摘要
目的 探讨子宫动脉超声检查参数对早发型子痫前期发生风险的评估价值。方法 选取医院孕检的孕妇640例。所有孕妇于妊娠16~20周完成子宫动脉多普勒超声检查,并获取子宫动脉超声检查参数:血流速度峰谷比(S/D)、搏动指数(PI)、阻力指数(RI)。随访并统计孕妇妊娠20~34周子痫前期,即早发型子痫前期发生情况,并依据发生情况将孕妇分别纳入发生组31例、未发生组609例。比较两组子宫动脉超声检查参数S/D、PI、RI,并绘制受试者工作特征(ROC)曲线、决策曲线,评估子宫动脉超声检查参数对早发型子痫前期发生风险的预测价值。结果 640例孕妇均顺利完成观察,无剔除病例。发生组子宫动脉超声检查参数S/D、PI、RI均高于未发生组,差异均有统计学意义(P<0.05)。绘制ROC曲线,结果显示S/D、PI、RI单独及联合预测早发型子痫前期发病风险的AUC均≥0.7,均有一定预测价值,且联合检测预测价值高于S/D、PI、RI单独检测(Z分别为2.611、2.458、1.888,P均<0.05)。绘制决策曲线,结果显示当高风险阈值为0.05~0.80时,净收益率>0;在阈值0.05~0.80时,S/D、PI、RI联合预测孕妇早发型子痫前期发病的净获益率高于单一指标检测。结论 孕妇子宫动脉超声检查参数S/D、PI、RI升高与早发型子痫前期发病存在一定关系,妊娠16~20周时S/D、PI、RI可用于早发型子痫前期的风险评估。
Objective To explore the value of uterine artery ultrasound parameters in assessing the risk of early-onset preeclampsia.Methods A total of 640 pregnant women were selected.All pregnant women were completed uterine artery Doppler ultrasound examination at 16~20 weeks of pregnancy and obtained uterine artery ultrasound parameters,including peak to valley ratio of blood flow velocity(S/D),pulsatility index(PI),and resistance index(RI).The incidence of preeclampsia(early-onset preeclampsia)in pregnant women at 20~34 weeks of pregnancy was followed up and counted,and the pregnant women were included in the occurrence group and the non-occurrence group according to the occurrence.The S/D,PI,and RI parameters of two groups of uterine artery ultrasound were compared,and receiver operating characteristic(ROC)curves and decision curves were drawn to evaluate the predictive value of uterine artery ultrasound parameters on the risk of early-onset preeclampsia.Results All 640 pregnant women were completed the observation successfully,and no case was eliminated.During the follow-up period,of 640 pregnant women,31 cases developed early-onset preeclampsia,with an incidence rate of 4.84%(31/640).The ultrasound parameters S/D,PI,and RI of the uterine artery in the occurrence group were higher than those in the non-occurrence group,and the differences were statistically significant(P<0.05).ROC curve was drawn,and the results showed that the AUC values of S/D,PI,and RI alone and in combination predicted the risk of early-onset preeclampsia with a certain value,and the combined detection had a higher predictive value than S/D,PI,and RI alone(Z=2.611,2.458,1.888,all P<0.05).The result of drawing the decision-making curve showed that when the high-risk threshold was between 0.05 and 0.80,the net return was greater than nil.Within the threshold range of 0.05~0.80,the net benefit rate of S/D,PI,and RI combined prediction for early onset preeclampsia in pregnant women was higher than that of single indicator detection.Conclusion There is a certain relationship between the elevated S/D,PI,and RI parameters of uterine artery ultrasound in pregnant women and the onset of early-onset preeclampsia.Examining S/D,PI,and RI levels at 16~20 weeks of pregnancy can be used for risk assessment of early-onset preeclampsia.
作者
李曹菲
陈仕宇
刘晓媛
LI Caofei;CHEN Shiyu;LIU Xiaoyuan(Emergency Department of Obstetrics and Gynecology at Northwest Women's and Children's Hospital,Xi'an 710000,China;Department of Ultrasound Medicine,Yueqing Hospital Affiliated to Wenzhou Medical University,Wenzhou 325600,China;Department of Obstetrics,the First People's Hospital of Xianyang City,Xianyang 712000,China)
出处
《医学影像学杂志》
2025年第7期123-127,共5页
Journal of Medical Imaging
基金
浙江省卫生健康科技计划项目(编号:2022KY1216)。
关键词
早发型子痫前期
超声检查
血流速度峰谷比
搏动指数
阻力指数
Early-onset preeclampsia
Ultrasonic examination
Peak to valley ratio of blood flow velocity
Pulse index
Resistance index
作者简介
李曹菲(1992-),女,毕业于延安大学,本科学历,护师,主要从事妇产科急诊工作;通信作者:刘晓媛,E-mail:liuxiaoy8685@163.com。
