多普勒超声参数联合孕妇血清学指标对胎儿生长受限的诊断效能  

Diagnostic Efficacy of Doppler Ultrasound Parameters Combined with Maternal Serum Markers for Fetal Growth Restriction

作　　者：胡芯端 应金巧 刘卓 卢莹莹 夏英华 Hu Xinduan;Ying Jinqiao;Liu Zhuo;Lu Yingying;Xia Yinghua(Department of Ultrasound,Yongkang Maternal and Child Health Care Hospital,Yongkang,Zhejiang 321300,China;Department of Obstetrics,Yongkang Maternal and Child Health Care Hospital,Yongkang,Zhejiang 321300,China;Department of Laboratory,Yongkang Maternal and Child Health Care Hospital,Yongkang,Zhejiang 321300,China)

机构地区：[1]永康市妇幼保健院超声科,浙江省永康市321300 [2]永康市妇幼保健院产科,浙江省永康市321300 [3]永康市妇幼保健院检验科,浙江省永康市321300

出　　处：《中国超声医学杂志》2025年第2期178-182,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨多普勒超声测定脐动脉收缩期最大血流速度/舒张末期血流速度(S/D)、脑胎盘率(CPR)联合孕妇血清学指标对胎儿生长受限(FGR)的诊断效能。方法回顾性收集诊断为FGR的孕妇80例设为FGR组,同期选取80例胎儿发育正常孕妇设为参照组。收集两组基线情况,比较两组多普勒超声检查的脐动脉S/D、CPR与酶联免疫吸附试验法测定的母体血清学指标[妊娠相关蛋白A(PAPP-A)、胎盘生长因子(PLGF)、可溶性fms样酪氨酸激酶1(sFlt-1)]水平。观察孕妇出现FGR的影响因素,分析多普勒超声指标、母体血清学指标对孕妇出现FGR的诊断效能。结果Logistic回归分析显示,脐动脉S/D、母体血清sFlt-1为孕妇出现FGR的独立危险因素,CPR、母体血清PAPP-A、PLGF为独立保护因素(P<0.05)。绘制ROC曲线显示,多普勒超声指标、母体血清学指标及两者联合诊断模型对孕妇出现FGR的诊断AUC分别为0.868、0.911、0.959,两者联合诊断模型具有更高的诊断价值(P<0.05)。结论应用多普勒超声测定S/D、CPR联合孕妇血清学指标可显著提高FGR诊断效能,为临床诊疗提供依据。Objective To investigate the diagnostic efficacy of Doppler ultrasound in the measurement of umbilical artery systolic/diastolic ratio(S/D),cerebroplacental ratio(CPR)combined with maternal serum markers for fetal growth restriction(FGR).Methods A retrospective analysis was conducted on 80 pregnant women diagnosed with FGR(FGR group),and 80 pregnant women with normal fetal development were selected as the reference group.Baseline characteristics were collected for both groups.The umbilical artery S/D ratio,CPR measured by Doppler ultrasound,and maternal serum markers[pregnancy-associated protein A(PAPP-A),placental growth factor(PLGF),and soluble fms-like tyrosine kinase-1(sFlt-1)]measured by enzyme-linked immunosorbent assay(ELISA)were compared between the two groups.Factors influencing FGR occurrence were observed,and the diagnostic efficacy of Doppler ultrasound parameters and maternal serum markers for FGR was analyzed.Results Logistic regression analysis showed that umbilical artery S/D and maternal serum sFlt-1 were independent risk factors for FGR,while CPR,maternal serum PAPP-A,and PLGF were independent protective factors(P<0.05).ROC curve analysis demonstrated that the area under the curves for Doppler ultrasound parameters,maternal serum markers,and the combined diagnostic model were 0.868,0.911,and 0.959,respectively.The combined diagnostic model had a higher diagnostic value(P<0.05).Conclusions The application of Doppler ultrasound in the measurement of S/D,CPR combined with maternal serum markers can significantly improve the diagnostic efficacy of FGR and provide a basis for clinical diagnosis and treatment.

关 键 词：多普勒超声 脐动脉 收缩期最大血流速度/舒张末期血流速度 脑胎盘率 母体血清学指标 胎儿生长受限 

分 类 号：R714.5[医药卫生—妇产科学] R445.1[医药卫生—临床医学]