超声心动图评估心外膜脂肪层厚度对子痫前期的预测价值  

The Predictive Value of Epicardial Adipose Thickness for Pre-eclampsia Evaluated by Echocardiography

作　　者：张青青 闻明 陈琦 ZHANG Qingqing;WEN Ming;CHEN Qi(Department of Obstetrics,Wuhu First People's Hospital,Wuhu Anhui 241060,China)

机构地区：[1]芜湖市第一人民医院产科,安徽芜湖241060

出　　处：《实用妇产科杂志》2025年第3期242-245,共4页Journal of Practical Obstetrics and Gynecology

基　　金：芜湖市科技计划项目(编号:2022cg35)。

摘　　要：目的:探讨超声心动图评估心外膜脂肪层厚度(EAT)对子痫前期(PE)的预测价值。方法:回顾性分析2020年9月至2023年11月芜湖市第一人民医院收治的242例孕早期孕妇的临床资料,按照是否发生PE分为PE组(n=31)和非PE组(n=211)。收集孕11+0~13周的超声心动图资料,采用多因素Logistic回归分析孕妇发生PE的影响因素。绘制受试者工作特征(ROC)曲线以评价EAT对孕妇发生PE的预测价值。结果:PE组与非PE组比较,年龄、受孕方式、体质量指数(BMI)、高血压病史、收缩压、舒张压、血清可溶性血管内皮生长因子受体-1(sFlt-1)/胎盘生长因子(PLGF)比值、EAT比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示:BMI增加(OR 1.492,95%CI 1.161~2.724)、有高血压病史(OR 3.684,95%CI 2.074~6.542)、血清sFlt-1/PLGF值升高(OR 1.982,95%CI 1.268~3.099)、EAT增加(OR 2.246,95%CI 1.292~3.903)是孕妇发生PE的独立危险因素(P<0.05)。ROC曲线分析结果显示:超声心动图评估EAT预测孕妇发生PE的曲线下面积(AUC)为0.848(95%CI 0.785~0.910,P<0.001),最佳截断值取5.63 mm时,敏感度为85.71%,特异度为67.14%。结论:超声心动图评估EAT用于PE的预测具有良好的应用价值。Objective:To explore the predictive value of epicardial adipose thickness(EAT)for pre-eclampsia(PE)evaluated by echocardiography.Methods:The clinical data of 242 early pregnant women admitted to Wuhu First People's Hospital from September 2020 to November 2023 were retrospectively analyzed.According to whether PE occurred,they were divided into PE group(n=31)and non-PE group(n=211).The echocardiographic data of pregnant women at 11+0-13+6 weeks of gestation were collected,and the influencing factors of PE in pregnant women were analyzed by multivariate logistic regression.Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of EAT for PE in pregnant women.Results:There were statistically significant differences in age,pregnancy mode,body mass index(BMI),history of hypertension,systolic and diastolic blood pressure,serum soluble vascular endothelial growth factor receptor-1(sFlt-1)/placental growth factor(PLGF)ratio and EAT between PE group and non-PE group(P<0.05).Multivariate Logistic regression analysis showed that increased BMI(OR 1.492,95%CI 1.161-2.724),history of hypertension(OR 3.684,95%CI 2.074-6.542),increased serum sFlt-1/PLGF value(OR 1.982,95%CI 1.268-3.099),and increased EAT(OR 2.246,95%CI 1.292-3.903)were independent risk factors for PE in pregnant women(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of ultrasound evaluation of EAT in predicting PE in pregnant women was 0.848(95%CI 0.785-0.910,P<0.001).When the optimal cutoff value was 5.63 mm,the sensitivity was 85.71%and the specificity was 67.14%.Conclusions:Ultrasound evaluation of EAT for PE prediction has good application value.

关 键 词：子痫前期 心外膜脂肪层厚度 超声心动图 

分 类 号：R714.24[医药卫生—妇产科学]