子宫动脉超声参数联合凝血指标检测对妊娠晚期孕妇胎盘早剥的预测价值  

Study on the predictive value of uterine artery ultrasound parameters combined with four coagulation indicators test for placental abruption in late pregnancy

作　　者：赵洪莲 李翠 许洁 林萍 Zhao Honglian;Li Cui;Xu Jie;Lin Ping(Department of Obstetrics,Linyi Central Hospital of Shandong Province,Linyi 276400,China;Department of Gynecology,Linyi Central Hospital of Shandong Province,Linyi 276400,China)

机构地区：[1]临沂市中心医院产科,临沂276400 [2]临沂市中心医院妇科,临沂276400

出　　处：《中华内分泌外科杂志（中英文）》2024年第5期733-738,共6页Chinese Journal of Endocrine Surgery

基　　金：山东省临沂市重点研发计划(医学类)(2022YX0014)。

摘　　要：目的探讨子宫动脉超声参数联合凝血指标检测对妊娠晚期孕妇胎盘早剥的预测价值。方法选取2021年1月至2022年12月在临沂市中心医院诊治的160例妊娠晚期胎盘早剥孕妇作为观察组,及同期160例正常分娩的妊娠晚期孕妇作为对照组。根据胎盘早剥不同分度分为I度65例,Ⅱ度54例,Ⅲ度41例。比较子宫动脉超声参数[子宫动脉搏动指数(pulse index,PI)、阻力指数(resistance index,RI)、收缩期最大血流速度(maximum systolic blood flow velocity,S)与舒张末期最大血流速度(end-diastolic maximum blood flow velocity,D)比值(S/D)]及凝血四项[凝血酶原时间(prothrombin time,PT)、纤维蛋白原(fibrinogen,FIB)、凝血酶时间(thrombin time,TT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)];对影响妊娠晚期孕妇胎盘早剥的因素进行Logistic回归分析;受试者工作特征(receiver operating characteristic,ROC)曲线分析子宫动脉超声参数联合凝血4项检测对妊娠晚期孕妇胎盘早剥的预测价值。结果与对照组相比,观察组妊娠晚期胎盘早剥孕妇PI、RI、S/D比值显著升高[(1.26±0.22)vs.(0.95±0.14)、(0.65±0.12)vs.(0.48±0.06)、(3.46±0.63)vs.(2.57±0.45)](P<0.05)。与对照组相比,观察组妊娠晚期胎盘早剥孕妇PT、TT、APTT均明显升高[(12.90±1.42)vs.(10.24±1.14)、(15.06±1.24)vs.(12.67±1.08)、(30.32±2.55)vs.(25.48±2.10)](P<0.05),FIB水平显著降低[(3.09±0.37)g/L vs.(3.96±0.58)g/L](P<0.05);与I度组相比,随着胎盘早剥分度增加,II度、III度组妊娠晚期孕妇PI、RI、S/D比值、PT、TT、APTT均依次升高(P<0.05),FIB水平依次降低(P<0.05)。Logistic回归分析发现,机械损伤、羊水过多、胎膜早破、妊娠期糖尿病、妊娠期高血压疾病、PI、RI、S/D比值、PT、TT、APTT是影响妊娠晚期孕妇胎盘早剥的危险因素(P<0.05),FIB是影响妊娠晚期孕妇胎盘早剥的保护因素(P<0.05)。PI、RI、S/D比值、PT、FIB、TT、APTT联�ObjectiveTo explore the predictive value of uterine artery ultrasound parameters combined with four coagulation indicators test for placental abruption in late pregnancy.MethodsA total of 160 pregnant women with placental abruption during the late pregnancy who were diagnosed and treated in our hospital from Jan.2021 to Dec.2022 were collected as the observation group,and 160 pregnant women with normal delivery were regarded as the control group.According to different grading of placental abruption,65 cases were classified as grade I,54 cases as gradeⅡ,and 41 cases as gradeⅢ.Ultrasound parameters of uterine artery[uterine artery pulsatility index(PI),resistance index(RI),ratio of maximum systolic blood flow velocity(S)to maximum diastolic blood flow velocity(D)(S/D)],and four coagulation parameters[prothrombin time(PT),fibrinogen(FIB),thrombin time(TT),and activated partial thromboplastin time(APTT)]were compared;Logistic regression analysis was conducted to analyze the factors affecting placental abruption in late pregnancy;receiver operating characteristic(ROC)curve was applied to analyze the predictive value of uterine artery ultrasound parameters combined with four coagulation indicators test for placental abruption in late pregnancy.ResultsCompared with the control group,PI,RI,and S/D ratios of pregnant women with placental abruption in the late pregnancy in the observation group were obviously increased[(1.26±0.22)vs.(0.95±0.14),(0.65±0.12)vs.(0.48±0.06),(3.46±0.63)vs.(2.57±0.45)](P<0.05);compared with the control group,PT,TT,and APTT in pregnant women with placental abruption in the late pregnancy in the observation group were obviously increased[(12.90±1.42)vs.(10.24±1.14),(15.06±1.24)vs.(12.67±1.08),(30.32±2.55)vs.(25.48±2.10)](P<0.05),the FIB level was obviously decreased[(3.09±0.37)g/L vs.(3.96±0.58)g/L](P<0.05);compared with the grade I group,as the grading of placental abruption increased,PI,RI,S/D ratio,PT,TT,and APTT in gradeⅡgroup and gradeⅢgroup increased in turn(P<0.05)and

关 键 词：妊娠晚期 胎盘早剥 子宫动脉超声参数 凝血指标 

分 类 号：R714.2[医药卫生—妇产科学]