摘要
目的:通过经阴道超声测量孕中期孕妇子宫颈弹性应变率(ESR)及子宫颈前角(ACA),探讨二者联合对早产的预测价值。方法:分析2020年6~12月在中国医科大学附属盛京医院产科超声检查的102例足月产孕妇(足月组)和28例早产孕妇(早产组)的临床资料。于孕16~28周采用经阴道超声弹性成像技术测量ESR[子宫颈内口弹性应变率(IESR)、子宫颈外口弹性应变率(EESR)、子宫颈整体弹性应变率(TESR)]及ACA,比较足月组与早产组ESR及ACA的差异,建立二分类Logistic回归模型,绘制单一及联合子宫颈参数预测早产的ROC曲线,计算曲线下面积(AUC)。结果:早产组IESR、TESR、ACA高于足月组,差异有统计学意义(P <0.05);两组间EESR差异无统计学意义(P> 0.05)。IESR、TESR以及ACA单独预测早产的AUC分别是0.836、0.696、0.744,采用AUC较大的IESR联合ACA联合预测早产的AUC最大为0.874,最佳截断值IESR为0.08 kpa,ACA为108.9°,敏感度为92.86%,特异度为74.51%。结论:ESR和ACA可用于预测早产,IESR联合ACA对早产的预测价值大,优于单一子宫颈参数预测。
Objective: To measure the elastic strain ratio and anterior uterocervical angle of pregnant women in the second trimester by transvaginal ultrasound to explore the predictive value of combing the two factors for preterm delivery. Methods: The clinical data of 102 full-term pregnant women and 28 women with preterm delivery were collected. All patients were examined by ultrasound in the Department of Obstetrics,Shengjing Hospital of China Medical University from June 2020 to December 2020. Cervical elastography strain ratio( ESR) including internal os elastography strain ratio( IESR),external os elastography strain ratio( EESR),and total cervical elastography strain ratio( TESR)) and anterior uterocervival angle( ACA) were measured by transvaginal ultrasound elastography at 16 th-28 th gestation week. We compared the ESR and ACA between the full-term group and the preterm group,established a two-class Logistic regression model,drawed the ROC curve of single and combined cervical parameters to predict preterm birth,and calculated the area under the curve( AUC). Results: The IESR,TESR,and ACA of the preterm group were higher than those of the full-term group( P < 0. 05),there was no statistically significant difference in EESR between the two groups( P > 0. 05). The AUC of IESR,TESR and ACA alone was 0. 836,0. 696,0. 744,respectively. The AUC of IESR combining with ACA was 0. 874. The optimal cut-off value of IESR was 0. 08 kpa,and ACA was 108. 9°. The sensitivity was 92. 86%,and specificity wa s74. 51%. Conclusions: ESR and ACA can be used for preterm birth. IESR together with ACA,better than their single parameter,has high predictive value.
作者
张晓娇
陈慧月
ZHANG Xiaojiao;CHEN Huiyue(Department of Obstetrics,Shengjing Hospital of China Medical University,Shenyang Liaoning 110022,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2022年第4期274-277,共4页
Journal of Practical Obstetrics and Gynecology
关键词
超声检查
子宫颈
早产
弹性应变率
子宫颈前角
Ultrasonography
Cervix
Premature delivery
Elastography strain ratio
Anterior uterocervical angle
