胎盘植入孕妇子宫动脉血流动力学参数与血管新生的关系及其相关指标诊断价值  

Relationship between hemodynamic parameters of uterine artery blood flow and angiogenesis in placenta implantation pregnant women and the diagnostic value of related indicators

作　　者：樊春云[1] 杨明珠 祝玉芳 李争[1] Fan Chunyun;Yang Mingzhu;Zhu Yufang;Li Zheng(Department of Ultrasound Diagnosis,Danyang People's Hospital,Danyang 212300,Jiangsu,China)

机构地区：[1]丹阳市人民医院超声诊断科,江苏丹阳212300

出　　处：《血管与腔内血管外科杂志》2024年第2期219-223,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的 探究胎盘植入孕妇子宫动脉血流动力学参数与血管新生的关系及其相关指标的诊断价值。方法 收集2016年1月至2021年4月于丹阳市人民医院常规超声检查疑似胎盘植入的125例孕妇的临床资料,根据产后最终临床诊断及病理诊断结果分为观察组(n=35,胎盘植入)与对照组(n=90,非胎盘植入)。比较两组孕妇的临床特征、子宫动脉血流动力学参数[子宫动脉搏动指数(PI)、阻力指数(RI)、收缩期峰值血流速度与舒张末期血流速度的比值(S/D)]及血管新生指标[可溶性血管内皮生长因子受体-1(sFlt-1)、血管内皮生长因子(VEGF)]。分析子宫动脉血流动力学参数、血管新生指标与胎盘植入的关系,子宫动脉血流动力学参数对胎盘植入的诊断价值,以及子宫动脉血流动力学参数与血管新生指标的相关性。结果 观察组孕妇的流产次数、剖宫产次数均明显多于对照组孕妇,PI、RI及sFlt-1水平均明显低于对照组孕妇,S/D、VEGF水平均明显高于对照组孕妇,差异均有统计学意义(P<0.01)。多因素分析结果显示,调整混杂因素流产次数、剖宫产次数后,PI、RI、S/D、VEGF、sFlt-1均仍为胎盘植入的独立影响因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,PI、RI、S/D、VEGF、sFlt-1诊断胎盘植入的曲线下面积(AUC)分别为0.716、0.717、0.626、0.797、0.793,各指标联合诊断胎盘植入的AUC为0.870。胎盘植入孕妇子宫动脉血流动力学参数PI、RI与VEGF呈负相关,与sFlt-1呈正相关(P<0.05);S/D与VEGF呈正相关,与sFlt-1呈负相关(P<0.05)。结论 胎盘植入孕妇彩色多普勒超声下的子宫动脉血流动力学参数与血管新生具有明显相关性,且临床监测子宫动脉血流动力学参数、血管新生指标对胎盘植入的诊断具有积极意义。Objective To investigate the relationship between hemodynamic parameters of uterine artery blood flow and angiogenesis in placenta implantation pregnant women,as well as its diagnostic value.Method The clinical data of 125 pregnant women suspected of placenta implantation through routine ultrasound examination at Danyang People's Hospital from January 2016 to April 2021 were collected.According to the final postpartum clinical diagnosis and pathological diagnosis results, they were divided into observation group (n=35, with placental implantation) and control group (n=90, without placental implantation). The clinical characteristics, hemodynamic parameters of uterine artery blood flow [uterine artery pulsatility index (PI), resistance index (RI), peak systolic/end-diastolic flow velocity (S/D)], angiogenesis indicators [soluble fms-like tyrosine kinase-1 (sFlt-1), vascular endothelial growth factor (VEGF)] between two groups of pregnant women were compared. The relationship between hemodynamic parameters of uterine artery blood flow, angiogenesis indicators, and placenta implantation were analyzed, and evaluated the diagnostic value of hemodynamic parameters of uterine artery blood flow for placenta implantation, and the correlation between hemodynamic parameters of uterine artery blood flow and angiogenesis indicators. Result The number of abortions and cesarean sections in the observation group were significantly more than those in the control group;the levels of PI, RI, and sFlt-1 were significantly lower than those in the control group, while the levels of S/D and VEGF were significantly higher than those in the control group, the differences were statistically significant (P<0.01). The results of multivariate analysis showed that after adjusting for confounding factors such as the number of abortions and cesarean sections, PI, RI, S/D, VEGF, and sFlt-1 remained independent factors affecting placenta implantation (P<0.05). The receiver operator characteristic (ROC) curve analysis results showed that the area

关 键 词：胎盘植入 子宫动脉 血流动力学参数 血管新生 血管内皮生长因子 可溶性血管内皮生长因子受体-1 

分 类 号：R543[医药卫生—心血管疾病]