超声检查脐动脉血流参数及孕妇血清sFlt-1、PP13水平对胎儿生长受限的诊断价值分析  

Diagnostic value of ultrasonic detection of umbilical artery blood flow parameters and maternal serum sFlt-1,PP13 levels in fetal growth restriction

作　　者：李娟 常茹晗 王辉 闫红杰 李葵 LI Juan;CHANG Ruhan;WANG Hui;YAN Hongjie;LI Kui(Department of Ultrasound Medicine,Zhengzhou 460 Hospital,Zhengzhou 450000,China;Department of Ultrasound Medicine,Zhengzhou People's Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州四六〇医院超声医学科,河南郑州450000 [2]郑州人民医院超声医学科,河南郑州450000

出　　处：《黑龙江医药科学》2024年第4期67-71,共5页Heilongjiang Medicine and Pharmacy

基　　金：河南省医学科技攻关联合共建项目,编号:LHGJ20221035。

摘　　要：目的:探讨超声检查脐动脉血流参数、孕妇血清可溶性酪氨酸激酶-1(sFlt-1)、胎盘蛋白13(PP13)水平对胎儿生长受限(FGR)的诊断价值。方法:回顾性选取2022年1月至2023年7月于郑州四六〇医院产检并确诊的186例FGR孕妇作为观察组,另匹配同期62例正常孕妇作为对照组。比较两组脐动脉血流参数[搏动指数(PI)、阻力指数(RI)、收缩期最大血流速度/舒张末期血流速度(S/D)]及血清sFlt-1、PP13水平。统计两组临床资料,并分析FGR发病影响因素。分析脐动脉血流参数、血清sFlt-1、PP13水平与FGR严重程度指标相关性。受试者工作特征曲线(ROC)及曲线下面积(AUC)分析脐动脉血流参数、血清sFlt-1、PP13对FGR的诊断价值。采用决策曲线(DCA)评价各指标联合诊断模型临床获益。结果:观察组PI、RI、S/D及血清sFlt-1水平高于对照组,血清PP13水平低于对照组(P<0.05);羊水过少、不良妊娠史、胎盘/脐带异常及PI、RI、S/D、sFlt-1为FGR发生的独立危险因素,胎盘质量、新生儿出生体质量、1min Apagar评分、PP13为FGR发生的独立保护因素(P<0.05);PI、RI、S/D、sFlt-1与胎盘质量、新生儿出生体质量、1min Apagar评分呈负相关,而与PP13呈正相关(P<0.05);脐动脉血流参数、血清sFlt-1、sFlt-1联合诊断FGR的AUC大于单项指标诊断(P<0.05),且DCA分析证实联合检测时临床净受益率优于单项指标检测。结论:FGR孕妇PI、RI、S/D及血清sFlt-1水平升高,PP13水平降低,且为FGR发生的独立影响因素,联合检测其水平对FGR发生具有一定诊断价值。Objective:To investigate the diagnostic value of ultrasonic detection of umbilical artery blood flow parameters,serum soluble tyrosine kinase-1(sFlt-1)and placental protein 13(PP13)levels in pregnant women in fetal growth restriction(FGR).Methods:A total of 186 pregnant women diagnosed with FGR from January 2022 to July 2023 were selected as the observation group,and 62 normal pregnant women were matched as the control group.The blood flow parameters[pulse index(PI),resistance index(RI),systolic maximum blood velocity/end-diastolic blood velocity(S/D)]and serum sFlt-1 and PP13 levels were compared between the two groups.The clinical data of the two groups were analyzed,and the influencing factors of FGR were analyzed.The correlation between umbilical artery blood flow parameters,serum sFlt-1,PP13 level and FGR severity index was analyzed.Receiver operating characteristic curve(ROC)and area under curve(AUC)were used to analyze umbilical artery flow parameters,serum sFlt-1,and the diagnostic value of PP13 in FGR.Decision curve(DCA)was used to evaluate the clinical benefit of the combined diagnosis model.Results:The levels of PI,RI,S/D and sFlt-1 in the observation group were higher than those in the control group,and the level of PP13 in the serum was lower than that in the control group(P<0.05).Hydramniotic fluid,adverse pregnancy history,placental/umbilical cord abnormality,PI,RI,S/D and sFlt-1 were independent risk factors for FGR,while placental mass,neonatal birth weight,1-min Apagar score and PP13 were independent protective factors for FGR(P<0.05).PI,RI,S/D and sFlt-1 were negatively correlated with placental mass,newborn birth weight and 1-min Apagar score,while PP13 were negatively correlated(P<0.05).The AUC of umbilical artery flow parameters,serum sFlt-1 and sFlt-1 combined diagnosis of FGR was higher than that of single index diagnosis(P<0.05),and DCA analysis confirmed that the clinical net benefit rate of combined detection was better than that of single index detection.Conclusion:The levels of PI,RI,

关 键 词：胎儿生长受限 脐动脉血流 可溶性酪氨酸激酶-1 胎盘蛋白13 超声 诊断 

分 类 号：R714.5[医药卫生—妇产科学]