指端容积血流脉动波、子宫动脉多普勒联合sFlt-1/PlGF比值对早发型子痫前期的预测  

The predictive value of combined detection of uterine artery ultrasound,photoplethysmography and sFlt-1/PlGF for early onset preeclampsia

作　　者：孙秀荣[1] 张杰生 邓宇傲[1] Sun Xiu-rong;Zhang Jie-sheng;Deng Yu-ao(Obstetrics and Gynecology Department,The 2nd Clinical Medical College of Jinan University,Shenzhen People’s Hospital,Shenzhen 518020,China)

机构地区：[1]暨南大学第二临床医学院附属深圳市人民医院妇产科,深圳518020

出　　处：《湖南师范大学学报（医学版）》2021年第3期31-35,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：广东省医学科学技术研究基金(A2020251)。

摘　　要：目的:探讨指端容积血流脉动波形图(PPG)、子宫动脉多普勒检查联合血清可溶性fms样酪氨酸激酶-1(sFlt-1)、胎盘生长因子(PlGF)检测对早发型子痫前期(PE)的预测价值。方法:选取500例符合纳入标准的早孕期妇女为研究对象,随访至产后6周,其中23例发生妊娠期高血压剔除,28例失访剔除,根据妊娠结局分为正常对照组(408例)、早发型PE组(22例)、晚发型PE组(19例)。收集所有研究对象在孕11~14周PPG反射指数(PPG RI)、孕20~24周PPG RI、子宫动脉(UtA)多普勒搏动指数(UtA PI)和阻力指数(UtA RI)及孕24~28周血清sFlt-1、PlGF检测值。统计分析各检测指标与早发型、晚发型PE发病的相关性。结果:相比正常对照组,早发型PE组及晚发型PE组UtA PI、UtA RI、PPG RI、PPG RI′数值明显升高,sFlt-1/PlGF比值明显升高;相比晚发型PE组,早发型PE组UtA PI、UtA RI数值更高,sFlt-1/PlGF比值更高。UtA PI、UtA RI、PPG RI、PPG RI′单独预测早发型PE的ROC曲线下面积(AUC)分别为0.826、0.819、0.798、0.833;单独预测晚发型PE的AUC分别为0.743、0.741、0.733、0.685,4个指标联合预测早发型PE的AUC分别为0.915、0.73、0.95;预测晚发型PE的AUC分别为0.757、0.90、0.73。结论:PPG、子宫动脉多普勒检查联合孕中期sFlt-1/PlGF比值检测显著提高早发型PE预测的准确性,值得临床推广。Objective To evaluate the predictive value of combined detection of uterine artery ultrasound,PPG combined with sFlt-1/PlGF ratio in early onset PE.Methods 500 cases of early pregnancy women who met the inclusion criteria were selected as the current case-control study.They were followed up to 6 weeks after delivery.Among them,51 cases were excluded from the follow-up.The data of photoplethysmography signals(PPG RI)at 11~14 weeks,the uterine artery Doppler velocimetry pulsatility indices(PI),resistance indices(RI)and photoplethysmography signals(PPG RI)at 20~24 weeks of gestation were collected.The serum levels of sFlt-1、PlGF at 24~28 weeks were determined.According to their pregnancy outcome,they were divided into three groups:the normal control group(408 cases),the early onset PE(22 cases)and late onset PE(19 cases).The correlation of each indexes were analyzed.Results Compared with the normal control group,the level of UtA PI、UtA RI、PPG RI、PPG RI′,and the sFlt-1/PlGF ratio in early onset and late onset PE group were significantly higher,especially in the early onset PE group.The AUC of UtA PI、UtA RI、PPG RI、PPG RI′separately predicted in the early onset PE were 0.826、0.819、0.798、0.833,and which were 0.743、0.741、0.733、0.685 for late onset PE.The combination AUC of these four indexes for predicting early onset PE were 0.915、0.73、0.95,and which were 0.757、0.90、0.73 for predicting late onset PE.Conclusion The detection of Photoplethysmography,uterine artery ultrasound examination sequential combined with sFlt-1/PlGF ratio in the mid-term pregnancy,can effectively improve the accuracy of early onset PE prediction.It is worthing on clinical practice.

关 键 词：指端容积血流脉动波 子宫动脉超声 可溶性fms样酪氨酸激酶-1 胎盘生长因子 子痫前期 

分 类 号：R446.6[医药卫生—诊断学]