子痫风险预测联合脐动脉S/D比值对妊娠期糖尿病患者妊娠结局的预测价值  

Prediction value of combined S/D ratio of umbilical artery and risk of eclampsia for predicting pregnancy outcomes in patients withgestational diabetes mellitus

作　　者：金海红[1] 王秀秀 JIN Haihong;WANG Xiuxiu(Obstetrics and Gynaecology,Taizhouhospital of Zhejiang Province Affiliated to Wenzhou Medical University,Taizhou 317000,Zhejiang,China)

机构地区：[1]浙江省台州医院妇产科,浙江台州317000

出　　处：《中国现代医生》2024年第17期38-41,46,共5页China Modern Doctor

基　　金：浙江省台州市社会发展科技计划项目(21ywb01);浙江省台州恩泽医疗中心(集团)课题项目(20EZC28)。

摘　　要：目的探讨子痫风险预测联合脐动脉收缩期峰值流速与舒张末期流速(peak systolic velocity/end diastolic velocity,S/D)比值对妊娠期糖尿病患者妊娠结局的预测价值。方法选取2021年1月至2023年1月笔者医院产科门诊收治的60例妊娠期糖尿病(gestational diabetes mellitus,GDM)患者作为妊娠糖尿病组;同一时间,选取笔者医院产科门诊孕检正常的健康孕妇30例作为对照组。采用磁微粒化学发光法检测血清胎盘生长因子(placental growth factor,PIGF),超声检测,S/D比值同时按照是否合并不良妊娠结局分为妊娠结局良好组及不良妊娠结局组,比较PIGF及S/D比值;采用受试者操作特征(receiver operating characteristic,ROC)曲线分析PIGF联合S/D比值对GDM患者妊娠结局的预测价值进行预测分析。结果与对照组比较,妊娠糖尿病组患者PIGF降低,S/D升高(P<0.05)。对照组不良妊娠结局的发生率为20.00%,妊娠糖尿病组不良妊娠结局的发生率为46.67%,与对照组比较,妊娠糖尿病组不良妊娠结局的发生率升高(P<0.05)。与妊娠结局良好组比较,不良妊娠结局组的GDM患者PIGF水平降低,S/D比值升高(P<0.05)。ROC曲线分析PIGF、S/D比值对GDM患者不良妊娠结局敏感度及特异性分析发现,S/D比值诊断效果高于PIGF,但联合更高。结论妊娠期糖尿病患者中PIGF水平降低,S/D比值增加,且与患者不良妊娠结局相关,PIGF联合S/D比值对患者不良妊娠结局的诊断效能最高。Objective To investigate the value of eclampsia risk prediction combined with umbilical artery peak systolic velocity/end diastolic velocity(S/D)ratio in predicting pregnancy outcomes in patients with gestational diabetes mellitus.Methods Select 60 cases of gestational diabetes mellitus(GDM)patients admitted to ourhospital's obstetrics outpatient department from January 2021 to January 2023 as the gestational diabetes group.At the same time,select 30healthy pregnant women who received regular prenatal check-ups in ourhospital's obstetrics outpatient department as the control group.Determination of placental growth factor(PIGF)in serum by magnetic particle chemiluminescence.The ratio of S/D ratio to was measured by ultrasound.At the same time,they were divided into good pregnancy outcome group and bad pregnancy outcome group according to whether combined with adverse pregnancy outcome,and the PIGF and S/D ratio were compared.We performed a predictive analysis using receiver operating characteristic(ROC)curve analysis to assess the predictive value of PIGF combined with the S/D ratio for the pregnancy outcomes in GDM patients.Results Compared with the control group,patients in the gestational diabetes mellitus(GDM)group showed a decrease in PIGF levels and an increase in the S/D ratio of systolic to diastolic velocities(S/D ratio)(P<0.05).The incidence of adverse pregnancy outcomes was 46.67%in the GDM group,significantlyhigher than the 20.00%in the control group(P<0.05).Compared with the group with favorable pregnancy outcomes,the GDM group with adverse pregnancy outcomeshad lower PIGF levels andhigher S/D ratio(P<0.05).ROC curve analysis showed that both PIGF and S/D ratio were sensitive markers for predicting adverse pregnancy outcomes in GDM patients,with S/D ratio having ahigher diagnostic efficacy than PIGF alone,but the combination of both markers yielded greater accuracy.Conclusion The decrease of PIGF level and the increase of S/D ratio in patients with gestational diabetes mellitus are correlated with adv

关 键 词：妊娠期糖尿病 胎盘生长因子 收缩期峰值流速与舒张末期流速比值 糖耐量降低 妊娠结局 

分 类 号：R714.3[医药卫生—妇产科学]