GDM孕妇脐血流动力学指标评估胎儿宫内窘迫的临床价值  

Clinical Value of Umbilical Hemodynamics Indexes in Evaluating Intrauterine Fetal Distress of Pregnant Women with GDM

作　　者：谭春梅[1] 谭红梅[1] 吴君[1] 张静[1] TAN Chunmei;TAN Hongmei;WU Jun;ZHANG Jing(First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院,四川成都610500

出　　处：《北华大学学报（自然科学版）》2020年第2期191-194,共4页Journal of Beihua University（Natural Science）

基　　金：四川省卫生与计划生育委员会科研课题(15020114).

摘　　要：目的探讨妊娠糖尿病(GDM)孕妇脐血流动力学指标评估胎儿宫内窘迫的临床价值.方法选择妊娠糖尿病(GDM)孕妇98例为GDM组,选取同期正常孕妇100例为对照组,于孕37周检测所有孕妇收缩期末血流速度(v_s)、舒张期末血流速度(v_d)、收缩期峰值,检测舒张末期流速之比(v_s/v_d)、阻力指数(RI)、搏动指数(PI),统计分析不同脐动脉频谱v_s/v_d区间胎儿窘迫发生率,将全部孕妇分为v_s/v_d≥3组与v_s/v_d<3组,观察两组孕妇胎儿宫内窘迫相关症状发生情况;使用多因素Logistic分析血流动力学相关指标,分析宫内窘迫发生的独立危险因素.结果 GDM组v_s、v_s/v_d、RI、PI显著高于对照组,v_d显著低于对照组(P<0.05);两组患者相同v_s/v_d区间胎儿窘迫发生率比较差异无统计学意义(P>0.05);v_s/v_d≥3组异常胎心率和新生儿窒息率为55.35%、33.92%,显著高于v_s/v_d<3组的13.95%、16.27%;v_s/v_d≥3、RI≥1.6、PI≥0.6为发生胎儿宫内窘迫的独立危险因素.结论产前GDM孕妇脐血流动力学检测对判断胎宫内窘迫具有较高的临床价值.Objective To study the clinical value of umbilical hemodynamics indexes in evaluating intrauterine fetal distress of pregnant women with GDM. Method A total of 98 pregnant women with gestational diabetes mellitus(GDM) were selected as observation group.100 normal pregnant women were selected as control group.All patients were given detection at 37 week,gestation of end-systolic blood flow velocity(v_s),end-diastolic blood flow velocity(v_d),ratio of systolic peak velocity and end-diastolic flow velocity(v_s/v_d),resistance index(RI) and pulsatility index(PI),and given statistical analysis of incidence rate of fetal distress in different umbilical artery spectrum v_s/v_dinterval. All pregnant women were divided into v_s/v_d≥3 group and v_s/v_d< 3 group,and the occurrence of intrauterine fetal distress-related symptoms was observed in the two groups.Multivariate Logistic analysis was used to analyze whether hemodynamics-related indexes were independent risk factors for occurrence of intrauterine distress. Results The v_s,v_s/v_d,RI and PI in GDM group were significantly higher than those in control group while the v_dwas significantly lower than that in control group(P<0.05).There was no significant difference in the incidence rate of fetal distress in the same v_s/v_dinterval between the two groups(P>0.05).The abnormal fetal heart rate and neonatal asphyxia rate were 55.35% and 33.92% in v_s/v_d≥3 group,which were significantly higher than those in v_s/v_d< 3 group with 13.95% and 16.27%.v_s/v_d≥3,RI≥1.6 and PI≥0.6 were independent risk factors for occurrence of intrauterine fetal distress. Conclusion Prenatal umbilical hemodynamics detection in GDM pregnant women has a high clinical value in judging intrauterine fetal distress.

关 键 词：妊娠糖尿病 胎儿宫内窘迫 脐血流动力学 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]