无创血液动力学检测于妊娠12周预测妊娠期高血压疾病的应用价值  

The study on predicting hypertensive disorders in pregnancy by noninvasive hemorrhage dynamics at the 12^(th) gastation week

作　　者：王玢[1] 

机构地区：[1]空军总医院妇产科,北京100142

出　　处：《空军医学杂志》2015年第1期52-54,共3页Medical Journal of Air Force

摘　　要：目的探讨无创血液动力学检测于妊娠12周预测妊娠期高血压疾病(hypertensive disorders in pregnancy,HDP)的可行性。方法随机选取我院门诊无妊娠合并症及妊娠并发症的孕妇472例,随机分为观察组(233例)和对照组(239例)。观察组于妊娠12周行无创血液动力学检测,以时量平均波形曲线下面积(AMP2)≥90%、中心动脉收缩压≥100 mm Hg为妊娠期高血压疾病阳性预测指标。对照组于妊娠20周行平均动脉压检测,以平均动脉压≥85 mm Hg为妊娠期高血压疾病阳性预测指标。结果观察组妊娠12周时量平均波形曲线下面积71.30%~134.51%,均值87.91%±20.93%,中位数85.90%,中心动脉收缩压81.22~115.43 mm Hg,均值(83.76±22.59)mm Hg,中位数83.21 mm Hg,预测发病人数14人,预测发病率6.01%,实际发病人数12人,实际发病率5.15%,敏感度85.71%,特异度99.10%。对照组平均动脉压69.33~106.15 mm Hg,平均值(81.33±18.47)mm Hg,中位数80.27 mm Hg,对照组预测发病人数41人,预测发病率17.67%,实际发病人数13人,实际发病率5.60%,敏感度31.70%,特异度88.66%。2种预测方法的敏感度、特异度相比较,差异均有统计学意义(P<0.05)。结论以时量平均波形曲线下面积≥90%、中心动脉收缩压≥100 mm Hg为阳性预测标准,于妊娠12周采用无创血液动力学检测预测妊娠期高血压疾病具有预测孕周早、敏感度高、特异性强等优点。Objective To explore the feasibility about predict the hypertensive diseases at the 12 th gestation week by the measurement ofnoninvasive hemorrhage dynamic. Method 472 cases ofpregnant women adhered to no secondary disorders and no complications were recruited randomly. They were divided into two groups： the observation group（233 cases）and the control group（239 cases）. The observation group cases were measured at their 12 th gestation week with the method ofnoninvasive hemorrhage dynamics, and the area ofmean pulse graph2（AMP2） ≥90% or the central artery pressure（CASP）≥100 mm Hg was designed as the positive predict norm; the control group cases were tested at their 20 th gestation week with the method ofmean artery pressure, whose ≥85 mm Hg was appointed as the positive standard. Result In the observation group, the area ofmean pulse graph2（AMP2） ranged from 71.30% to 134.51%,the average 87.91%±20.93%, the medium 85.90%, the central artery systolic pressure（CASP） arrayed from 81.22 mm Hg to 115.43 mm Hg, the average（83.76±22.59） mm Hg, the median 83.21 mm Hg, the predict patient number 14, the predict morbidity 6.01 %, the actual patient number 12, the actual morbidity 5.15%, the sensitiveness 85.71%, the specifi city 99.10%. In the control group, the mean artery pressure（MAP） ranged from 69.33 mm Hg to 106.15 mm Hg,the average（81.33±18.47）mm Hg, the median 80.27 mm Hg, the predict patient number 41, the predict morbidity 17.67%, the actual patient number 13, the actual morbidity 5.60%, the sensitiveness 31.70%, the specifi city 88.66%. The differences in the sensitiveness and the specificity between the two groups relatively were very significant（P〈0.05）. Conclusion The method noninvasive hemorrhage dynamics adopted AMP2≥90% or CASP≥100 mm Hg measured at 12^th gestation week as positive predict standard is feasible for the superiority ofearlier predicting, higher sensitiveness, keener specifi city, etc.

关 键 词：无创血液动力学 妊娠12周 预测 妊娠期高血压疾病 

分 类 号：R714.25[医药卫生—妇产科学]