摘要
目的探讨脑胎盘率(CPR)对胎儿生长受限(FGR)围生结局的预测价值。方法回顾性选取2021年5月至2022年3月上海交通大学医学院附属国际和平妇幼保健院产科孕期超声诊断为FGR的孕妇50例为FGR组,另选取非FGR孕妇50例为对照组。检测两组胎儿脐动脉搏动指数(UA PI)、大脑中动脉搏动指数(MCA PI),计算二者的比值(UA PI/MCA PI,即CPR),并运用受试者工作特征曲线(ROC曲线)预测UA、MCA、CPR对FGR不良围生结局的影响,分析胎儿CPR、UA PI、UA S/D及MCA PI、大脑中动脉阻力指数(MCA RI)、大脑中动脉血流收缩期最大血流速度及舒张期末期血流速度比值(MCA S/D)对FGR不良妊娠结局的预测价值。结果FGR组胎儿UA的PI、RI、S/D值分别为1.26±0.21、0.68±0.05、2.93±0.24,均明显高于对照组(0.81±0.08、0.55±0.04、2.44±0.12),MCA的PI、RI、S/D值及CPR分别为1.45±0.19、0.70±0.08、4.12±0.17、1.15±0.14,均明显低于对照组(1.82±0.13、0.84±0.06、4.96±0.35、2.25±0.18),差异均有统计学意义(P<0.05)。在FGR组中有19例患者CPR值<1.08,发生率为38.00%,对照组有1例患者CPR值<1.08,发生率为2.00%,FGR组胎儿CPR值<1.08的发生率明显高于对照组,差异有统计学意义(P<0.05)。两组CPR<1.08的敏感度为95.82%,特异度为79.13%。两组共发现20例CPR值<1.08患者,80例CPR值>1.08的患者。以CPR为1.08为临界值,分为CPR<1.08组与CPR>1.08组。与CPR<1.08组相比,CPR>1.08组出生孕周、脐动脉血气pH值、出生体重升高,出生体重<第10百分位数、5 min Apgar评分<7.0、胎儿窘迫行剖宫产、异常无创胎心监测、入住新生儿重症监护室、不良围生儿结局发生率降低,差异均有统计学意义(P<0.05)。结论胎儿CPR可评估FGR不良围生事件的产生,是FGR胎儿不良围生结局的重要预测指标,与胎儿转归联系密切。
Objective To investigate the value of cerebral placental rate(CPR)in predicting perinatal outcome of fetal growth restriction(FGR).Methods From May 2021 to March 2022,50 pregnant women diagnosed with FGR by ultrasound during pregnancy in International Peace Maternal and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were selected as the FGR group,and 50 non-FGR pregnant women were selected as the control group.The umbilical artery beat index(UAPI)and middle cerebral artery beat index(MCAPI)of the two groups were detected,and the ratio of UAPI/MCA PI(CPR)was calculated.The receiver operating characteristic curve(ROC curve)was used to predict the effects of UA,MCA and CPR on adverse perinatal outcomes of FGR.CPR,UA PI,fetal umbilical artery resistance index(UA RI),fetal umbilical artery end-diastolic velocity ratio(UA S/D),MCA PI,middle cerebral artery resistance index(MCA RI),middle cerebral artery maximum systolic velocity ratio and end-diastolic velocity ratio(MCA)were analyzed (S/D)in predicting adverse pregnancy outcomes in FGR.Results The PI,RI,S/D of UA in the FGR group were 1.26±0.21,0.68±0.05,2.93±0.24,respectively,which were significantly higher than those in the control group(0.81±0.08,0.55±0.04,2.44±0.12),the PI,RI,S/D and CPR of MCA in the FGR group were 1.45±0.19,0.70±0.08,4.12±0.17,1.15±0.14,respectively,which were significantly lower than those in the control group(1.82±0.13,0.84±0.06,4.96±0.35,2.25±0.18),the differences were statistically significant(P<0.05).In the FGR group,there were 19 patients with CPR value<1.08,the incidence rate was 38.00%,while in the control group,there was 1 patient with CPR value<1.08,the incidence rate was 2.00%.The incidence of fetal CPR value<1.08 in the FGR group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).The sensitivity and specificity of CPR<1.08 were 95.82%and 79.13%,respectively.Twenty patients with CPR value<1.08 and 80 patients with CPR valu
作者
史宏
张丽君
SHI Hong;ZHANG Li-jun(Departmet of Obstetrics,Shanghai Jiao Tong University School of Medicine Affiliated to International Peace Maternity and Child Health Hospital,Shanghai 200030,China)
出处
《临床和实验医学杂志》
2023年第8期866-870,共5页
Journal of Clinical and Experimental Medicine
基金
上海市自然科学基金支持项目(编号:20ZR1463200-1)。
关键词
胎儿生长受限
围生结局
脑胎盘率
Fetal growth restriction
Perinatal outcome
Brain placenta rate
