彩色多普勒超声血流显像技术在孕期预测胎儿宫内生长受限的价值分析  

Predictive value of color Doppler flow imaging in fetal growth restriction during pregnancy

作　　者：孙莉 胡频[1] 宋玉荣[1] 储继军[2] 黄才敏[1] SUN Li;HU Pin;SONG Yurong;CHU Jijun;HUANG Caimin(Department of Obstetrics and Gynecology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230001,China;Department of Gynecology,The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230031,China)

机构地区：[1]安徽医科大学第二附属医院妇产科,安徽合肥230001 [2]安徽中医药大学第一附属医院妇科,安徽合肥230031

出　　处：《西部医学》2024年第12期1859-1862,1867,共5页Medical Journal of West China

基　　金：2020年度安徽省自然科学基金项目(2008085QD162)。

摘　　要：目的 探究彩色多普勒超声血流显像技术在孕期预测胎儿宫内生长受限(FGR)的价值。方法 选取2020年3月—2022年8月安徽医科大学第二附属医院定期入院孕检的102例孕晚期孕妇为观察对象,其中晚发型FGR 31例作FGR组,正常孕妇71例作对照组。比较两组胎儿生长发育指标、子宫动脉、脐动脉及大脑中动脉血流参数及妊娠结局,并分析血流参数对FGR的预测价值。结果 FGR组胎儿头围、双顶径、腹围及股骨径低于对照组,差异均有统计学意义(P<0.05);FGR组母体子宫动脉PI、RI、S/D,胎儿脐动脉PI、RI、S/D高于对照组,胎儿大脑中动脉PI、RI低于对照组,差异均有统计学意义(P<0.05);子宫动脉PI、RI、S/D,胎儿脐动脉PI、RI、S/D,胎儿大脑中动脉PI、RI均对FGR具有一定的预测价值,曲线下面积(AUC)分别为0.677、0.721、0.722、0.674、0.695、0.700、0.702、0.672,联合子宫动脉、脐动脉及大脑中动脉超声参数预测FGR的AUC为0.852,高于个单项指标(P<0.05);FGR组急诊剖宫产、早产、1 min Apgar评分<7分及转入新生儿重症监护病房(NICU)发生率高于对照组,分娩孕周、新生儿出生体重低于对照组,差异均有统计学意义(P<0.05)。结论 彩色多普勒超声血流显像技术可用于孕期预测晚发型FGR,联合子宫动脉、脐动脉及大脑中动脉超声参数具有较高的预测效能。Objective To explore the predictive value of color Doppler flow imaging(CDFI)in fetal growth restriction(FGR)during pregnancy.Methods A total of 102 pregnant women in late pregnancy undergoing regular pregnancy tests in the hospital were enrolled as the research objects from March 2020 to August 2022,including 31 cases with late-onset FGR in FGR group and 71 normal cases in control group.The fetal growth and development indexes,blood flow parameters of uterine artery,umbilical artery and middle cerebral artery,and pregnancy outcomes were compared between the two groups.The predictive value of blood flow parameters for FGR was analyzed.Results The FETAL head circumference,biparietal diameter,abdominal circumference and femur diameter in FGR group were lower than those in control group(P<0.05).PI,RI and S/D of maternal uterine artery and fetal umbilical artery in FGR group were higher than those in control group,while PI and RI of fetal middle cerebral artery were lower than those in control group(P<0.05).PI,RI and S/D of uterine artery,PI,RI and S/D of fetal umbilical artery,PI and RI of fetal middle cerebral artery were of certain predictive value for FGR,and the area under the curve(AUC)values of 0.677,0.721,0.722,0.674,0.695,0.700,0.702 and 0.672,respectively.AUC of combined detection was 0.852,greater than that of single index(P<0.05).The incidence of emergency cesarean section,premature delivery,1 min Apgar score<7 points and transfer to neonatal intensive care unit(NICU)in FGR group was higher than that in control group,while gestational age and neonatal birth weight were lower than those in control group(P<0.05).Conclusion CDFI can be applied to predict late-onset FGR during pregnancy.The combined detection with blood flow parameters of uterine artery,umbilical artery and middle cerebral artery has higher predictive efficiency.

关 键 词：胎儿宫内生长受限 彩色多普勒超声血流显像技术 脐动脉 大脑中动脉 子宫动脉 预测价值 

分 类 号：R445.1[医药卫生—影像医学与核医学]