彩色多普勒检测子宫动脉在妊娠期糖尿病孕妇中的临床价值  

Clinical value of color Doppler ultrasonography for detection of uterine artery in pregnant women with gestational diabetes mellitus

作　　者：张佐炳[1] 方苇[1] 

机构地区：[1]厦门大学附属第一医院超声科,福建厦门361003

出　　处：《中国妇幼保健》2012年第31期4996-4999,共4页Maternal and Child Health Care of China

摘　　要：目的:探讨超声多普勒检测母体子宫动脉的血流动力学及血流评分在妊娠期糖尿病(GDM)孕妇中临床应用价值。方法:GDM孕妇107例,同期分娩正常孕妇60例为对照组,于妊娠晚期超声多普勒分别检测子宫动脉的阻力指数(RI)、搏动指数(PI)及收缩期峰值流速和舒张末期流速的比值(S/D),并行子宫动脉PI评分,比较各组动脉血液动力学变化及妊娠结局。结果:GDM组子宫动脉RI、PI、S/D及舒张早期切迹发生率均高于对照组,差异有统计学意义(P<0.05);GDM组新生儿体重、巨大儿发生率、早产率、产后出血发生率、围产儿结局不良发生率均高于对照组,胎儿的胎龄低于对照组,差异均有统计学意义(P<0.05);在GDM组,随着子宫动脉PI评分增加,胎儿宫内窘迫所致急诊剖宫产、小于孕龄儿、早产、新生儿窒息、转入NICU逐渐上升趋势,胎龄逐渐下降趋势,差异有统计学意义(P<0.05)。结论:超声多普勒检测子宫动脉血流动力学是了解围产儿预后的有效监护手段,在GDM患者中,子宫动脉PI评分越高,提示妊娠合并症和围产儿结局不良发生率越高。Objective： To explore the clinical application value of color Doppler uhrasonography for hemodynamic detection of uterine artery and blood flow score in pregnant women with gestational diabetes mellitus （ GDM ） . Methods ： A total of 107 GDM pregnant women and 60 normal pregnant women were selected as GDM group and control group, respectively, ultrasonograpby was performed during the third trimester of pregnancy to detect the resistance index （ RI）, pulsatility index （ PI）, and the ratio of peak systolic velocity to end diastolic velocity （S/D） of uterine artery, PI score of uterine artery was obtained, hemodynamic changes and pregnancy outcomes in the two groups were compared. Results： RI, PI, S/D, and the incidence of incisura during early diastole phase of uterine artery in GDM group were statistically significantly higher than those in control group （ P 〈 0. 05 ） . The neonatal weight, the incidences of macrosomia, premature delivery, postpartum hemorrhage, and perinatal adverse outcomes in GDM group were statistically significantly higher than those in control group （P 〈 0. 05 ）, the fetal age in GDM group was lower than that in control group （ P 〈 0. 05 ） . In GDM group, with the increase of PI score of uterine artery, the rate of emergent cesarean section induced by fetal uterine distress, the incidences of small for gestational age infants, premature delivery, and neonatal asphyxia, transferring rate to NICU showed increasing trends, fetal age showed a decreasing trend, there was statistically significant difference （ P 〈 0. 05 ） . Conclusion： Detecting hemodynamics of uterine artery by ultrasonography is an effective monitoring method to understand the prognosis of perinatal infants, among GDM patients, the higher PI score of uterine artery is, the higher the incidences of pregnancy complications and perinatal outcomes are.

关 键 词：超声检查 子宫动脉 血流动力学 胎儿 妊娠期糖尿病 

分 类 号：R587.1[医药卫生—内分泌]