滋养层血流在超声诊断早期宫内妊娠中的应用  

Application of trophoblastic blood flow in the ultrasound diagnosis of early intrauterine pregnancy

作　　者：柳忠锋 刘美燕 孙艳华 殷伟红 史历 杨蓓蓓 刘莉红 LIU Zhongfeng;LIU Meiyan;SUN Yanhua;YIN Weihong;SHI Li;YANG Beibei;LIU Lihong(Department of Ultrasound,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264100,Shandong,China)

机构地区：[1]滨州医学院烟台附属医院超声医学科,山东烟台264100

出　　处：《中国性科学》2020年第6期56-59,共4页Chinese Journal of Human Sexuality

摘　　要：目的探讨以滋养层血流作为早期宫内妊娠(IUP)的诊断标志在临床中的应用。方法对120例意外妊娠患者进行阴道彩色多普勒超声检查,将二维图像、血流分布及频谱特征进行回顾性分析并将105例宫内妊娠与105例非妊娠育龄期妇女比较,将意外妊娠患者超声检查结果与手术病理结果或临床随访结果进行对照分析并对宫内液性暗区旁双向血流频谱的峰值流速(PSV)、舒张期末速度(EDV)、最大收缩期速度(S)与舒张期末速度(D)的比值(S/D)、阻力指数(RI)构建ROC曲线。结果宫内妊娠妇女滋养层血流的PSV(10.37±4.35)cm/s,EDV(5.48±2.32)cm/s,S/D 1.92±0.23,RI 0.47±0.06与子宫螺旋动脉的PSV(16.0±4.03)cm/s,EDV(6.47±1.82)cm/s,S/D 2.53±0.31,RI 0.60±0.05相比,差异均具有统计学意义(均P<0.05),滋养层血流频谱形态不同于子宫螺旋动脉。以宫内液性暗区旁双向血流频谱PSV、EDV、RI、S/D构建的ROC曲线下面积分别为0.856、0.65、0.981、0.978。结论滋养层血流频谱形态不同于子宫螺旋动脉,可以作为诊断早期IUP的标志,并且可以将诊断早期宫内妊娠的时间提前到卵黄囊出现之前,具有重要的临床应用价值。Objective To explore the application of trophoblastic blood flow as a marker of early intrauterine pregnancy(IUP).Methods Vaginal color doppler ultrasonography was performed on 120 patients with unplanned pregnancy.The characteristics of two-dimensional images,blood flow distribution and frequency spectrum were analyzed retrospectively,and compared between 105 cases of IUP(IUP group)and non-pregnant women(non-pregnant group).The results of ultrasound examination in unplanned pregnancy were compared with the results of surgical pathology or clinical follow-up,and the receiver operating characteristic(ROC)curve of two-way blood flow to the side way of the dark area of fluid in the uterine cavity was constructed.Results The peak flow velocity(PSV,10.37±4.35 cm/s),end-diastolic velocity(EDV,5.48±2.32 cm/s),S/D(1.92±0.23)and resistance index(RI,0.47±0.06)of trophoblastic blood flow in IUP group and the PSV(16.0±4.03 cm/s),EDV(6.47±1.82 cm/s),S/D(2.53±0.31),RI(0.60±0.05)of spiral artery were significantly different in non-pregnant group,with statistically significant differences(P<0.05).The blood flow spectrum of trophoblast was different from the uterine spiral artery.The area under the ROC curve of PSV,EDV,RI and S/D was 0.856,0.65,0.981 and 0.978 respectively.Conclusions Trophoblastic blood flow as an early marker of diagnosing IUP is different from the uterine spiral artery which can advance the time of early diagnosis of IUP before the yolk sac appeared,with high application value.

关 键 词：宫内妊娠 滋养层血流 子宫螺旋动脉 

分 类 号：R714[医药卫生—妇产科学]