摘要
目的:分析孕晚期脐动脉超声参数联合胰岛素抵抗指数(HOMA-IR)对妊娠糖尿病(GDM)孕妇不良妊娠结局的预测价值。方法:回顾性收集2021年11月-2023年12月本院收治的孕晚期GDM孕妇167例临床资料,根据其妊娠结局分为不良组(n=35)与对照组(n=132)。收集两组临床资料并分析脐动脉超声参数联合HOMA-IR对GDM孕妇不良妊娠结局的预测价值。结果:不良组妊娠期高血压疾病占比及搏动指数(PI)、收缩期/舒张期流速比(S/D)、阻力指数(RI)、HOMA-IR水平均高于对照组(均P<0.05);经logistic回归分析显示,妊娠期高血压疾病以及PI、S/D、RI、HOMA-IR升高均为GDM孕妇不良妊娠结局的危险因素(均P<0.05);经ROC曲线分析,脐动脉超声参数PI、S/D、RI联合HOMA-IR诊断GDM孕妇不良妊娠结局的曲线下面积(0.871)及敏感度(88.6%)较各指标单独诊断提高(P<0.05)。结论:孕晚期脐动脉超声参数联合HOMA-IR可提高对GDM孕妇不良妊娠结局的预测价值,对临床评估及干预具有临床意义。
Objective:To analyze the predictive value of the umbilical artery ultrasound parameters values combined with the homeostasis model assessment of insulin resistance(HOMA-IR)of pregnant women with gestational diabetes mellitus(GDM)during the third trimester of pregnancy for their adverse pregnancy outcomes.Methods:A retrospective study was conducted on the clinical data of 167 pregnant women with GDM who were admitted to the hospital during the third trimester of pregnancy from November 2021 to December 2023.These women were divided into study group(35 pregnant women with adverse pregnancy outcomes)and control group(132 pregnant women without adverse pregnancy outcomes)according to pregnancy outcomes.The clinical data of the women in the two groups were collected.The predictive value of the umbilical artery ultrasound parameters values combined with HOMA-IR of the pregnant women with GDM for their adverse pregnancy outcomes was analyzed.Results:The proportion of the hypertensive disorders complicating pregnancy,and the values of pulsatility index(PI),systolic/diastolic velocity ratio(S/D),resistance index(RI)and HOMA-IR of the women in the study group were significantly higher than those of the women in the control group(all P<0.05).Logistic regression analysis showed that the hypertensive disorders complicating pregnancy,the increased values of PI,S/D,RI and HOMA-IR of the women with GDM were the risk factors of their adverse pregnancy outcomes(all P<0.05).Receiver operator characteristic(ROC)curve analysis showed that the area under the curve and the sensitivity of the values of the umbilical artery ultrasound parameters,such as PI,S/D and RI,combined with the HOMA-IR value of the pregnant women with GDM for diagnosing their adverse pregnancy outcomes were 0.871 and 88.6%,and which were significantly higher than those of the PI value,the S/D value,the RI value or the HOMA-IR value alone(P<0.05).Conclusion:The values of the umbilical artery ultrasound parameters combined with the HOMA-IR value of the pregnant women with GDM during the third trimester of pregnancy can improve the predictive value for their adverse pregnancy outcomes,and which is significant for the clinical evaluation and intervention of the GDM of the pregnant women.
作者
李延荣
刘雪妮
冯晶
齐进利
LI Yanrong;LIU Xueni;FENG Jing;QI Jinli(Yan'an Hospital of Traditional Chinese Medicine,Yan'an,Shanxi Province,716000)
出处
《中国计划生育学杂志》
2025年第6期1405-1409,共5页
Chinese Journal of Family Planning
关键词
妊娠期糖尿病
孕晚期
脐动脉超声参数
胰岛素抵抗指数
不良妊娠结局
评估
Gestational diabetes mellitus
The third trimester of pregnancy
Umbilical artery ultrasound parameter
Insulin resistance index
Adverse pregnancy outcomes
Assessment
