摘要
目的探讨三维能量多普勒超声参数联合胎盘生长因子(PLGF)对早发型胎儿生长受限(FGR)的预测价值。方法选取早发型FGR孕妇80例为FGR组,另选取同期产检健康孕妇50例为对照组。在孕11~13周+6对所有研究对象进行三维能量多普勒超声检查,收集胎盘容积(PV)、血管化指数(VI)、血流指数(FI)、血管化-血流指数(VFI)等指标。在孕14~16周+6检测所有研究对象血清PLGF水平。结果FGR组的PV、VI、FI、VFI以及血清PLGF水平均低于对照组,差异有统计学意义(P<0.05)。多元Logistic回归方程分析显示,PV、VI、FI、VFI以及血清PLGF水平过低是早发型FGR的危险因素(P<0.05)。受试者工作特征(ROC)曲线分析显示,PV、VI、VFI以及血清PLGF均对早发型FGR有一定的预测价值,曲线下面积分别为0.723(95%CI:0.629~0.817)、0.776(95%CI:0.693~0.860)、0746(95%CI:0.653~0.839)、0.799(95%CI:0.713~0.884),FI对早发型FGR的预测价值一般,曲线下面积为0.625(95%CI:0.524~0.725)。经分析显示,PLGF联合VI以及PLGF联合VFI对早发型FGR的预测价值较好,PLGF联合VI的敏感度、特异度和约登指数分别为86.25%、76.00%、0.623,PLGF联合VFI的敏感度、特异度和约登指数分别为81.25%、80.00%、0.613。结论三维能量多普勒超声参数联合PLGF对早发型FGR有一定的预测价值,可用于临床筛查早发型FGR高风险人群。
Objective To explore the value of three-dimensional energy Doppler ultrasound parameters combined with placental growth factor(PLGF)in predicting early-onset fetal growth restriction(FGR).Methods Eighty pregnant women with early-onset FGR were selected as FGR group,and another 50 healthy pregnant women with prenatal examination were selected as control group.Three-dimensional energy Doppler ultrasonography was performed for all subjects at 11 to 13 weeks plus 6 days of gestation,and placental volume(PV),vascularization index(VI),flow index(FI)and vascularization-flow index(VFI)were collected.Serum PLGF level was measured in all subjects at 14 to 16 weeks plus 6 days of gestation.Results The PV,VI,FI,VFI and serum PLGF level in the FGR group were significantly lower than those in the control group(P<0.05).Multiple Logistic regression analysis showed that low PV,VI,FI and VFI as well as serum PLGF level were risk factors for early-onset FGR(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that PV,VI,VFI and serum PLGF had certain predictive value for early-onset FGR,with areas under the curve of 0.723(95%CI,0.629 to 0.817),0.776(95%CI,0.693 to 0.860),0.746(95%CI,0.653 to 0.839)and 0.799(95%CI,0.713 to 0.884)respectively.The predictive value of FI for early-onset FGR was moderate,with an area under the curve of 0.625(95%CI,0.524 to 0.725).Analysis showed that the combination of PLGF and VI as well as PLGF and VFI had good predictive values for early-onset FGR,the sensitivity,specificity and Youden index of PLGF combined with VI were 86.25%,76.00%and 0.623 respectively,while those of PLGF combined with VFI were 81.25%,80.00%and 0.613 respectively.Conclusion The combination of three-dimensional energy Doppler ultrasound parameters and PLGF has certain predictive value for early-onset FGR,and can be used for clinical screening of high-risk populations with early-onset FGR.
作者
李娟娟
林雁
王卫平
LI Juanjuan;LIN Yan;WANG Weiping(Department of Ultrasound,Zhengzhou Maternal and Child Health Care Hospital in Henan Province,Zhengzhou,Henan,453000)
出处
《实用临床医药杂志》
CAS
2024年第10期13-16,23,共5页
Journal of Clinical Medicine in Practice
基金
河南省医学科技攻关计划联合共建项目(LHGJ20200750)。
关键词
胎儿生长受限
三维能量多普勒超声
胎盘生长因子
预测价值
fetal growth restriction
three-dimensional energy Doppler ultrasound
placental growth factor
predictive value
