certain predictive value for the outcome of FGR in these patients.
作者
郭歌
张静敏
王迁
GUO Ge;ZHANG Jingmin;WANG Qian(Department of Ultrasound Medicine,Anyang People's Hospital,Anyang Henan 455000,China)
出处
《实用心电与临床诊疗》
2025年第2期194-198,共5页
PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT
基金
河南省医学科技攻关联合共建项目(LHGJ20213159)。
关键词
妊娠期高血压
胎儿生长受限
胎儿脐动脉血流
预测价值
gestational hypertension
fetal growth restriction
fetal umbilical artery blood flow
predictive value
