摘要
目的:探讨妊娠期高血压疾病(hypertensive disorders of pregnancy,HDP)患者孕晚期胎盘剪切波速度(SWV)值、脐动脉收缩压与舒张压比值(脐动脉S/D值)预测围产儿预后的临床价值。方法:选取上海市东方医院吉安医院2020年1月-2022年1月收治的HDP孕妇和血压正常孕妇203例为研究样本,HDP孕妇为观察组(n=102),血压正常孕妇为对照组(n=101),采用声辐射力脉冲成像超声诊断仪监测反映胎盘弹性的胎盘SWV值、围产儿脐动脉S/D值,比较两组胎盘SWV值、脐动脉S/D值,分析其预测围产儿预后的价值。结果:观察组围产儿不良结局发生率高于对照组(P<0.05);观察组妊娠正常结局孕妇胎盘SWV值、脐动脉S/D值与对照组相比,差异均无统计学意义(P>0.05),观察组妊娠不良结局孕妇胎盘SWV值、脐动脉S/D值均高于正常结局与对照组(P<0.05);受试者工作特征(ROC)曲线反映,胎盘SWV值预测妊娠不良结局约登(Youden)指数最大0.790时对应截断值(Cutoff)1.000 m/s,曲线下面积(AUC)0.892,预测HDP妊娠不良结局的敏感度86.84%,特异度90.62%;脐动脉S/D值预测妊娠不良结局Youden指数最大0.790时对应Cut-off为2.800,AUC为0.894,预测妊娠不良结局敏感度为86.84%,特异度为92.19%。结论:孕晚期反映胎盘弹性的胎盘SWV值、脐动脉S/D值在评价胎盘功能上有参考意义,为妊娠期高血压疾病孕妇的临床诊断提供了新维度的超声参考价值,为评估围产儿预后提供一定程度的科学证据。
Objective: To investigate the clinical value of placental SWV value and umbilical artery systolic and diastolic blood pressure ratio(umbilical artery S/D value) in predicting perinatal prognosis in patients with hypertensive disorders of pregnancy(HDP) in the third trimester. Method: From January 2020 to January 2022, 203pregnant women with HDP and normal blood pressure pregnant women admitted to Shanghai East Hospital Ji’an Hospital were selected as study samples. HDP pregnant women were selected as observation group(n=102) and normal blood pressure pregnant women were selected as control group(n=101). Placental SWV value of perinatal infants reflecting the elasticity of placenta and S/D value of umbilical artery were monitored by ultrasonic diagnostic instrument of acoustic radiation force pulse imaging. Placental SWV value and S/D value of umbilical artery of perinatal infants were compared between the two groups, and their prognostic value were analyzes. Result: The incidence of perinatal adverse outcomes in the observation group was higher than that in the control group(P<0.05).The placental SWV and umbilical artery S/D of pregnant women with normal pregnancy outcome in the observation group were not significantly different from those in the control group(P>0.05), but the placental SWV and umbilical artery S/D of pregnant women with adverse pregnancy outcome in the observation group were higher than those in the normal pregnancy outcome and the control group(P<0.05). Receiver operating characteristic(ROC) curve showed that placental SWV value was 1.000 m/s when Youden index was 0.790, and the area under the curve(AUC) was 0.892, and the sensitivity of predicting HDP adverse pregnancy outcome was 86.84%, specificity was 90.62%. When the maximum Youden index was 0.790, the Cut-off value of umbilical artery S/D value was 2.800, AUC was 0.894,the sensitivity and specificity of predicting adverse pregnancy outcomes were 86.84% and 92.19%, respectively.Conclusion: The placental SWV value and umbilical artery S/D
作者
王强
刘玲红
陈雪梅
敖小华
刘琴
卢咏梅
WANG Qiang;LIU Linghong;CHEN Xuemei;AO Xiaohua;LIU Qin;LU Yongmei(Shanghai East Hospital Ji’an Hospital,Ji’an 343000,China;不详)
出处
《中国医学创新》
CAS
2022年第35期165-169,共5页
Medical Innovation of China
基金
江西省卫生健康委科技计划项目(202212850)。
关键词
妊娠期高血压疾病
声辐射力脉冲成像
胎盘
SWV
值
脐动脉S/D值
Hypertensive disorders of pregnancy
Acoustic radiation force pulse imaging
SWV value of placenta
Umbilical artery S/D value
