血清学指标与超声监测参数对FGR的预测价值  

Predictive Value of Serological Indicators and Ultrasonic Monitoring Parameters for FGR

作　　者：那娜 全丽虹 NA Na;QUAN Lihong(Department of Obstetrics,the Second Affiliated Hospital of Guilin Medical College,Guilin Guangxi 541199,China)

机构地区：[1]桂林医学院第二附属医院产科,广西桂林541199

出　　处：《中国卫生标准管理》2024年第24期29-32,共4页China Health Standard Management

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z-C20221001);2021年广西壮族自治区医疗卫生重点(培育)学科建设项目(桂卫科教发[2022]4号)。

摘　　要：目的探讨血清学指标与超声监测参数对胎儿生长受限(fetal growth restriction,FGR)的预测价值。方法便利抽样法选取桂林医学院第二附属医院2020年1月—2022年12月所收治的FGR孕妇135例作为观察组,另选取同期83例正常妊娠单胎孕妇作为对照组。比较2组孕妇的脐动脉血流阻力指数(resistance index,RI)、搏动指数(pulse index,PI)、脐静脉心室收缩期峰值血流速度与最大心房收缩期回流速度比值(systolic peak velocity/atrial peak flow velocity,S/a)、血清维生素D、胎盘生长因子(plasma placental growth factor,PLGF)水平,绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析血清学指标与超声监测参数对FGR的预测价值。结果观察组的RI、PI、S/a分别为(0.82±0.16)、(1.20±0.22)、(2.75±0.27),均高于对照组的(0.61±0.10)、(0.92±0.13)、(2.59±0.23);血清维生素D、PLGF水平分别为(23.91±4.74)nmol/L、(281.61±24.80)pg/mL,均低于对照组的(33.01±6.75)nmol/L、(321.12±24.22)pg/mL;差异均有统计学意义(P<0.05)。ROC曲线分析结果中PI、RI、S/a的曲线下面积(area under curve,AUC)分别为0.841、0.798、0.713,血清维生素D、PLGF的AUC值分别为0.835、0.838,血管超声参数联合血清学指标的AUC值为0.933;血管超声参数联合血清学指标对FGR的预测价值高于上述指标单独检测,差异有统计学意义(P<0.05)。结论血清学指标联合超声监测参数对FGR的预测价值较高,临床可以此为基础对孕妇进行综合检查,及时诊治以期改善预后。Objective To explore the predictive value of serological indicators and ultrasonic monitoring parameters for fetal growth restriction(FGR).Methods A total of 135 cases of FGR pregnant women admitted to the Second Affiliated Hospital of Guilin Medical College from January 2020 to December 2022 were selected by convenience sampling method as the observation group,and 83 cases of normal pregnant singleton pregnant women were selected as the control group.The umbilical artery blood flow resistance index(RI),pulsatility index(PI),systolic peak velocity/atrial peak flow velocity(S/a),serum vitamin D and placental growth factor(PLGF)levels were statistically compared between the two groups.The predictive value of receiver operating characteristic(ROC)curve analysis serological indicators and ultrasonic monitoring parameters for FGR was plotted.Results The RI,PI and S/a of the observation group were(0.82±0.16),(1.20±0.22)and(2.75±0.27),respectively,which were higher than those of the control group(0.61±0.10),(0.92±0.13)and(2.59±0.23);the levels of serum vitamin D and PLGF were(23.91±4.74)nmol/L and(281.61±24.80)pg/mL,respectively,which were lower than those in the control group(33.01±6.75)nmol/L and(321.12±24.22)pg/mL,respectively,and the differences were statistically significant(P<0.05).The area under curve(AUC)values of PI,RI and S/a were 0.841,0.798 and 0.713 respectively,the AUC values of serum vitamin D and PLGF were 0.835 and 0.838 respectively,and the AUC value of vascular ultrasound parameters combined with serological indexes was 0.933.The predictive value of vascular ultrasound parameters combined with serological indexes for FGR was higher than that of the above indexes alone,with the significant difference(P<0.05).Conclusion The ultrasonic monitoring parameters combined with ultrasound monitoring have high predictive value for FGR,and the clinic can make comprehensive examination and timely diagnosis and treatment of pregnant women on this base,in order to improve the prognosis.

关 键 词：胎儿生长受限 超声参数 血清学指标 维生素D 胎盘生长因子 预测价值 

分 类 号：R715[医药卫生—妇产科学]