胎儿肾上腺动脉彩色多普勒血流参数预测分娩发动时间的价值分析  

Analysis on fetal adrenal artery color Doppler flow parameters in predicting delivery initiation time for pregnancy woman

作　　者：陆海岚 李琳 吴鹏西[2] 赵新美[2] 丁炎[2] LU Hailan;LI Lin;WU Pengxi;ZHAO Xinmei;DING Yan(Department of Ultrasound,NO.8 Wuxi People’s Hospital,Jiangsu 214000,China)

机构地区：[1]江苏省无锡市第八人民医院超声科,214000 [2]无锡市人民医院超声医学科

出　　处：《临床超声医学杂志》2019年第9期700-702,共3页Journal of Clinical Ultrasound in Medicine

基　　金：江苏省卫计委妇幼健康科研项目(F201567);无锡市卫计委科教强卫工程青年人才项目(QNRC069)

摘　　要：目的探讨胎儿肾上腺动脉彩色多普勒血流参数预测分娩发动时间的价值。方法选取于孕39周行肾上腺动脉彩色多普勒检查且随访至分娩的200例初产妇,其中孕41周后发动分娩或未发动分娩改行人工干预的孕妇为分娩发动延迟组,孕41周前自然发动分娩的孕妇为对照组。比较两组胎儿肾上腺动脉搏动指数(PI)、阻力指数(RI)及收缩压与舒张压的比值(S/D),绘制受试者工作特征曲线评价肾上腺动脉血流参数预测分娩发动延迟的诊断效能,计算曲线下面积。结果177例初产妇成功测得胎儿肾上腺动脉血流参数,其中分娩发动延迟组53例,对照组124例。分娩发动延迟组胎儿肾上腺动脉PI和RI分别为1.89±1.10和0.81±0.19,对照组胎儿肾上腺动脉PI和RI分别为1.47±0.38和0.72±0.09,两组比较差异均有统计学意义(均P<0.05);S/D比较差异无统计学意义。胎儿肾上腺动脉PI和RI预测分娩发动延迟的最佳界值分别为1.65和0.78,敏感性、特异性、阳性预测值、阴性预测值及准确率分别为71.1%、70.6%、86.5%、48.0%、71.0%和61.5%、77.8%、66.7%、73.7%、71.0%,曲线下面积分别为0.665和0.679。结论分娩发动延迟的胎儿肾上腺动脉PI和RI均高于正常时间发动分娩的胎儿,肾上腺动脉血流参数可能作为预测分娩发动延迟的指标,具有重要临床应用价值。Objective To evaluate the value of fetal adrenal artery color Doppler flow parameters in predicting delivery initiation time.Methods A total of 200 primiparas with 39 gestational weeks followed-up to delivery outcome were enrolled.Among them,pregnant women who initiated delivery after 41 weeks of pregnancy or who did not initiate delivery but changed to manual intervention were the delayed delivery group,and primiparas who initiated delivery naturally before 41 weeks of pregnancy were the control group.Parameters of fetal adrenal artery,including the pulsatility index(PI),resistance index(RI)and systole/diastole(S/D)between two groups were compared.The ROC curve was drawn to evaluate the diagnostic efficiency of adrenal artery blood flow parameters in predicting delivery onset delay,and the area under the curve was calculated.Results The flow parameters of adrenal artery of 177 pregnant women were successfully measured.53 pregnant women were devided into the delayed delivery group and 124 pregnant women were devided into the control group.The PI and RI of the fetal adrenal artery in delayed delivery group were 1.89±1.10 and 0.81±0.19,respectively.The PI and RI of the fetal adrenal artery in control group were 1.47±0.38 and 0.72±0.09,respectively.There were statistically significant differences(both P<0.05).While there was no significant difference of S/D between two groups.The cut off values of PI and RI for predicting delivery onset delay were 1.65 and 0.78,respectively,the sensitivity,specificity,postive predictive value,negative predictive value and accuracywere 71.1%,70.6%,86.5%,48.0%,71.0% and 61.5%,77.8%,66.7%,73.7%,71.0%,respectively.The area under the ROCcurve were 0.665 and 0.679,respectively.Conclusion PI and RI in delivery onset delay women are higher than that of controlgroup,the fetal adrenal artery Doppler flow parameters can be used to predicte the prolonged pregnancy.

关 键 词：超声检查 肾上腺动脉 胎儿 搏动指数 阻力指数 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.5[医药卫生—诊断学]