摘要
目的探讨胎盘血管指数(VI)、胎儿脐动脉收缩期峰值血流速度/舒张期最低血流速度(S/D)及血浆晚期氧化蛋白产物(AOPP)预测妊娠期高血压疾病(HDCP)不良妊娠结局的价值。方法2022年1月—2023年6月,选取十堰市人民医院确诊的HDCP病人180例为研究对象,对其临床资料进行回顾性分析。根据妊娠结局将病人分为不良妊娠结局组(观察组,83例)和正常妊娠结局组(对照组,97例),对两组病人妊娠中期的VI、S/D和AOPP进行比较;采用多因素Logistic回归模型分析HDCP孕妇不良妊娠结局的危险因素;采用受试者工作特征(ROC)曲线下面积(AUC)评估VI、S/D和AOPP预测HDCP孕妇不良妊娠结局的价值。结果观察组妊娠中期的胎盘VI明显低于对照组,而S/D和AOPP则明显高于对照组,差异均有统计学意义(t=-3.998~4.964,P<0.05);妊娠中期胎盘VI降低、脐动脉S/D增高、血浆AOPP增高、24 h尿蛋白定量增高和病情达到子痫前期等均是HDCP病人不良妊娠结局的独立危险因素(OR=0.600~3.330,95%CI=(0.386~1.386)~(0.933~9.863),P均<0.05)。ROC曲线分析显示,VI、S/D和AOPP单独及三者联合预测HDCP孕妇不良妊娠结局的AUC分别为0.665、0.686、0.753和0.923(95%CI=(0.586~0.885)~(0.745~0.961),P均<0.05),以三者联合检测的预测价值最高。结论HDCP病人妊娠中期胎盘VI明显降低,而脐动脉S/D和血浆AOPP均明显增高,且与不良妊娠结局密切相关,三者联合检测对不良妊娠结局具有较高的预测价值。
Objective To investigate the value of placental vascular index(VI),fetal umbilical artery peak systolic blood flow velocity/minimum diastolic blood flow velocity(S/D)ratio,and plasma advanced oxidation protein products(AOPP)in predicting the adverse pregnancy outcomes of hypertensive disorder complicating pregnancy(HDCP).Methods A retrospective analysis was performed for the clinical data of 180 patients who were diagnosed with HDCP in Shiyan People’s Hospital from January 2022 to June 2023,and according to the pregnancy outcome,the patients were divided into adverse pregnancy outcome group(observation group with 83 patients)and normal pregnancy outcome group(control group with 97 patients).The two groups were compared in terms of VI,S/D,and AOPP in the second trimester of pregnancy.The multivariate logistic regression analysis was used to investigate the risk factors for adverse pregnancy outcomes in pregnant women with HDCP,and the area under the receiver operating characteristic curve(AUC)was used to assess the value of VI,S/D,and AOPP in predicting adverse pregnancy outcomes in pregnant women with HDCP.Results Compared with the control group,the observation group had a significantly lower placental VI and significantly higher S/D ratio and AOPP in the second trimester of pregnancy(t=-3.998 to 4.964,P<0.05).A reduction in placental VI,an increase in umbilical artery S/D ratio,an increase in plasma AOPP,an increase in 24 h urinary protein,and preeclampsia in the second trimester of pregnancy were independent risk factors for adverse pregnancy outcomes in patients with HDCP(OR=0.600-3.330,95%CI=0.386-1.386 to 0.933-9.863,all P<0.05).The receiver operating characteristic curve analysis showed that VI,S/D ratio,and AOPP used alone or in combination had an AUC of 0.665,0.686,0.753,and 0.923,respectively,in predicting adverse pregnancy outcomes in pregnant women with HDCP(95%CI=0.586-0.885 to 0.745-0.961,all P<0.05),suggesting that combined measurement of the three indicators had the highest predictive value.Conclusion There is a significant reduction in placental VI and significant increases in umbilical artery S/D ratio and plasma AOPP in patients with HDCP during the second trimester of pregnancy,which are closely associated with adverse pregnancy outcomes,and combined measurement of the three indicators has a relatively high value in predicting adverse pregnancy outcomes.
作者
孙美玲
高霞
李艳
吴莹莹
左娜
SUN Meiling;GAO Xia;LI Yan;WU Yingying;ZUO Na(Department of Obstetrics,Shiyan People’s Hospital,Shiyan 442000,China)
出处
《青岛大学学报(医学版)》
2025年第5期738-742,共5页
Journal of Qingdao University(Medical Sciences)
基金
湖北省卫生健康委员会面上项目(WJ2019M-049)。
关键词
高血压
妊娠性
妊娠结局
超声检查
产前
胎盘
脐动脉
晚期氧化蛋白产物
预测
hypertension,pregnancy-induced
pregnancy outcome
ultrasonography,prenatal
placenta
umbilical arteries
advanced oxidation protein products
forecasting
