妊娠晚期脐动脉S/D比值变化与胎儿综合生长发育情况的关系  

The relationship between the change of umbilical artery S/D ratio in the third trimester of pregnancy and the overall growth and development of the fetus

作　　者：张坚贞 董金华 吴燕 凌利 ZHANG Jian-zhen;DONG Jin-hua;WU Yan;LING Li(Department of Obstetrics,Jiaxing Maternal and Child Health Hospital,Affiliated Maternal and Child Hospital of Jiaxing University,Jiaxing,Zhejiang 314000,China)

机构地区：[1]嘉兴市妇幼保健院,嘉兴学院附属妇儿医院,浙江嘉兴314000

出　　处：《中国妇幼保健》2023年第4期740-744,共5页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划项目(2021KY357);浙江省嘉兴市科技计划公益性应用技术研究计划(2018AD32106)。

摘　　要：目的 探讨妊娠晚期脐动脉收缩期与舒张末期峰值血流速率比(S/D)比值变化与胎儿综合生长发育情况的关系。方法 选择2020年1月—2020年12月嘉兴市妇幼保健院产科治疗的45例妊娠期高血压孕妇(HDP组)、45例妊娠期糖尿病孕妇(GDM组)作为研究对象,另选取同期来嘉兴市妇幼保健院产科治疗的45例健康孕妇作为对照组。观察比较3组孕妇S/D值及胎儿综合生长发育相关指标变化。结果 与对照组相比,HDP组体质量、臀顶长、身长、腹围、头顶径、超声胎儿体质量明显低于明显降低,平均动脉压明显升高(均P<0.05);GDM组胸围、体质量、羊水指数、平均动脉压明显升高(均P<0.05)。与HDP组相比,GDM组胸围、头围、体质量、臀顶长、腹围明显升高,平均动脉压明显降低(均P<0.05)。经Pearson相关性分析显示,妊娠晚期脐动脉SD比值与ZLI、RI值均呈负相关(r=-0.537,P=0.014;r=-0.781,P=0.005)。随着妊娠的不断进行,其S/D值均呈现降低的趋势,且GDM组S/D值升高程度低于HDP组。在37周以后,对照组的S/D值均低于2.0。38周以前,HDP组S/D值降低较为显著,之后虽然有一定上升,但均低于36周前水平。结论 妊娠晚期脐动脉S/D值与RI、ZLI均具有一定相关性,且可较好地反映胎儿宫内的综合生长发育情况,对临床终止妊娠具有重要的指导意义。Objective To explore the relationship between the ratio of umbilical artery systolic and end-diastolic peak blood flow rate(S/D) ratio in the third trimester of pregnancy and the overall growth and development of the fetus.Methods From January 2020 to December 2020,45 pregnant women with gestational hypertension(HDP group) and 45 pregnant women with gestational diabetes(GDM group) who were treated by the obstetric department of our hospital were selected as the research objects.Another 45 healthy pregnant women who came to our hospital for obstetric treatment during the same period were selected as the control group.Observe and compare the changes of S/D values of pregnant women and related indexes of fetal comprehensive growth and development in the three groups.Results Compared with the control group, the weight, hip top length, body length, abdominal circumference, head diameter and ultrasound fetal weight of HDP group were significantly lower than those of the control group, and the mean arterial pressure was significantly higher(P<0.05);the;The chest circumference, body weight, amniotic fluid index and mean arterial pressure were significantly increased in GDM group(P<0.05).Compared with HDP group, the chest circumference, head circumference, body weight, hip top length, neonatal Alzheimer’s score and abdominal circumference of GDM group were significantly increased, and the mean arterial pressure was significantly decreased(P<0.05).Pearson correlation analysis showed that the SD ratio of umbilical artery in the third trimester was negatively correlated with zli and RI(r=-0.537,P=0.014;r=-0.781,P=0.005).As the pregnancy continued, their S/D values showed a decreasing trend, and the increase in S/D values of the GDM group was lower than that of the HDP group.After 37 weeks, the S/D value of the control group was lower than 2.0.Before 38,the S/D value of the HDP group decreased significantly.Although there was a certain increase thereafter, they were all lower than the level before 36 weeks.Conclusion The S/

关 键 词：妊娠晚期 脐动脉收缩期与舒张末期峰值血流速率比 彩色超声多普勒 新生儿 综合生长发育 

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]