摘要
目的:探讨脐动脉(UA)、大脑中动脉(MCA)、肾动脉(RA)血流参数在胎儿宫内缺氧中的诊断价值。方法:回顾性分析2019年2月-2020年8月产检、分娩并出现胎儿宫内缺氧的51例孕妇的临床资料,根据胎儿缺氧程度分为轻度缺氧组(n=28,根据胎心、羊水污染监测判断为胎儿轻度缺氧者)和中重度缺氧组(n=23,根据胎心、羊水污染监测判断为胎儿中重度缺氧者)。比较两组UA,MCA和RA血流参数[搏动指数(PI)、阻力指数(RI)],采用Spearman相关性分析法分析PI_(UA),RI_(UA),PI_(MCA),RI_(MCA),PI_(RA)和RI_(RA)与胎儿缺氧程度的相关性,采用受试者工作特征(ROC)曲线评估上述参数对胎儿缺氧程度的诊断效能。结果:中重度缺氧组PI_(UA),RI_(UA),PI_(RA)和RI_(RA)水平均显著高于轻度缺氧组(P<0.05),PI_(MCA)和RI_(MCA)水平显著低于轻度缺氧组,差异有统计学意义(P<0.05);Spearman相关性分析结果表明,胎儿缺氧程度与PI_(UA),RI_(UA),PI_(RA)和RI_(RA)水平呈正相关(P<0.05),与PI_(MCA)和RI_(MCA)水平呈负相关(P<0.05);PI_(UA),RI_(UA),PI_(MCA),RI_(MCA),PI_(RA)和RI_(RA)诊断胎儿宫内缺氧的ROC曲线下面积(AUC)分别为0.977,0.906,0.957,0.984,0.983和0.946,截断值分别为1.368,0.682,1.585,0.701,1.689和0.738;上述指标ROC曲线AUC与参考线比较,差异有统计学意义(P<0.05)。结论:UA,MCA和RA等动脉血流参数与胎儿宫内缺氧状态具有显著相关性,其在诊断胎儿缺氧程度方面具有良好效能,可作为临床重要警示信号,指导实施相应措施。
Objective:To explore the diagnostic value of blood flow parameters of umbilical artery(UA),middle cerebral artery(MCA)and renal artery(RA)on fetal intrauterine hypoxia.Methods:A retrospective analysis was performed on the clinical data of 51 pregnant women who had undergone antenatal check-ups,delivery and fetal intrauterine hypoxia during the period from February 2019 to August 2020 in hospital.According to the degree of fetal hypoxia,the pregnant women were divided into mild hypoxia group(n=28,judged as fetal mild hypoxia according to fetal heart and amniotic fluid pollution monitoring)and moderate-to-severe hypoxia group(n=23,judged as fetal moderate-to-severe hypoxi according to fetal heart and amniotic fluid pollution monitoring).The blood flow parameters of UA,MCA and RA [pulsation index(PI),resistance index(RI)]were compared between the two groups.Spearman correlation analysis was used to analyze the correlation between PI_(UA),RI_(UA),PI_(MCA),RI_(MCA),PIRA and RI_(RA)and degree of fetal hypoxia.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of the above parameters on the degree of fetal hypoxia.Results:The levels of PI_(UA),RI_(UA),PIRA and RI_(RA)in moderate-to-severe hypoxia group were significantly higher than those in mild hypoxia group(P<0.05),while the levels of PI_(MCA) and RI_(MCA) were significantly lower than those in mild hypoxia group,there was significient difference(P<0.05).Spearman correlation analysis results showed that the degree of fetal hypoxia was positively correlated with the levels of PI_(UA),RI_(UA),PI_(RA)and RI_(RA)(P<0.05),and negatively correlated with levels of PI_(MCA) and RI_(MCA)(P<0.05).The AUC values of the ROC curves of PI_(UA),RI_(UA),PI_(MCA),RI_(MCA),PI_(RA)and RI_(RA)in the diagnosing fetal intrauterine hypoxia were 0.977,0.906,0.957,0.984,0.983 and 0.946 respectively.The cut-off values were 1.368,0.682,1.585,0.701,1.689 and 0.738.The differences in the AUC values of ROC curves of above-mentioned indexes were statistically
作者
张玉
ZHANG Yu(People's Hospital of Wan'an County,Ji'an 343800,China)
出处
《临床医药实践》
2022年第1期32-35,共4页
Proceeding of Clinical Medicine
关键词
脐动脉
大脑中动脉
肾动脉
血流参数
胎儿宫内缺氧
预测效能
umbilical artery
middle cerebral artery
renal artery
blood flow parameters
fetal intrauterine hypoxia
predictive efficacy
