主肺动脉收缩期加速时间/射血时间比值评估重度子痫前期胎儿肺成熟度  

Assessment of fetal lung maturity in severe preeclampsia using main pulmonary artery accelerated systolic time/ejection time ratio

作　　者：田飞[1] 窦连峰[2] 唐丽玮[1] 刘玉芳[3] TIAN Fei;DOU Lianfeng;TANG Liwei;LIU Yufang(Department of Ultrasound Medicine,Binzhou Medical University Hospital,Binzhou 256603,China;Department of Emergency,Binzhou MedicalUniversity Hospital,Binzhou 256603,China;Department of Gynecology and Obstetrics,Binzhou Medical University Hospital,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院超声医学科,山东滨州256603 [2]滨州医学院附属医院急诊科,山东滨州256603 [3]滨州医学院附属医院妇产科,山东滨州256603

出　　处：《中国医科大学学报》2024年第3期213-217,共5页Journal of China Medical University

基　　金：山东省自然科学基金(ZR2021MH247);山东省医药卫生科技发展计划项目(202005020624)。

摘　　要：目的探讨胎儿主肺动脉收缩期加速时间(AT)/射血时间(ET)比值对重度子痫前期胎儿肺成熟度的预测价值。方法选取2021年1月至2022年12月因重度子痫前期在我院住院并自愿接受超声检查的孕妇65例,根据孕周分为早发型(孕20~33^(+6)周)重度子痫前期组(A组,n=30)和晚发型(孕34~40周)重度子痫前期组(B组,n=35)。选取超声检查孕周与A、B组相匹配的正常孕妇作为各自对照组(分别为30例、35例)。超声多普勒测量胎儿主肺动脉血流参数,包括AT、ET、AT/ET、收缩期峰值流速(PSV)。于分娩即刻采集羊水(约15 mL),检测羊水卵磷脂/鞘磷脂(L/S)值。比较A、B组胎儿主肺动脉血流参数及其与对照组有无差异,分析血流参数与羊水L/S的相关性。结果A组、B组胎儿主肺动脉AT、ET、AT/ET、PSV比较差异有统计学意义(P<0.05),且均小于各自对照组(均P<0.05)。A组、B组胎儿主肺动脉AT/ET比值与羊水L/S均呈正相关(r分别为0.821、0.383,均P<0.05)。受试者操作特征曲线分析显示AT/ET诊断早发型及晚发型子痫前期的曲线下面积分别为0.839、0.833,当假阳性率为5%时,灵敏度分别为0.853、0.912,特异度分别为0.583、0.611,截断值分别为0.185、0.255。结论胎儿主肺动脉AT/ET比值能对重度子痫前期做出初步诊断,并可定量评估胎儿肺成熟度,可为临床提供一种新的简单、无创、可重复的评估方法。Objective To investigate the assessment of fetal lung maturity using main pulmonary artery accelerated systolic time(AT)/ejection time(ET)ratio in patients with severe preeclampsia.Methods A total of 65 pregnant women who were hospitalized in our hos-pital due to severe preeclampsia,from January 2021 to December 2022,and voluntarily underwent ultrasound examination were enrolled in this study.The patients were divided into early-onset(20 to 33^(+6) weeks gestation)severe preeclampsia group(group A,n=30)and late-onset(34 to 40 weeks)severe preeclampsia group(group B,n=35).Healthy pregnant women with gestational age-matched to groups A and B via ultrasound examination were selected as controls(n=30 and n=35,respectively).Fetal main pulmonary artery blood flow parameters were measured using ultrasound Doppler:AT,ET,AT/ET,and peak systolic flow rate(PSV).Amniotic fluid(approximately 15 mL)was collected immediately after delivery,and the lecithin/sphingomyelin(L/S)values were measured.The blood flow parameters of the main pulmonary artery of the fetuses in groups A and B were compared,and whether there was any difference between them and the control group was analyzed.The correlation between the blood flow parameters and amniotic fluid L/S was also analyzed.Results There were statistically significant differences in AT,ET,AT/ET,and PSV in the fetal main pulmonary artery between groups A and group B(P<0.05),and all of them were smaller than those in the control group(P<0.05).The AT/ET ratio of the fetal main pulmonary artery in groups A and B was positively correlated with amniotic fluid L/S(r=0.821 and 0.383,respectively,P<0.05).Receiver operating charac-teristic curve analysis showed that the area under the curve of AT/ET in the diagnosis of early-onset and late-onset preeclampsia was 0.839 and 0.833,respectively,and the sensitivity was 0.853 and 0.912,the specificity was 0.583 and 0.611,and the cut-off values were 0.185 and 0.255,respectively.The false positive rate was 5%.Conclusion The AT/ET value of the fetal mai

关 键 词：超声检查 重度子痫前期 胎儿肺成熟度 主肺动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学]