彩超监测下血流动力学变化对预测妊娠高血压综合征妊娠结局的价值分析  

The Value of Hemodynamic Changes under Color Doppler Ultrasonography in Predicting Pregnancy Outcome with Pregnancy-induced Hypertension Syndrome

作　　者：郭瑞芳[1] GUO Rui-fang(Ultrasound Department,Zhengzhou Maternal and Child Health Care Hospital,Zhengzhou,Henan,450000,China)

机构地区：[1]郑州市妇幼保健院超声科,河南郑州450000

出　　处：《黑龙江医学》2022年第20期2469-2471,2475,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨彩超监测下血流动力学变化对妊娠高血压综合征(PIH)妊娠结局的预测价值。方法:选择2020年1月-2020年12月郑州市妇幼保健院就诊的90例PIH患者为PIH组,选择同期来院正常产检的90例健康孕妇作为对照组,均经腹部彩超检查子宫动脉血流动力学参数,比较两组患者子宫动脉血流动力学参数及不良妊娠结局,按照病情严重程度将90例PIH患者分为轻度PIH组、中度PIH组、重度PIH组,每组各30例。比较三组患者子宫动脉血流动力学参数及不良妊娠结局。采用多因素COX回归模型分析产妇的子宫动脉血流动力学参数预测PIH患者发生不良妊娠结局的作用。结果:PIH组子宫动脉的阻力指数(RI)、搏动指数(PI)、收缩/舒张流速比值(S/D)显著高于对照组,差异有统计学意义(t=16.298、12.103、16.004,P<0.05)。PIH组的剖宫产率、早产率、胎儿窘迫率、羊水异常率、新生儿窒息率显著高于对照组,差异有统计学意义(χ^(2)=17.729、0.132、11.058、12.776、7.750、11.916,P<0.05)。重度PIH组患者的RI、PI、S/D值均显著高于轻度PIH组、中度PIH组,中度PIH组患者的RI、PI、S/D值均显著高于轻度PIH组,差异有统计学意义(t=36.600、33.743、32.124,P<0.05)。重度PIH组患者的剖宫产率、早产率、羊水异常率显著高于轻度PIH组、中度PIH组,中度PIH组患者的剖宫产率、早产率显著高于轻度PIH组,差异有统计学意义(P<0.05)。多因素COX回归分析显示:子宫动脉RI、PI、S/D值是PIH患者不良妊娠结局的独立危险因素。结论:彩超监测下血流动力学变化有利于评估妊娠高血压综合征的病情严重程度,有利于临床医师预测母婴不良妊娠结局,为临床预防及控制PIH病情提供科学的参考依据。Objective:To investigate the predictive value of hemodynamic changes monitored by color Doppler ultrasound on pregnancy outcome in pregnancy-induced hypertension(PIH).Methods:90 PIH patients who visited the hospital from January 2020 to December 2020 were selected as the PIH group,and 90 healthy pregnant women who came to the hospital for normal obstetric examination during the same period were selected as the control group.The hemodynamic parameters of the uterine artery were examined by abdominal ultrasound in all pregnant women.The uterine artery hemodynamic parameters and adverse pregnancy outcomes were compared between the two groups.According to the severity of the disease,90 PIH patients were divided into mild PIH group,moderate PIH group and severe PIH group,with 30 cases in each group.The uterine artery hemodynamic parameters and adverse pregnancy outcomes were compared among the three groups.Multivariate COX regression model was used to analyze the role of maternal uterine artery hemodynamic parameters in predicting adverse pregnancy outcomes in patients with PIH.Results:The resistance index(RI),pulsatility index(PI),and systolic/diastolic velocity ratio(S/D)of uterine artery in PIH group were significantly higher than those in control group,and the difference was statistically significant(t=16.298,12.103,16.004,P<0.05).The cesarean section rate,preterm birth rate,fetal distress rate,amniotic fluid abnormality rate,and neonatal asphyxia rate in the PIH group were significantly higher than those in the control group,and the difference was statistically significant(χ^(2)=17.729,0.132,11.058,12.776,7.750,11916,P<0.05).The RI,PI and S/D values of the severe PIH group were significantly higher than those of the mild PIH group and the moderate PIH group,the RI,PI and S/D values of patients in the moderate PIH group were significantly higher than those in the mild PIH group,and the difference was statistically significant(t=36.600,33.743,32.124,P<0.05).The cesarean section rate,preterm birth rate,and amniotic

关 键 词：妊娠高血压综合征 彩超 血流动力学 妊娠结局 预测价值 

分 类 号：R714.246[医药卫生—妇产科学]