E-cervix宫颈弹性成像技术在先兆早产孕妇中的应用:120例分析  

Application of E-cervix elastography technology in pregnant women with threatened preterm birth:an analysis of 120 cases

作　　者：缪雨田 龙煜[1] 骆迎春[1] 张帅 Miao Yutian;Long Yu;Luo Yingchun;Zhang Shuai(Department of Ultrasonography,Hunan Provincial Maternal and Child Health Care Hospital,Changsha 410008,China)

机构地区：[1]湖南省妇幼保健院超声科,长沙410008

出　　处：《中华围产医学杂志》2024年第8期656-661,共6页Chinese Journal of Perinatal Medicine

摘　　要：目的使用E-cervix宫颈弹性成像技术检测有先兆早产症状的单胎妊娠孕妇宫颈组织弹性,为评估早产风险提供依据。方法本研究为前瞻性队列研究,纳入2022年5月至2023年5月就诊于湖南省妇幼保健院产科门诊的孕20+0~32周+6出现先兆早产症状但既往无早产史的单胎妊娠孕妇。运用超声E-cervix宫颈弹性成像技术获取宫颈长度(cervical length,CL)、硬组织弹性占比(hardness ratio,HR)、宫颈内口应变值(internal ostium,IOS)和宫颈外口应变值(external ostium,EOS)等宫颈数据。比较不同妊娠结局(早产或足月产)和不同CL孕妇宫颈弹性成像数据的差异。采用协方差分析(校正孕周)、χ^(2)检验或校正χ^(2)检验及Pearson相关进行统计学分析。结果共纳入120例孕妇,按妊娠结局分为早产组(39例,32.5%)与足月产组(81例,67.5%);按CL分为CL≤25 mm组(41例,34.2%)与CL>25 mm组(79例,65.8%);CL≤25 mm孕妇再根据是否发生早产分为CL≤25 mm早产组(26例)与CL≤25 mm足月产组(15例)。早产组与足月产组相比,宫颈HR较低[(35.75±8.94)%与(61.30±10.69)%,F=156.88],而IOS和EOS较高(0.47±0.13与0.31±0.09,F=54.99;0.45±0.11与0.34±0.08,F=34.57);CL≤25 mm组与CL>25 mm组相比,宫颈HR较低[(43.17±14.32)%与(58.09±13.94)%,F=26.03],而IOS和EOS较高(0.46±0.14与0.32±0.08,F=38.71;0.44±0.12与0.34±0.08,F=21.36);CL≤25 mm早产组与CL≤25 mm足月产组相比,宫颈HR较低而IOS和EOS较高;以上差异均有统计学意义(P值均<0.001)。CL≤25 mm伴HR<50%组较CL≤25 mm伴HR≥50%组的早产率高[95.5%(21/22)与5/19,χ²=21.01];CL>25 mm伴HR<50%组较CL>25 mm伴HR≥50%组的早产率高[61.9%(13/21)与0.0%(0/58),校正χ²=38.59];CL≤25 mm伴HR<40%组较CL≤25 mm伴HR≥40%组的早产率高[18/18与34.8%(8/23),χ²=18.51];CL>25 mm伴HR<40%组较CL>25 mm伴HR≥40%组的早产率高[11/14与3.1%(2/65),校正χ²=42.42];以上差异均有统计学意义(P值均<0.001)。对CL和HR进行Pearson相关性分析,CL与HR呈�ObjectiveTo evaluate the cervical elasticity in pregnant women with singleton pregnancies exhibiting symptoms of threatened preterm labor using E-cervix elastography,and provide a basis for assessing the risk of preterm birth.MethodsThis prospective cohort study included pregnant women with singleton pregnancies between 20+0 and 32+6 weeks of gestation and no history of preterm birth who developed symptoms of threatened preterm labor and attended the obstetrics outpatient clinic of the Hunan Provincial Maternal and Child Health Care Hospital from May 2022 to May 2023.Several cervical elastography data,including cervical length(CL),hardness ratio(HR),internal ostium(IOS),and external ostium(EOS),were obtained using E-cervix technology,and the differences in these data were compared between women with different pregnancy outcomes(preterm or full-term birth)or different CLs.Statistical analysis was performed using covariance analysis(adjusted for gestational age),Chi-square test or corrected Chi-square test,and Pearson correlation analysis.ResultsA total of 120 pregnant women were included,with 39(32.5%)in the preterm group and 81(67.5%)in the full-term group.There were 41 women(34.2%)with CL≤25 mm and 79(65.8%)with CL>25 mm.Among the 41 women with CL≤25 mm,26 had preterm birth and 15 delivered at term.Compared with the full-term group,the preterm group had a lower cervical HR[(35.75±8.94)%vs.(61.30±10.69)%,F=156.88],but higher IOS and EOS(0.47±0.13 vs.0.31±0.09,F=54.99;0.45±0.11 vs.0.34±0.08,F=34.57)(all P<0.001).The patients with CL≤25 mm had a lower cervical HR[(43.17±14.32)%vs.(58.09±13.94)%,F=26.03],but higher IOS and EOS(0.46±0.14 vs.0.32±0.08,F=38.71;0.44±0.12 vs.0.34±0.08,F=21.36)as compared with those with CL>25 mm,with all differences being statistically significant(all P<0.001).Among the women with CL≤25 mm,preterm birth cases had lower cervical HR but higher IOS and EOS than those delivered at term(all P<0.001).In both CL≤25 mm and CL>25 mm groups,the preterm birth rate was higher i

关 键 词：E-cervix 弹性成像 先兆早产 宫颈 

分 类 号：R714.21[医药卫生—妇产科学]