摘要
目的探讨序贯性子宫动脉超声、光电容积脉搏波(PPG)检查联合血清胎盘生长因子(PLGF)、可溶性Endoglin(sEng)检测对妊娠期高血压(GH)、子痫前期(PE)的诊断价值。方法选取233例孕早期妇女为研究对象,进行长程随访,将出现的GH或PE的孕妇分别纳入GH组、PE组,其余孕妇为正常对照组。记录所有研究对象在孕11~16周、孕20~24周序贯性子宫动脉超声、PPG检查结果及孕24~28周时血清PLGF、sEng水平。统计分析检查指标单独或联合对预测GH、PE的价值。结果(1)与对照组相比,GH组、PE组孕妇的阻力指数(RI)1、搏动指数(PI)1、RI2、PI2、RI′1、RI′2水平明显较高,PLGF/sEng值明显较低(P<0.05);与GH组相比,PE组RI2、PI2水平更高,PLGF、PLGF/sEng值较低(P>0.05)。(2)RI1、PI1、RI2、PI2、RI′1、RI′2单独预测GH的曲线下面积(AUC)分别为0.720、0.704、0.732、0.826、0.816、0.775;单独预测PE的AUC分别为0.795、0.816、0.813、0.915、0.911、0.849,随着联合指标的数量增多,AUC及灵敏度、特异度也逐渐升高。当动脉超声6项指标全部联合诊断时,对GH诊断的AUC最高可达0.889,灵敏度为85.8%,特异度为90.5%;对PE诊断的AUC最高可达0.931,灵敏度为87.6%,特异度为93.2%。(3)PLGF、sEng、PLGF/sEng单独预测GH的AUC分别为0.655、0.679、0.698,诊断效能较低;单独预测PE的AUC分别为0.808、0.830、0.838,均达中度诊断效能。(4)PLGF/sEng联合全部超声指标时,对GH诊断的AUC可达0.893,对PE诊断的AUC最高可达0.963,预测效能已十分可靠。结论早、中期序贯性子宫动脉超声、光电容积脉搏波检查序贯性联合孕中期PLGF/sEng检测,可有效提高GH、PE预测的准确性,值得临床推广。
Objective To evaluate the diagnostic value of uterine artery ultrasound,PPG combined with PLGF and sEng in GH and PE.Methods A total of 233pregnant women were randomly divided into GH group,PE group and normal control group.The ultrasonographic and PPG results of sequential uterine artery and the levels of serum PLGF and sEng in pregnant women from 11to 16wand 20to 24wwere recorded.Results(1)Compared with the control group,the levels of RI1,PI1,RI2,PI2,RI′1and RI′2 were significantly higher in the GH group,and the PLGF/sEng value was significantly smaller(P<0.05).(2)RI1,PI1,RI2,PI2,RI′1,RI′2separately predicted the AUC of GH were 0.720,0.704,0.732,0.826,0.816,0.775respectively.The AUC respectively predicted PE were 0.795,0.816,0.813,0.915,0.911,and 0.795respectively.The highest AUC is up to 0.931.(3)PLGF,sEng and PLGF/sEng separately predicted the AUC of GH were 0.655,0.679and 0.698respectively,and AUC of PE were 0.808,0.830,0.838respectively.(4)When PLGF/sEng combined with RI2and PI2,the AUC diagnosis of GH was 0.861.When PLGF/sEng combined with all ultrasonic indexes,AUC reached 0.893.The AUC of PLGF/sEng combined with RI1and PI1for PE diagnosis was 0.867.Conclusion Early and middle stage sequential uterine artery ultrasound,optical capacitive pulse wave examination sequential combined with PLGF/sEng detection in the mid-term pregnancy,can effectively improve the accuracy of GH and PE prediction,which is worthy of clinical promotion.
作者
刘婷婷
王娟妮
吴晓玲
张卫华
赵乃蒙
LIU Tingting;WANG Juanni;WU Xiaoling;ZHANG Weihua;ZHAO naimeng(Department of Obstetrics and Gynecology,Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China)
出处
《新疆医科大学学报》
CAS
2019年第11期1423-1429,共7页
Journal of Xinjiang Medical University
基金
国家自然科学基金青年基金(81702578)
关键词
子宫动脉超声
光电容积脉搏波
妊娠期高血压
子痫前期
uterine artery ultrasound
photo capacitance pulse wave
gestational hypertension
pre-eclampsia