孕中期胎盘三维能量多普勒指数联合子宫动脉血流参数在预测子痫前期中的价值  

The value of placental three-dimensional power Doppler index combined with uterine artery blood flow parameters in the prediction of preeclampsia in the second trimester

作　　者：许明明 黄浩良 张婉玲 杨银广 邓懋恩 余玉华 刘华俭 陈丹[2] XU Mingming;HUANG Haoliang;ZHANG Wanling;YANG Yinguang;DENG Mao'en;YU Yuhua;LIU Huajian;CHEN Dan(Department of Ultrasound,Songshan Lake Central Hospital of Donguan City,Guangdong,Dongguan 523326,China;Department of Ultrasound,Maternity and Child Healthcare Hospital of Guangdong Province,Guangdong,Guangzhou 510010,China)

机构地区：[1]广东省东莞市松山湖中心医院超声科,广东东莞523326 [2]广东省妇幼保健院超声科,广东广州510010

出　　处：《中国医药科学》2022年第7期158-162,共5页China Medicine And Pharmacy

基　　金：广东省东莞市社会科技发展(一般)项目(201950715024935)。

摘　　要：目的评价孕中期胎盘三维能量多普勒指数联合子宫动脉血流参数在预测子痫前期中的价值。方法选取2019年1月至2020年12月在东莞市松山湖中心医院规范产检的孕妇732例,诊断为子痫前期的55例孕妇为观察组,其余正常677例孕妇作为对照组。采用GE E8超声仪检测胎盘三维能量多普勒指数,包括血管化指数(VI)、血流指数(FI)、血管化-血流指数(VFI),以及检测子宫动脉血流参数,包括搏动指数(PI)、阻力指数(RI)、收缩期与舒张期血流速度比值(S/D),并比较两组参数。应用ROC曲线评价各个参数或两两联合与子痫前期的关系。结果两组VI、FI、VFI、PI、RI及S/D比较,差异有统计学意义(P<0.05);ROC曲线分析显示VI、FI、VFI、PI、RI及S/D ROC曲线下面积分别为0.804、0.869、0.773、0.799、0.880和0.861,当假阳性率为5%时这些参数的灵敏度分别为28.4%、41.1%、46.1%、6.8%、41.6%和37.4%。FI联合PI及FI联合RI时ROC曲线下面积分别为0.933和0.917,当假阳性率为5%时这些联合参数的灵敏度分别为63.8%和61.6%。结论VI、FI、VFI、PI、RI及S/D具有不同程度预测子痫前期的价值,FI联合PI及FI联合RI预测价值较高。Objective To evaluate the value of placental three-dimensional power Doppler index combined with uterine artery blood flow parameters in the prediction of preeclampsia in the second trimester.Methods A total of 732 pregnant women who had undergone standardized obstetric examinations in Songshan Lake Central Hospital from January 2019 to December 2020 were selected.55 pregnant women diagnosed with preeclampsia were included in the observation group,and the remaining 677 healthy pregnant women were included in the control group.GE E8 ultrasound system was used to detect placental three-dimensional energy Doppler index,including vascularization index(VI),flow index(FI)and vascularization flow index(VFI),and to detect uterine artery blood flow parameters,including pulsation index(PI),resistance index(RI),systolic-to-diastolic flow velocity ratio(S/D).The two sets of parameters were compared.The ROC curve was used to evaluate the relationship between each parameter or pairwise parameters and preeclampsia.Results There were statistically significant differences between the two groups of VI,FI,VFI,PI,RI and S/D(P<0.05);ROC curve analysis showed that VI,FI,VFI,PI,RI and S/D areas under the ROC curve were 0.804,0.869,0.773,0.799,0.880 and 0.861.When the false positive rate was 5%,the sensitivities of these parameters were 28.4%,41.1%,46.1%,6.8%,41.6%,and 37.4%,respectively.The areas under the ROC curve of FI combined with PI and FI combined with RI were 0.933 and 0.917,respectively.When the false positive rate was 5%,the sensitivity of these pairwise parameters was 63.8%and 61.6%,respectively.Conclusion VI,FI,VFI,PI,RI and S/D have different levels of predictive value for preeclampsia,and the two pairwise parameters,i.e.,FI combined with PI and FI combined with RI,have higher predictive value.

关 键 词：子痫前期 胎盘血流灌注 子宫动脉血流 超声检查 三维能量多普勒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.244[医药卫生—诊断学]