孕晚期超声S/D值联合尿酸水平预测子痫前期并发胎儿生长受限不良妊娠结局的临床价值  

Clinical Predictive Value of Ultrasound S/D in Late Pregnancy Combined with Uric Acid in Adverse Pregnancy Outcomes of Patients with Preeclampsia Complicated with Fetal Growth Restriction

作　　者：高海侠[1] 张晓月 GAO Haixia;ZHANG Xiaoyue(Department of Obstetrics and Gynecology,Chengde Central Hospital)

机构地区：[1]河北省承德市中心医院产科

出　　处：《中国医学计算机成像杂志》2024年第5期599-603,共5页Chinese Computed Medical Imaging

基　　金：承德市科技计划项目(202301A018)。

摘　　要：目的:探讨孕晚期超声脐动脉收缩期与舒张期峰值流速比(S/D)值联合尿酸水平预测子痫前期(PE)并发胎儿生长受限(FGR)不良妊娠结局的临床价值。方法:选取本院2018年1月-2023年5月收治的PE患者150例作为研究对象,根据患者是否并发FGR分为FGR组(n=54)和非FGR组(n=96),比较2组临床资料、孕晚期超声S/D值、血清生化指标[尿酸、白蛋白、乳酸脱氢酶(LDH)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、肌酐]以及不良妊娠结局。采用logistic回归分析考察PE患者FGR的影响因素,并采用受试者工作特征(ROC)曲线分析孕晚期超声S/D值联合尿酸对PE并发FGR患者不良妊娠结局的预测价值。结果:FGR组S/D值,尿酸、LDH、ALT水平均高于非FGR组,白蛋白水平低于非FGR组(P<0.05)。Logistic回归分析结果显示,S/D值、尿酸为影响PE患者FGR的独立危险因素(P<0.05)。FGR组胎儿窘迫、新生儿窒息、围产儿死亡等不良妊娠结局的总发生率高于非FGR组(P<0.05);不良妊娠结局组S/D值、尿酸水平高于非不良妊娠结局组(P<0.05)。ROC曲线显示,S/D值联合尿酸预测PE并发FGR患者的不良妊娠结局的曲线下面积(AUC)为0.812,高于S/D值的0.779、尿酸的0.692。结论:孕晚期超声S/D值和尿酸是PE患者FGR的影响因素,二者联合可用于预测PE并发FGR患者不良妊娠结局。Purpose:To explore the clinical predictive value of ultrasound peak systolic velocity/end diastolic velocity ratio(S/D)in late pregnancy combined with uric acid in adverse pregnancy outcomes of patients with preeclampsia(PE)complicated with fetal growth restriction(FGR).Methods:A total of 150 patients with PE in our hospital between January 2018 and May 2023 were selected as the study subjects.According to presence or absence of FGR,they were divided into FGR group(n=54)and non-FGR group(n=96).The clinical data,ultrasound S/D in late pregnancy,serum biochemical indexes[uric acid,albumin,lactate dehydrogenase(LDH),alanine transaminase(ALT),aspartate transaminase(AST),creatinine]and adverse pregnancy outcomes were compared between the two groups.The influencing factors of FGR in PE patients were analyzed using logistic regression analysis.The predictive value of ultrasound S/D in late pregnancy combined with uric acid for adverse pregnancy outcomes was analyzed using receiver operating characteristic(ROC)curves.Results:S/D value,levels of uric acid,LDH and ALT in FGR group were higher than those in non-FGR group,while albumin level was lower than that in non-FGR group(P<0.05).The results of logistic regression analysis showed that S/D value and uric acid were independent influencing factors for FGR in PE patients(P<0.05).The total incidence of adverse pregnancy outcomes(fetal distress,neonatal asphyxia,perinatal death)in FGR group was higher than that in non-FGR group(P<0.05).S/D value and level of uric acid in adverse pregnancy outcome group were higher than those in good pregnancy outcome group(P<0.05).ROC curves analysis showed that area under the curve(AUC)of S/D value combined with uric acid for predicting adverse pregnancy outcomes of patients with PE complicated with FGR was 0.812,which was greater than that of single index(0.779,0.692).Conclusion:Ultrasound S/D in late pregnancy and uric acid are influencing factors for FGR in PE patients,and their combination can be used to predict adverse pregnancy outcom

关 键 词：子痫前期 超声 尿酸 胎儿生长受限 

分 类 号：R714.2[医药卫生—妇产科学]