脐动脉血流参数联合Tei指数对妊娠高血压患者孕晚期胎儿宫内缺氧的预测价值  

Predictive value of umbilical artery blood flow parameters combined with Tei index for fetal intrauterine hypoxia in the third trimester of pregnancy in patients with pregnancy-induced hypertension

作　　者：霍红梅 任文静[2] 陈屏[1] 蔡丹灵[1] 马雪生 Huo Hongmei;Ren Wenjing;Chen Ping;Cai Danling;Ma Xuesheng(Department of Ultrasound,Yellow River Central Hospital,Yellow River Water Conservancy Commission,Zhengzhou 450000,China;Department of Ultrasound,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]黄河水利委员会黄河中心医院超声科,郑州450000 [2]河南中医药大学第一附属医院超声科,郑州450000

出　　处：《中国实用医刊》2022年第14期54-57,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析脐动脉血流参数联合Tei指数对妊娠高血压患者孕晚期胎儿宫内缺氧的预测价值。方法抽取2020年3月至2022年3月黄河中心医院就诊且住院分娩的妊娠高血压孕妇85例,孕晚期均行超声检查,依据胎儿出生后临床诊断分为缺氧组32例和正常组53例。比较两组超声脐动脉血流参数、左右心室Tei指数及母婴结局,分析脐动脉血流参数联合Tei指数对妊娠高血压患者孕晚期胎儿宫内缺氧的预测价值。结果缺氧组脐动脉搏动指数(PI)、阻力指数(RI)、动脉收缩末期峰值/舒张末期流速(S/D)均高于正常组,缺氧组左、右心室Tei指数及平均值高于正常组(P<0.05);缺氧组羊水异常、剖宫产、胎儿宫内生长受限、新生儿窒息等不良母婴结局发生率高于正常组,缺氧组出生后7 d新生儿神经行为测定评分(NBNA)低于正常组(P<0.05);胎儿脐动脉的PI、RI、S/D、Tei指数及四者联合预测妊娠高血压患者孕晚期胎儿宫内缺氧的敏感度分别为0.68、0.65、0.66、0.76、0.78,特异度分别为0.64、0.77、0.69、0.75、0.77,曲线下面积分别为0.769、0.765、0.798、0.804、0.838,脐动脉血流参数联合Tei指数的评估价值最高。结论孕晚期超声脐动脉血流参数联合Tei指数对妊娠高血压患者孕晚期胎儿宫内缺氧有较好的预测价值。Objective To analyze the predictive value of umbilical artery blood flow parameters combined with Tei index for fetal hypoxia in the third trimester of pregnancy in patients with pregnancy-induced hypertension.Methods A total of 85 pregnant women with gestational hypertension who were treated and gave birth in the Yellow River Central Hospital from March 2020 to March 2022 were selected,all of them received ultrasonography in late pregnancy.According to the clinical diagnosis after the baby was born,the pregnant women were divided into hypoxia group(32 cases)and normal group(53 cases).The ultrasonic umbilical artery blood flow parameters,Tei index of left and right ventricles and maternal and infant outcomes were compared between the two groups.The predictive value of umbilical artery blood flow parameters combined with Tei index in predicting fetal intrauterine hypoxia in pregnant women with gestational hypertension in late pregnancy was analyzed.Results The umbilical artery pulsatility index(PI),resistance index(RI),and arterial peak end-systolic/end-diastolic velocity(S/D)in the hypoxia group were higher than those in the normal group.The left and right ventricular Tei index values,and the mean value in the hypoxia group were higher than those in the normal group(P<0.05).The incidence of adverse maternal and neonatal outcomes such as abnormal amniotic fluid,cesarean section,intrauterine growth restriction,and neonatal asphyxia in the hypoxia group were higher than those in the normal group,the Neonatal Behavioral Neurological Assessment score of the hypoxia group 7 days after the baby was born was lowe than that of the normal group(P<0.05).The sensitivity of PI,RI,S/D of fetal umbilical artery,Tei index alone and combination of them to predict intrauterine hypoxia in pregnant women with gestational hypertension were 0.68,0.65,0.66,0.76 and 0.78,respectively;the specificity of them were 0.64,0.77,0.69,0.75 and 0.77,respectively;the areas under the curve of them were were 0.769,0.765,0.798,0.804 and 0.838,respec

关 键 词：孕晚期 超声 脐动脉血流参数 TEI指数 妊娠高血压 胎儿缺氧 

分 类 号：R714.246[医药卫生—妇产科学] R714.5[医药卫生—临床医学]