多参数超声评估中孕期妊娠期糖尿病患者胎盘功能的临床价值  

Clinical Value of Multi-parameter Combined Ultrasound in Placental Function Evaluation in Patients with Gestational Diabetes Mellitus During Second Trimester

作　　者：李欢 胡兵[1] 卢佳 丁凌[1] 杨莹 Li Huan;Hu Bing;Lu Jia;Ding Ling;Yang Ying(Department of Ultrasound,Affiliated Renhe hospital of China Three Gorges University,Yichang,Hubei 443001,China)

机构地区：[1]三峡大学附属仁和医院超声科,湖北省宜昌市443001

出　　处：《中国超声医学杂志》2023年第1期56-59,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 探讨多参数超声评估中孕期妊娠期糖尿病(GDM)患者胎盘功能的应用价值。方法 选取中孕期孕妇(正常组73例、GDM组54例)于孕20~24周行超声检查。对比两组超声数据差异,绘制受试者工作特征(ROC)曲线对各参数进行评价。结果 与正常组相比,GDM组的子宫动脉(UtA)血流参数和胎盘弹性模量值明显升高,而血管指数(VI)和血管-血流指数(VFI)则明显降低,差异均有统计学意义(P<0.01);两组脐动脉(UA)血流参数无明显差异。ROC曲线分析显示,超声多参数联合应用在中孕期评估GDM患者胎盘功能的曲线下面积为0.913,均大于各单一参数,差异均具有统计学意义(P<0.01)。结论 常规超声、三维能量多普勒超声(3D-PDU)、剪切波弹性成像(SWE)多参数联合应用在评估中孕期GDM患者胎盘功能受损情况中有较高的应用价值,可为临床尽早诊治提供可靠依据。Objective To investigate the practical value of multi-parameter combined ultrasound in placental function evaluation in patients with gestational diabetes mellitus during second trimester.Methods Pregnant women in second trimester were randomly selected [73 cases of normal and 54 cases of gestational diabetes mellitus(GDM)],all cases underwent ultrasound examination at 20 to 24 weeks of gestation.The difference of ultrasonic data between two groups were compared,and the receiver operating characteristic(ROC) curve was plotted to evaluate each parameter.Results Compared with the normal group,the blood flow parameters in uterine artery(UtA) and placental elastic modulus were significantly increased,while vascularization index(VI) and vascularization-flow index(VFI) were significantly decreased in the GDM group,the differences were statistically significant(P<0.01);there was no significant difference between the two groups in the umbilical artery(UA) flow parameters.According to the ROC curve analysis,the area under the curve of the multi-parameter combined ultrasound in placental function evaluation in patients with GDM during second trimester was 0.913,which was larger than that of each parameter used alone,the differences were statistically significant(P<0.01).Conclusions The combination of conventional ultrasound,three-dimensional power Doppler ultrasound(3 D-PDU) and shear wave elastography(SWE) has a high clinical practical value in the damage evaluation of placental function in patients with GDM during second trimester,and may provide a reliable evidence for early clinical diagnosis and treatment.

关 键 词：中期妊娠 妊娠期糖尿病 胎盘功能 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.256[医药卫生—诊断学]