血清PGE1、GPX1及子宫动脉超声参数评估凶险性前置胎盘植入导致的产后出血  

Values of the levels of serum prostaglandin E1 and glutathione peroxidase 1,and the uterine artery ultrasound parameters of women for evaluating their postpartum hemorrhage caused by dangerous placenta previa and placenta implantation

作　　者：瞿思宇 陈艳莉 张荣丽 陈薇 QU Siyu;CHEN Yanli;ZHANG Rongli;CHEN Wei(The First Maternal and Child Health Hospital,Tongji University,Shanghai,201204)

机构地区：[1]同济大学附属第一妇婴保健院,上海201204

出　　处：《中国计划生育学杂志》2023年第11期2692-2697,共6页Chinese Journal of Family Planning

摘　　要：目的:探讨血清前列腺素E1(PGE1)、谷胱甘肽过氧化物酶1(GPX1)及子宫动脉超声参数与凶险性前置胎盘植入导致产后出血关系。方法:回顾性收集2019年4月-2022年4月本院治疗的凶险性前置胎盘植入产妇98例临床资料为观察组,凶险性前置胎盘不伴植入产妇80例为对照组,分析两组血清PGE1、GPX1及子宫动脉超声参数阻力指数(RI)、搏动指数(PI)、血管最大血流速度(PSV)和收缩/舒张期速度比值(S/D)等,分析观察组不同临床特征、胎盘植入分类、发生和未发生产后出血产妇上述指标差异,受试者工作特征(ROC)分析上述指标预测产后出血价值。结果:观察组血清PGE1(35.54±9.32pg/ml)和GPX1(30.50±9.14U/L)低于对照组(47.49±9.20 pg/ml、38.38±9.40 U/L)。RI(0.37±0.10)、PI(0.46±0.11)低于对照组(0.44±0.12、0.57±0.10),PSV(44.50±8.12cm/s)和S/D(6.80±1.10)高于对照组(36.61±8.05 cm/s、5.82±1.03)(均P<0.05)。观察组不同年龄、分娩孕周和体质指数产妇血清PGE1、GPX1及子宫动脉超声参数比较无差异(P>0.05),粘连型胎盘植入、植入性胎盘植入、穿透性胎盘植入者RI和PI依次降低,PSV和S/D依次升高,发生产后出血产妇血清PGE1、GPX1、RI和PI均低于未发生产后出血产妇(均P<0.05)。PGE1、GPX1、RI和PI与产后出血量呈负相关(P<0.05)。PGE1、GPX1及RI、PI预测凶险性前置胎盘植入产后出血的ROC曲线下面积分别为0.651、0.668、0.623和0.636。结论:血清PGE1、GPX1及子宫动脉超声参数与凶险性前置胎盘植入的胎盘植入程度、产后出血有关,PGE1、GPX1、RI和PI预测产后出血有一定价值。Objective:To investigate the correlation between the serum prostaglandin E1(PGE1),glutathione peroxidase 1(GPX1),and uterine artery ultrasound parameters of women and their postpartum hemorrhage caused by the dangerous placenta previa and placenta implantation.Methods:The clinical data of 98 women with dangerous placenta previa and placenta implantation from April 2019 to April 2022(in study group)were collected retrospectively.80 pregnant women with dangerous placenta previa and without placenta implantation were selected in control group.The levels of serum PGE1 and GPX1,and the values of ultrasound parameters of uterine artery,such as resistance index(RI),pulsatility index(PD),peak systolic velocity(PSV),and systolic/diastolic velocity ratio(S/D)of the women in the two groups were analyzed.The differences of the levels of serum PGE1 and GPX1,and the values of RI,PI,PSV,and S/D of the women with different clinical characteristics.of the women with different classification of placenta implantation,of the women with or without postpartum hemorrhage in the observation group were analyzed.Receiver operating characteristic(ROC)was used to analyze the predictive values of the levels of serum PGE1 and GPX1,and the values of RI,PI,PSV,and S/D of the women for their postpartum hemorrhage.Results:In the study group,there were no significant differences in the levels of serum PGE1 and GPX1,and the values of ultrasound parameters of uterine artery among the women with different ages,the women with different delivery gestational weks,or the women with different body mass index(P>0.05).The values of RI and PI of the women with adherent placenta accreta,of the women with implantation placenta accreta,and of the women with penetrability placenta accreta had decreased gradually,and their PSV and S/D values had increased gradually.The levels of serum PGE1 and GPX1,and the values of RI and PI of the women with postpartum hemorrhage were significantly lower than those in women without postpartum hemorrhage(all P<0.05).The levels o

关 键 词：凶险性前置胎盘 胎盘植入 产后出血 前列腺素E1 胱甘肽过氧化物酶1 子宫动脉超声参数 相关性 预测 

分 类 号：R714.461[医药卫生—妇产科学]