母体肝功能联合脐动脉血流诊断胎儿生长受限的临床价值  

Clinical value of maternal liver function combined with umbilical artery blood flow in diagnosing fetal growth restriction

作　　者：刘书洁 张敏怡 徐映华 霍佳欣 尹倩[3] 胡贵方[1] LIU Shu-jie;ZHANG Min-yi;XU Ying-hua;HUO Jia-xin;YIN Qian;HU Gui-fang(Department of Epidemiology,School of Public Health,Southern Medical University,Guangzhou,Guangdong 510515,China;不详)

机构地区：[1]南方医科大学公共卫生学院流行病学系,广东广州510515 [2]南方医科大学南方医院临床研究中心 [3]南方医科大学南方医院妇产科

出　　处：《现代预防医学》2025年第5期955-960,共6页Modern Preventive Medicine

摘　　要：目的 评估母体肝功能指标联合脐动脉血流参数诊断胎儿生长受限(fetal growth restriction, FGR)的临床价值。方法本研究采用病例对照设计,纳入2017年12月-2022年7月在南方医科大学南方医院接受产检并分娩的孕妇,其中临床诊断FGR的172例孕妇为病例组,同期292例在该院产检的正常妊娠孕妇为对照组。采集孕妇孕晚期肝功能指标及脐动脉血流参数,通过多因素logistic回归分析评估与FGR风险的关联,并使用受试者工作特征曲线、净重分类改善指数和综合判别改善指数评估各指标及联合模型的效能。结果 本研究FGR组孕妇的丙氨酸氨基转移酶(ALT)、血清白蛋白(ALB)水平和脐动脉血流参数(S/D)值显著高于对照组。多因素logistic回归分析显示,ALT(OR=1.744,95%CI:1.332~2.283)、ALB(OR=1.290,95%CI:1.002~1.661)和S/D(OR=1.778,95%CI:1.324~2.387)是FGR的重要危险因素,且三者联合模型对胎儿生长受限诊断价值较高。结论 母体肝功能指标(ALT、ALB)和脐动脉血流参数(S/D)与FGR的发生风险有关,且三者的联合分析可以显著提高FGR的诊断效率。Objective To evaluate the clinical value of maternal liver function indicators combined with umbilical artery blood flow parameters in diagnosing fetal growth restriction(FGR).Methods This study employed a case-control design,including pregnant women who underwent prenatal examinations and delivered at Southern Hospital of Southern Medical University from December 2017 to July 2022.The case group consisted of 172 pregnant women clinically diagnosed with FGR,while the control group included 292 pregnant women with normal pregnancies who were examined at the same hospital during the same period.Maternal late-pregnancy liver function indicators and umbilical artery blood flow parameters were collected.Multivariate logistic regression analysis was conducted to assess the association of these indicators with the risk of FGR.The performance of each indicator and the combined model was evaluated using receiver operating characteristic curves,net reclassification improvement index,and integrated discrimination improvement index.Results In this study,pregnant women in the FGR group had significantly higher levels of ALT,ALB,and S/D ratio of umbilical artery blood flow compared to the control group.Multivariate logistic regression analysis indicated that ALT(OR=1.744,95%CI:1.332-2.283),ALB(OR=1.290,95%CI:1.002-1.661),and S/D ratio(OR=1.778,95%CI:1.324-2.387)were significant risk factors for FGR,and the combined model of these three indicators exhibited high diagnostic value for fetal growth restriction.Conclusion Maternal liver function indicators(ALT,ALB)and umbilical artery blood flow parameters(S/D ratio)are associated with the risk of FGR,and the combined analysis of these factors can significantly enhance the diagnostic efficiency for FGR.

关 键 词：胎儿生长受限 妊娠 丙氨酸转氨酶 白蛋白 脐动脉血流参数 

分 类 号：R714.2[医药卫生—妇产科学]