摘要
目的:探讨孕中期孕妇子宫动脉超声检查联合性激素检测预测晚发型胎儿宫内生长受限(LO-FGR)的临床价值。方法:回顾性分析2019年1月-2020年7月本院收治的LO-FGR孕妇68例(观察组),规律产前检查健康孕妇68例(对照组)临床资料。两组孕妇均于孕25~27周时行子宫动脉超声检查,记录搏动指数(PI)、阻力指数(RI)和收缩期峰值流速/舒张期流速(S/D),同时测定血清游离雌三醇(FE_(3))、孕激素(P)水平。分析子宫动脉超声指标与性激素水平预测LO-FGR价值。结果:观察组与对照组子宫动脉超声PI(0.77±0.21、0.60±0.17)、RI(0.50±0.19、0.42±0.14)、S/D(2.04±0.77、1.62±0.54),血清FE_(3)(16.33±1.89 nmol/L、25.69±3.27 nmol/L)及P(14.72±3.85 ng/ml、24.66±5.02ng/ml)]均有差异(均P<0.05)。受试者工作特征曲线分析显示,子宫动脉超声检查预测LO-FGR的曲线下面积(AUC)为0.783(95%CI 0.621~0.822),灵敏度为79.8%,特异度为69.8%;血清FE_(3)在最佳截断值17.27 nmol/L时预测LO-FGR的AUC为0.606(95%CI 0.506~0.709),灵敏度为68.3%,特异度为65.2%;血清P在最佳截断值15.69 ng/ml时对预测LO-FGR的AUC为0.624(95%CI 0.510~0.724),灵敏度为70.0%,特异度为59.9%;超声联合血清检测预测LO-FGR的AUC为0.902,灵敏度为90.3%,特异度为91.3%。结论:发生LO-FGR的孕妇子宫动脉超声血流指标及血清FE_(3)、P水平均异常改变,超声联合血清激素检测预测LO-FGR有较好的临床价值。
Objective:To explore the clinical value of uterine artery parameters by ultrasonography combined with sex hormone detective levels of pregnant women during the second trimester of pregnancy for predicting their late-onset fetal growth restriction(LO-FGR).Methods:The clinical data of 68 pregnant women with LO-FGR in observation group from January 2019 to July 2020 and another 68 healthy pregnant women in control group who received regular antenatal examination during the same period were analyzed retrospectively.The uterine artery parameters of the women during 25-27 gestational weeks in the two groups were examined by ultrasonography,and the values of the pulsatile index(PI),resistance index(RI),and systolic peak velocity/diastolic velocity(S/D)of the uterine artery of the women were recorded.The levels of serum free estriol(FE_(3))and progesterone(P)of the women in the two groups were detected.The values of the uterine artery parameters by ultrasound and the sex hormones levels for predicting LO-FGR were analyzed.Results:There were significant differences in the values of PI(0.77±0.21 vs.0.60±0.17),RI(0.50±0.19 vs.0.42±0.14),and S/D(2.04±0.77 vs.1.62±0.54),and the levels of serum FE_(3)(16.33±1.89 nmol/L vs.25.69±3.27 nmol/L)and P(14.72±3.85 ng/ml vs.24.66±5.02 ng/ml)of the women between the two groups(all P<0.05).Receiver operator characteristic(ROC)curve analysis showed that the area under curve(AUC)of uterine artery parameters for predicting LO-FGR was 0.783(95%CI:0.621-0.822),with the sensitivity of 79.8%and the specificity of 69.8%.When the optimal cut-off value of serum FE_(3)level was 17.27nmol/l,the AUC of which for predicting LO-FGR was 0.606(95%CI:0.506-0.709),with the sensitivity of 68.3%and the specificity of 65.2%.When the optimal cut-off value of serum P level was 15.69ng/ml,the AUC of which for predicting LO-FGR was 0.624(95%CI:0.510-0.724),with the sensitivity of 70.0%and the specificity of 59.9%.The AUC,the sensitivity,and the specificity of the uterine artery parameters values combined with the levels of serum FE_(3) and P for predicting LO-FGR were 0.902,90.3%,and 91.3%,respectively.Conclusion:The ultrasonic blood flow parameters of uterine artery and the levels of FE_(3) and P of the pregnant women with LO-FGR are abnormal changes.The combinations of ultrasonic blood flow parameters of uterine artery combined with the levels of FE_(3) and P of the pregnant women have better value for predicting their LO-FGR.
作者
吴青京
陈昌钊
符俊娟
张婷
颜雪萍
WU Qingjing;CHEN Changzhao;FU Junjuan;ZHANG Ting;YAN Xueping(Hainan Women and Children Medical Center,Haikou,Hainan Province,570206)
出处
《中国计划生育学杂志》
2022年第8期1893-1896,共4页
Chinese Journal of Family Planning
关键词
晚发型胎儿宫内生长受限
孕中期
超声子宫动脉血流指标
游离雌三醇
孕激素
预测价值
Late-onset fetal growth restriction
The second trimester of pregnancy
Uterine artery parameters by ultrasonography
Free estriol
Progesterone
Predictive value
