孕中晚期超声血流参数与甲状腺功能异常及新生儿结局的关系分析  

Analysis of the Relationship between Ultrasound Blood Flow Parameters in the Middle and Late Pregnancy and Thyroid Dysfunction and Neonatal Outcomes

作　　者：黄虹 陈静君 曾春茶 陈焕彬 HUANG Hong;CHEN Jingjun;ZENG Chuncha;CHEN Huanbin(Department of Ultrasound,The Third People’s Hospital of Shantou,Shantou 515000,Guangdong,P.R.China)

机构地区：[1]汕头市第三人民医院超声科,广东汕头515000

出　　处：《影像科学与光化学》2024年第6期638-645,共8页Imaging Science and Photochemistry

基　　金：汕头市科技计划医疗卫生类别项目(210508186492849)。

摘　　要：目的:探讨孕中晚期超声血流参数与甲状腺功能异常及新生儿结局之间的关系。方法:选取汕头市第三人民医院2020年1月至2022年12月行规律产检的孕中晚期(13~36周)妊娠期女性2465例为研究对象,根据其孕中期间(13~27周)常规甲状腺激素检测结果将研究对象分为甲亢组(41例)、甲减组(58例)和正常组(2366例)。比较三组孕中期、孕晚期脐动脉及子宫动脉超声血流参数,分析脐动脉及子宫动脉超声血流参数与甲状腺功能的关系。随访研究对象至分娩结束,统计比较三组新生儿围生期结局指标,根据新生儿结局将研究对象分为不良结局组和正常结局组,分析甲状腺功能与超声血流参数、新生儿围生期结局的关系。Logistic单因素和多因素分析甲状腺激素水平、超声血流参数对新生儿围生期结局的影响。ROC曲线分析甲状腺激素水平、超声血流参数对新生儿围生期结局的预测效能。结果:妊娠中期甲减组相比正常组子宫动脉S/D值、脐动脉RI值、脐动脉PI值、脐动脉S/D值降低,甲亢组脐动脉PI值相比甲减组增高(均P<0.05);妊娠晚期甲减组相比正常组子宫动脉RI值、子宫动脉S/D值降低,甲亢组子宫动脉S/D值相比正常组增高(均P<0.05);子宫动脉与脐动脉RI、PI、S/D值与FT3、FT4、促甲状腺激素(TSH)均无相关性(P>0.05);2465例研究对象中,发生新生儿窒息12(0.49%)例,低体质量出生儿232(9.41%)例,巨大儿274(11.12%)例,新生儿不良结局人数518(21.01%)例;不良结局组妊娠中期子宫动脉超声血流参数RI、脐动脉超声血流参数RI高于正常结局组;不良结局组妊娠晚期超声血流参数均高于正常结局组;不良结局组与正常结局组在FT3、FT4和TSH之间均有差异(P<0.05);妊娠晚期动脉超声血流参数、TSH为影响新生儿结局的因素(P<0.05),妊娠晚期子宫动脉RI、PI、S/D值AUC分别为0.702、0.647、0.670,灵敏度分别为60.5%、68.5%、65.5%,特异度Objective:To explore the relationship between ultrasound blood flow parameters in middle and late pregnancy and thyroid dysfunction and neonatal outcome.Methods:A total of 2465 pregnant women in the middle and late pregnancy(13-36 weeks)who underwent regular prenatal examination in the Third People’s Hospital of Shantou from January 2020 to December 2022 were selected as the research participants.According to the results of routine thyroid hormone test during the middle pregnancy(13-27 weeks),the research objects were divided into hyperthyroidism group(41 cases),hypothyroidism group(58 cases)and normal group(2366 cases).The ultrasonic blood flow parameters of umbilical artery and uterine artery in the middle and late pregnancy of the three groups were compared,and the relationship between ultrasonic blood flow parameters of umbilical artery and uterine artery and thyroid function was analyzed.The subjects were followed up to the end of delivery.The perinatal outcome indexes of the three groups were statistically compared.According to the neonatal outcome,the subjects were divided into adverse outcome group and normal outcome group.The relationship between thyroid function and ultrasound blood flow parameters and neonatal perinatal outcome was analyzed.Logistic univariate and multivariate analysis of thyroid hormone levels,ultrasound blood flow parameters on neonatal perinatal outcomes.ROC curve was used to analyze the predictive efficacy of thyroid hormone level and ultrasound blood flow parameters on neonatal perinatal outcome.Results:The uterine artery S/D value,umbilical artery RI value,umbilical artery PI value and umbilical artery S/D value in the hypothyroidism group were lower than those in the normal group,and the umbilical artery PI value in the hyperthyroidism group was higher than that in the hypothyroidism group(all P<0.05).The RI value and S/D value of uterine artery in hypothyroidism group were lower than those in normal group,and the S/D value of uterine artery in hyperthyroidism group was higher

关 键 词：孕中晚期 超声血流参数 甲状腺功能 新生儿结局 

分 类 号：R714[医药卫生—妇产科学]