超声测量生物学指标Z-评分值与大脑中动脉、脐动脉血流参数相关性及联合诊断孕晚期胎儿生长受限的临床价值  

The correlation between the biological index Z-score of ultrasound measurement and the blood flow parameters of the middle cerebral artery and the umbilical artery and the clinical value of combined diagnosis of fetal growth restriction in the third trimes

作　　者：李陈锐 王颖[2] 郑会贤[1] 金华[1] 胡丽蓉 LI Chenrui;WANG Ying;ZHENG Huixian;JIN Hua;HU Lirong(Department of Obstetrics and Gynecology,Zigong Maternal and Child Health Hospital,Zigong,Sichuan 643000,China;Department of Obstetrics,Guizhou Provincial People’s Hospital,Guiyang,Guizhou 550000,China;The First People’s Hospital of Chengdu,Chengdu,Sichuan 610000,China)

机构地区：[1]自贡市妇幼保健院妇产科,四川自贡643000 [2]贵州省人民医院产科,贵州贵阳550000 [3]成都市第一人民医院,四川成都610000

出　　处：《中国优生与遗传杂志》2022年第5期891-895,共5页Chinese Journal of Birth Health & Heredity

基　　金：2016年四川省卫生和计划生育科研课题资助项目(16PJ065)。

摘　　要：目的探究超声测量生物学指标Z-评分值与大脑中动脉、脐动脉血流参数相关性及联合诊断孕晚期胎儿生长受限(FGR)的临床价值。方法选取2020年1月至2021年1月我院56例孕晚期FGR孕妇作为研究组,依据1∶1配对原则随机选取56例正常孕妇作为对照组。分析FGR的影响因素,并比较两组生物学指标Z-评分值、大脑中动脉、脐动脉血流参数,分析FGR孕妇生物学指标Z-评分值与大脑中动脉、脐动脉血流参数的相关性以及在孕晚期FGR的诊断价值。结果研究组年龄大于对照组,妊娠高血压、妊娠糖尿病、吸烟、羊水过少率均高于对照组(P<0.05);年龄、吸烟、妊娠高血压均与FGR的发生显著相关(P<0.05);研究组腹围Z-评分值以及大脑中动脉PI、RI、S/D均低于对照组,脐动脉PI、RI、S/D均高于对照组(P<0.05);FGR腹围Z-评分值与脐动脉PI、RI、S/D负相关,与大脑中动脉PI、RI、S/D正相关(P<0.05);腹围Z-评分值大脑中动脉、脐动脉血流参数诊断FGR的曲线下面积(AUC)均>0.7,各指标联合诊断的AUC最大,为0.902。结论孕晚期发生FGR孕妇胎儿腹围Z-评分值与大脑中动脉、脐动脉血流参数存在良好线性关系,采用超声测量上述指标可辅助临床对FGR进行诊断。Objective To explore the correlation between the Z-score of the biological index measured by ultrasound and the blood flow parameters of the middle cerebral artery and the umbilical artery and the clinical value of combined diagnosis of fetal growth restriction(FGR)in the third trimester of pregnancy.Methods Fifty-six pregnant women with FGR in the third trimester of pregnancy in our hospital from January 2020 to January 2021 were selected as the research group.Fifty-six normal pregnant women were randomly selected as the control group according to the 1∶1 pairing principle.The influencing factors of FGR were analyzed.The biological index Z-score,middle cerebral artery and umbilical artery blood flow parameters between the two groups were compared.The correlation between the biological index Z-score value of pregnant women with FGR and the blood flow parameters of the middle cerebral artery and umbilical artery and the diagnostic value of FGR in the third trimester were analyzed.Results The study group was older than the control group,and the rates of gestational hypertension,gestational diabetes,smoking,and oligohydramnios were higher than those in the control group(P<0.05).Age,smoking,and hypertension during pregnancy were significantly related to the occurrence of FGR(P<0.05).Z-score of abdominal circumference,middle cerebral artery PI,RI,and S/D of the study group were lower than those of the control group,Umbilical artery PI,RI,and S/D were all higher than those of the control group(P<0.05).FGR abdominal circumference Z-score value was negatively correlated with umbilical artery PI,RI,S/D,and positively correlated with middle cerebral artery PI,RI,S/D(P<0.05).The area under the curve(AUC)of the middle cerebral artery and umbilical artery blood flow parameters of the abdominal circumference Z-score in the diagnosis of FGR are all>0.7,and the AUC of the combined diagnosis of each index is the maximum,0.902.Conclusion There is a good linear relationship between Z-score of fetal abdominal circumference and blo

关 键 词：胎儿生长受限 孕晚期 超声 生物学指标Z-评分值 动脉血流参数 

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]