超声定量参数联合母体纤溶酶原对胎儿生长受限的诊断价值  

Diagnostic Value of Ultrasound Quantitative Parameters Combined with Maternal Plasminogen for Fetal Growth Restriction

作　　者：肖四华 XIAO Sihua(Department of Ultrasound Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院超声医学科,河南郑州450000

出　　处：《河南医学研究》2025年第7期1312-1316,共5页Henan Medical Research

摘　　要：目的探讨超声定量参数联合母体纤溶酶原(Plg)对胎儿生长受限(FGR)的诊断价值。方法选取2021年10月至2022年12月在郑州大学附属郑州中心医院产检并确诊的63例FGR孕妇作异常组,另选同期胎儿生长发育健康的71例孕妇作健康组,均行超声检查,对比两组脐动脉、大脑中动脉血流参数[搏动指数(PI)、收缩期最大血流速度/舒张末期血流速度(S/D)、阻力指数(RI)]、静脉导管血流参数[心房收缩谷流速(a)、心室收缩峰流速(S)]、主动脉弓峡部血流参数[收缩期末流速(PSV)、收缩末反流流速(ESRV)]以及母体Plg水平,偏回归分析FGR的影响因素,利用受试者工作特征(ROC)曲线分析超声定量参数联合母体Plg水平诊断FGR价值。结果健康组孕妇分娩孕周、胎儿出生体重均多于异常组(P<0.05)。异常组脐动脉PI、RI、S/D、主动脉弓峡部ESRV、母体Plg水平高于健康组,大脑中动脉PI、RI、S/D、主动脉弓峡部PSV以及静脉导管a、S均低于健康组(P<0.05)。logistic回归模型分析,脐动脉PI≥1.02、RI≥0.63、S/D≥3.00、大脑中动脉PI<1.41、RI<0.68、S/D<3.52、主动脉弓峡部PSV<105.90 mL·min^(-1)、ESRV≥30.88 mL·min^(-1)、静脉导管a<16.80 cm·s^(-1)、S<34.00 cm·s^(-1)、母体Plg水平≥130.17%属于发生FGR的独立危险因素(P<0.05)。ROC曲线结果显示,超声定量参数、母体Plg水平联合诊断FGR的曲线下面积为0.831,最佳诊断敏感度、特异度为85.71%、88.73%(P<0.05)。结论脐动脉、主动脉弓峡部、大脑中动脉、静脉导管血流参数以及母体Plg水平在FGR中表达异常,动态监测其水平变化有助于临床早期诊断FGR,便于临床早期制定防治措施以降低FGR发生风险。Objective To explore the diagnostic value of ultrasound quantitative parameters combined with maternal plasminogen(Plg)in fetal growth restriction(FGR).Methods A total of 63 pregnant women who underwent prenatal examination and confirmed FGR in Zhengzhou Central Hospital Affiliated to Zhengzhou University from October 2021 to December 2022 were selected as the abnormal group,and 71 pregnant women with healthy fetal growth and development during the same period were selected as the healthy group,all of whom underwent ultrasound examination,compare the blood flow parameters of the umbilical artery,middle cerebral artery[pulse index(PI),maximum systolic flow velocity/end-diastolic flow velocity(S/D),resistance index(RI)],venous catheter[atrial systolic valley flow velocity(a),ventricular systolic peak flow velocity(S)],aortic arch isthmus[end-systolic flow velocity(PSV),end-systolic flow velocity],and maternal Plg levels between the two groups,analyze the influencing factors of FGR through partial regression,and The receiver operating characteristic(ROC)curve was used to analyze the value of ultrasound quantitative parameters combined with maternal Plg levels in diagnosing FGR.Results The gestational week and birth weight of the fetus in the healthy group were higher than those in the abnormal group(P<0.05).The levels of umbilical artery PI,RI,S/D,ESRV in isthmus of aortic arch and maternal Plg in abnormal group were higher than those in healthy group,while the levels of middle cerebral artery PI,RI,S/D,PSV in isthmus of aortic arch and intravenous catheter a and S were lower than those in healthy group(P<0.05).Logistic regression model analysis,Umbilical artery PI≥1.02,RI≥0.63,S/D≥3.00,middle cerebral artery PI<1.41,RI<0.68,S/D<3.52,isthmus of aortic arch PSV<105.90 mL·min^(-1),ESRV≥30.88 mL·min^(-1),venous catheter a<16.80 cm·s^(-1),S<34.00 cm·s^(-1) and maternal Plg level≥130.17%were independent risk factors for FGR(P<0.05).ROC curve results showed that the area under curve of FGR combined with ultr

关 键 词：超声定量参数 纤溶酶原 生长受限 临床意义 

分 类 号：R445.1[医药卫生—影像医学与核医学]