摘要
目的分析不同严重程度妊娠期高血压疾病(HDCP)患者子宫动脉血流参数与胎儿发育及结局的相关性,探讨彩色多普勒超声检测子宫动脉血流在预测胎儿结局的临床应用价值。方法将我院2015年1月~2017年6月确诊的145例HDCP孕妇根据血压和并发症情况分为妊娠高血压组55例、轻度子痫前期组48例、重度子痫前期组42例,并以同期入院的健康孕妇60例作为对照组。彩色多普勒超声检测所有孕妇子宫动脉血流阻力指数(RI)、搏动指数(PI)、收缩期与舒张期流速比(S/D),测定胎儿左右心室Tei指数,随访并记录胎儿生长受限、宫内窘迫、早产、新生儿窒息的发生情况。比较四组孕妇子宫动脉血流参数和胎儿左右心室Tei指数的差异,并分析两者之间的相关性,比较四组胎儿不良结局发生率的差异。结果妊娠高血压组、轻度子痫前期组、重度子痫前期组孕妇的子宫动脉血流参数RI、PI、S/D和胎儿左右心室Tei指数明显高于对照组(P<0.05),轻度子痫前期组、重度子痫前期组明显高于妊娠高血压组(P<0.05),重度子痫前期组又明显高于轻度子痫前期组(P<0.05);孕妇子宫动脉血流RI、PI、S/D与胎儿左右心室Tei指数均呈正相关(P<0.01);四组胎儿生长受限、宫内窘迫、早产、新生儿窒息的不良结局的发生率具有明显统计学差异(P<0.01)。结论随着HDCP严重程度的增加,孕妇子宫动脉血流RI、PI、S/D与胎儿左右心室Tei指数也随之增加,且两者具有明显相关关系,胎儿不良结局的发生率也明显升高。彩色多普勒检测高血压疾病患者子宫动脉血流参数可为预测胎儿发育及不良结局的发生提供数据依据。
Objective To analyze the correlation between uterine artery blood flow parameters of patients with hypertensive disorder complicating pregnancy(HDCP)of different severity and fetal development and outcome,and to explore the clinical value of detecting uterine artery blood flow by color Doppler ultrasound in predicting the fetal outcome.Methods According to blood pressure and complications,145 HDCP women diagnosed in our hospital from January 2015 to June 2017 were divided into pregnancy hypertension group(55 cases),mild preeclampsia group(48 cases)and severe preeclampsia group(42 cases).60 healthy pregnant women admitted to hospital at the same time were selected as control group.Flow resistance index(RI),pulsatility index(PI),systolic blood flow velocity/diastolic blood flow velocity(S/D)of uterine arteries of all pregnant women were measured by color Doppler ultrasound.The Tei index of fetal left and right ventricles were also detected.We followed up and recorded the occurrence of fetal growth restriction,fetal distress,premature delivery,neonatal asphyxia,compared the different of uterine artery blood flow parameters among four groups pregnant women and Tei index of fetal left and right ventricles,analyzed the correlation between them,and compared the incident of adverse outcomes among the four groups fetuses.Results The uterine arteries RI,PI and S/D of pregnant women and Tei index of fetal left and right ventricles of pregnancy hypertension group,mild preeclampsia group and severe preeclampsia group were significantly higher than those of the control group(P<0.05).These index of mild preeclampsia group and severe preeclampsia group was significantly higher than those of the pregnancy hypertension group(P<0.05).These index of severe preeclampsia group were significantly higher than that of the mild preeclampsia group(P<0.05).There was a positive correlation between RI,PI,S/D of uterine artery and Tei index of fetal left and right ventricles(P<0.01).There were significant statistical differences for the incident of fetal growth restriction,fetal distress,premature delivery,neonatal asphyxia among the four groups(P<0.01).Conclusion With the aggravation of the HDCP,uterine artery RI,PI,S/D of pregnant women and Tei index of fetal left and right ventricles were increased.There was a obvious correlation between them,the incidence of fetal adverse outcomes was also increased significantly.The measurement of uterine artery blood flow parameters of HDCP patients by color Doppler ultrasound can provide data basis for the prediction of fetal development and adverse outcome.
作者
庞静
聂红艳
陈伟伟
PANG Jing;NIE Hongyan;CHEN Weiwei(Department of Ultrasound Diagnosis, Maternity and Child Care Center of Qinhuangdao, Qinhuangdao 066000, P.R.China)
出处
《医学影像学杂志》
2020年第7期1265-1269,共5页
Journal of Medical Imaging
基金
河北省秦皇岛市科学技术研究与发展计划项目(编号:201703A129)。
关键词
妊娠期高血压疾病
胎儿
子宫动脉
彩色多普勒超声
Hypertensive disorders complicating pregnancy
Fetus
Uterine artery
Color Doppler ultrasound
