基于宫颈弹性成像构建早孕期早产预测模型  

Construction of Prediction Model for Preterm Birth in Early Pregnancy via Cervical Elastography

作　　者：陈思晗 胡兵[1] 向小珍 丁凌[1] 杨莹 CHEN Sihan;HU Bing;XIANG Xiaozhen;DING Ling;YANG Ying(Department of Ultrasound,the Affiliated Renhe Hospital of Three Gorges University,Yichang 443001,China)

机构地区：[1]三峡大学附属仁和医院超声科,湖北宜昌443001

出　　处：《中国医学影像学杂志》2023年第12期1298-1303,共6页Chinese Journal of Medical Imaging

基　　金：湖北省卫生健康委员会联合基金面上项目(WJ2019H541)。

摘　　要：目的基于临床病史及多项超声参数,初步建立早孕期评估早产的预测模型。资料与方法纳入2020年9月—2021年9月三峡大学附属仁和医院200名妊娠6~8周早孕期女性,收集其临床病史、二维超声成像、宫颈弹性成像资料,进行Logistic回归分析,筛选、赋值,初步建立早孕期评估早产的临床预测模型。结果最终41名孕妇发生早产(早产组),159名孕妇未发生早产(足月组)。单因素分析显示,流产史、早产史、宫颈角度、宫颈内口前唇杨氏模量值(A)、宫颈内口前唇应变率比值(A1)均为早产的独立相关危险因素,多因素分析得到公式Logit(P)=1.495×流产史+1.060×A1+0.795×宫颈角度+1.354×A-14.951,此模型通过Hosmer-Lemeshow拟合优度检验拟合度好,其诊断效能为96.9%。结论早孕期预测模型可以有效预测单胎妊娠孕妇发生早产。Purpose To preliminarily establish a predictive model for assessing preterm birth in the first trimester via clinical history and multiple ultrasound parameters.Materials and Methods This study included 200 women in the first trimester of pregnancy from 6 to 8 weeks in the Affiliated Renhe Hospital of Three Gorges University from September 2020 to September 2021,and their clinical history,two-dimensional imaging data and cervical elastography data were collected.Logistic regression analysis,screening and assignment were performed to initially establish a clinical prediction model for evaluating preterm birth during the first trimester.Results Finally,41 pregnant women developed preterm birth(preterm birth group),and 159 pregnant women did not develop preterm birth(term group).History of miscarriage,history of preterm birth,uterocervical angle(UCA),A,and A1 were the independent risk factors for preterm birth via univariate analysis,and multivariate analysis was carried out to obtain the formula:Logit(P)=1.495×abortion history+1.060×A1+0.795×UCA+1.354×A-14.951,which had a good fit via Hosmer-Lemeshow goodness-of-fit test,and the diagnostic efficiency was 96.9%.Conclusion The early pregnancy prediction model can effectively predict the occurrence of preterm birth in pregnant women with singleton pregnancy.

关 键 词：早产 超声检查 多普勒 彩色 弹性显像技术 子宫颈 预测模型 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.21[医药卫生—诊断学]