脑脐血流超声联合糖代谢指标诊断子痫前期合并胎儿生长受限患者的价值  

Value of cerebral cord blood flow ultrasound combined with glucose metabolism indexes in the diagnosis of preeclampsia with fetal growth restriction

作　　者：张晓月 高京京 刘晓铮 高海侠[1] ZHANG Xiaoyue;GAO Jingjing;LIU Xiaozheng;GAO Haixia(Department of Obstetrics,Chengde Central Hospital,Chengde,Hebei 067000,China)

机构地区：[1]承德市中心医院产科,河北承德067000

出　　处：《国际检验医学杂志》2025年第8期971-975,共5页International Journal of Laboratory Medicine

基　　金：承德市科技计划项目(202301A018)。

摘　　要：目的探讨脑脐血流超声联合糖代谢指标诊断子痫前期(PE)合并胎儿生长受限(FGR)患者的价值。方法该研究为前瞻性队列病例对照研究,收集该院2017年1月至2022年1月收治的PE患者198例,根据是否合并FGR分为A组(PE合并FGR,101例)和B组(PE不合并FGR,97例)。同期选取该院健康产检的孕妇45例作为C组,分析3组脑脐血流超声指标、糖代谢指标的差异及诊断PE合并FGR的效能。结果A组、B组和C组空腹血糖和空腹胰岛素水平逐渐降低(P<0.05);A组、B组和C组胎儿大脑中动脉(MCA)的收缩期血流峰值流速/舒张末期血流峰值流速(S/D)、阻力指数(RI)及搏动指数(PI)均逐渐升高(P<0.05);A组、B组和C组脐动脉(UA)的S/D、RI、PI均逐渐降低(P<0.05);受试者工作特征曲线结果显示,空腹胰岛素、空腹血糖、胎儿MCA的S/D、RI、PI,胎儿UA的S/D、RI、PI及联合应用的曲线下面积分别为0.782、0.748、0.765、0.836、0.805、0.758、0.811、0.795及0.895,联合应用诊断效能高于单独诊断(Z=4.327、4.862、4.551、3.400、3.946、4.679、3.742、4.102,P<0.05)。结论糖代谢指标及脑脐血流超声指标联合应用对PE合并FGR患者的鉴别诊断价值较大,具有较好的临床应用价值。Objective To explore the diagnostic value of brain cord blood flow ultrasound combined with glucose metabolism indexes in the patients with preeclampsia(PE)complicated with fetal growth restriction(FGR).Methods This study was a prospective cohort case-control study.A total of 198 PE patients admitted to the hospital from January 2017 to January 2022 were collected and divided into group A(PE patients complicated with FGR,101 cases)and group B(PE patients without FGR,97 cases)according to whether they were complicated with FGR.45 pregnant women with healthy prenatal examination in the hospital were selected as group C,and the differences of brain cord blood flow ultrasound indexes and glucose metabolism indexes among the three groups and the efficiency for diagnosing PE complicated with FGR were analyzed.Results Fasting blood glucose and fasting insulin levels in group A,group B and group C were gradually decreased(P<0.05).The peak systolic flow velocity/peak diastolic flow velocity(S/D),resistance index(RI)and pulsatility index(PI)of middle cerebral artery(MCA)of fetus in group A,group B and group C increased gradually(P<0.05).The levels of umbilical artery(UA)of fetus in group A,group B and group C decreased gradually(P<0.05).The area under the curve of fasting insulin,fasting blood glucose,S/D,RI and PI of MCA,S/D,RI,PI of UA and the combined detection were 0.782,0.748,0.765,0.836,0.805,0.758,0.811,0.795 and 0.895,respectively.The diagnostic efficiency of combined detection was higher than that of single diagnosis(Z=4.327,4.862,4.551,3.400,3.946,4.679,3.742,4.102,P<0.05).Conclusion The combined detection of glucose metabolism indexes and brain cord blood flow ultrasound indexes is of great value in the differential diagnosis of patients with PE complicated with FGR,and has good clinical application value.

关 键 词：脑脐血流超声指标 空腹胰岛素 空腹血糖 子痫前期 胎儿生长受限 

分 类 号：R446.1[医药卫生—诊断学]