孕晚期胎儿大脑中动脉与脐动脉血流参数的相关性及联合检测的临床应用价值  

Correlation of blood flow parameters of fetal middle cerebral artery and umbilical artery in the third trimester of pregnancy and clinical application value of combined detection

作　　者：王帅 张俊芳[1] 王佳玲[2] WANG Shuai;ZHANG Junfang;WANG Jialing(First Department of Functional(Color Ultrasound Room),Affiliated Hospital of Hebei Engineering University,Handan,Hebei 056002,China;Department of Ultrasound,The First Hospital of Handan,Handan,Hebei 056002,China)

机构地区：[1]河北工程大学附属医院功能一科(彩超室),河北邯郸056002 [2]河北省邯郸市第一医院超声科,河北邯郸056002

出　　处：《国际检验医学杂志》2022年第23期2885-2890,共6页International Journal of Laboratory Medicine

基　　金：河北省2020年度医学科学研究课题计划(20200434)。

摘　　要：目的探讨孕晚期胎儿大脑中动脉与脐动脉血流参数的相关性及联合检测的临床应用价值。方法选取2020年5月至2021年5月于河北工程大学附属医院就诊的90例高危妊娠(HRP)孕妇作为研究组,另选取同期健康产检孕妇60例作为对照组。利用超声检查孕晚期胎儿大脑中动脉及脐动脉血流参数[收缩期末流速与舒张期末流速比值(S/D)、搏动指数(PI)、阻力指数(RI)]。比较两组孕晚期胎儿大脑中动脉与脐动脉血流参数;分析研究组孕晚期胎儿大脑中动脉与脐动脉血流参数间的相关性;比较两组妊娠结局;比较研究组不同妊娠结局孕妇孕晚期胎儿大脑中动脉与脐动脉血流参数;分析孕晚期胎儿大脑中动脉与脐动脉血流参数对HRP孕妇妊娠结局的影响及对HRP孕妇不良妊娠结局的预测价值。结果研究组孕晚期胎儿大脑中动脉S/D、PI、RI较对照组降低,脐动脉S/D、PI、RI较对照组升高,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示,研究组孕晚期胎儿大脑中动脉S/D、PI、RI与脐动脉S/D、PI、RI均呈负相关(P<0.05)。研究组早产、胎儿宫内窘迫、新生儿窒息、胎儿生长受限发生率均较对照组高,差异有统计学意义(P<0.05)。研究组共有37例孕妇发生不良妊娠结局,不良妊娠结局孕妇孕晚期胎儿大脑中动脉S/D、PI、RI低于正常妊娠结局孕妇,脐动脉S/D、PI、RI高于正常妊娠结局孕妇,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,孕晚期胎儿大脑中动脉S/D、PI、RI及脐动脉S/D、PI、RI均为HRP孕妇妊娠结局的独立影响因素(P<0.05)。孕晚期胎儿大脑中动脉S/D、PI、RI及脐动脉S/D、PI、RI联合检测预测HRP孕妇不良妊娠结局的AUC为0.888,高于各项参数单独检测。结论HRP孕妇孕晚期胎儿大脑中动脉与脐动脉血流参数具有一定的相关性,且各项参数对HRP孕妇不良妊娠结局具有一定的预测价值,联合检Objective To investigate the correlation of blood flow parameters of fetal middle cerebral artery and umbilical artery in the third trimester of pregnancy and clinical application value of combined detection.Methods A total of 90 pregnant women with high-risk pregnancy(HRP)who visited the Affiliated Hospital of Hebei Engineering University from May 2020 to May 2021 were selected as the study group,another 60 healthy pregnant women underwent prenatal examination were selected as the control group.The blood flow parameters of fetal middle cerebral artery and umbilical artery in the third trimester of pregnancy[ratio of end systolic flow velocity to end diastolic flow velocity(S/D),pulsatility index(PI),resistance index(RI)]were examined by ultrasound.The fetal middle cerebral artery and umbilical artery blood flow parameters between the two groups in the third trimester of pregnancy were compared.Analyzed the correlation between the blood flow parameters of fetal middle cerebral artery and umbilical artery in the third trimester of the study group.Pregnancy outcomes were compared between the two groups.The blood flow parameters of fetal middle cerebral artery and umbilical artery in the third trimester of pregnancy of pregnant women with different pregnancy outcomes were compared.Analyzed the influence of fetal middle cerebral artery and umbilical artery blood flow parameters in the third trimester of pregnancy on pregnancy outcomes of HRP women and their predictive value for adverse pregnancy outcomes of HRP women.Results The S/D,PI and RI of fetal middle cerebral artery in the third trimester of pregnancy in the study group were lower than those in the control group,while the S/D,PI and RI of fetal umbilical artery in the third trimester of pregnancy were higher than those in the control group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that S/D,PI,RI of fetal middle cerebral artery were negatively correlated with S/D,PI,RI of fetal umbilical artery in the third

关 键 词：高危妊娠 超声 大脑中动脉 脐动脉 血流参数 妊娠结局 

分 类 号：R445.1[医药卫生—影像医学与核医学]