晚孕期胎儿阻力参数比值在预测胎儿轻度缺氧中的价值  

THE VALUE OF DETECTING RESISTANT PARAMETER RATIO OF BLOOD FLOW OF FETUS IN LATE PREGNANCY ON THE PREDICTION FETAL HYPOXIA SLIGHTLY

作　　者：刘晓东[1] 李丽梅[2] 齐铮琴[1] 于杰[1] 邵俊涛[1] 史文宗[3] 

机构地区：[1]河北省秦皇岛市第一医院超声科,066000 [2]河北省秦皇岛市第一医院疼痛科,066000 [3]河北省秦皇岛市第一医院统计科,066000

出　　处：《中国煤炭工业医学杂志》2016年第5期661-665,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省科学技术研究与发展指导计划(编号:072761615)

摘　　要：目的探讨晚孕期胎儿脐动脉（UA）、大脑中动脉（MCA）及肾动脉（RA）阻力参数比值在预测胎儿宫内轻度缺氧中的价值。方法选取孕30~40周的孕妇212例,分为高危妊娠组83例和正常对照组129例。应用彩色多普勒超声检测胎儿UA、MCA和RA收缩期峰值流速与舒张末期流速比值（S/D）、阻力指数（RI）及搏动指数（PI）。计算UA与MCA阻力参数比值,RA与MCA阻力参数比值。结果高危妊娠组UA的S/D、RI、PI较对照组均增高（P〈0.01）;MCA的S/D、RI、PI较对照组均降低（P〈0.01）;高危妊娠组UA与MCA阻力参数比值、RA与MCA阻力参数比值较对照组均增高（P〈0.01）;当S/D（UA/MCA）〉0.55,RI（UA/MCA）〉0.79,PI（UA/MCA）〉0.59时,预测胎儿宫内缺氧的灵敏度为96%,特异度为98%;当S/D（RA/MCA）〉1.34,RI（RA/MCA）〉1.05,PI（RA/MCA）〉1.28时,预测胎儿宫内缺氧的灵敏度为82%,特异度为71%。结论联合检测UA/MCA阻力参数比值、RA/MCA阻力参数比值,在预测胎儿宫内缺氧方面,比UA、MCA和RA单项阻力参数敏感性更高、特异性更高。与RA/MCA阻力参数比值相比,UA/MCA阻力参数比值在预测胎儿宫内缺氧方面敏感性更高、特异性更高。Objective To evaluate the value of detecting resistant parameter ratio of UA to MCA and RA to MCA in late pregnancy on the prediction fetal hypoxia slightly. Methods A total of 212 late pregnant women with a gestation age of 30 - 40 weeks were selected, including 83 cases of high - risk pregnancy group and 129 cases of normal control group. The ratio of the systolic peak velocity and diastolic velocity IS/D）, resistance index （RI） and pulsatility index （PI} of MCA, UA and RA were measured by color Doppler ultrasonography. The resistant parameter ratio of UA to MCA and RA to MCA were calculated based on the measurements. Results The S/D,RI and PI of fetal UA in the high- risk group were signifi- cantly higher than those in normal control group（P〈0.01）. The S/D,RI and PI of fetal MCA in the high - risk group were also significantly lower than those in normal control group（P〈0.01）. The resistant pa- rameter ratio of UA to MCA and the ratio of RA to MCA in the high- risk group were significantly higher than those in normal control group（P〈0.01）. The sensitivity and specificity of the resistant parameter ra- tio of UA to MCA in predicting fetal hypoxia was 96%o and 98%, respectively. The sensitivity and specific- ity of the resistant parameter ratio of RA to MCA in predicting fetal hypoxia was respectively 82M and 71M. Conclusions The resistant parameter ratio of UA to MCA and the ratio of RA to MCA are more sensitive and specific in predicting fetal hypoxia,compared with the UA, MCA and RA single resistant pa- rameter. The resistant parameter ratio of UA to MCA is more sensitive and specific than the ratio of RA to MCA in predicting fetal hypoxia.

关 键 词：彩色多普勒超声 大脑中动脉 血流阻力参数比值 高危妊娠 胎儿宫内轻度缺氧 

分 类 号：R714.5[医药卫生—妇产科学]