摘要
目的应用多普勒超声评估中晚孕期特发性羊水偏少(isolated borderline oligohydramnios,IBO)胎儿肾动脉血流参数变化并评估其与妊娠结局的相关性。方法选取2019年4-10月于中南大学湘雅二医院超声科进行中晚孕期产前系统筛查的27例IBO胎儿(IBO组)和27例孕龄匹配的正常胎儿(对照组)进行肾动脉血流参数的测量,包括肾动脉搏动指数(pulsatility index,RAPI)、肾动脉体积校正搏动指数(volume corrected renal artery pulsatility index,vcRAPI),比较两组间肾脏血流参数、母婴妊娠结局有无差异。IBO组一经诊断则建议前往产科门诊进行咨询及干预,评估干预前RAPI、vcRAPI与临产前羊水量以及母婴妊娠结局的相关性,绘制ROC曲线得出最佳预测参数。结果IBO组vcRAPI高于对照组(P=0.015),IBO组中临产前仍为IBO的胎儿其干预前的vcRAPI高于临产前羊水量恢复的胎儿(P=0.048),IBO组中干预前vcRAPI与临产前IBO的相关性差异有统计学意义(OR=2.41,95%CI=1.06~5.43,P=0.035),ROC曲线示vcRAPI对IBO预测的敏感性为0.67,特异性为0.75(P=0.002)。结论相比RAPI,vcRAPI能更及时地体现IBO胎儿肾动脉灌注阻力的增高;IBO组干预前vcRAPI升高的胎儿,临产前羊水量不易恢复,vcRAPI的升高为IBO的较好预测指标。
Objective To evaluate the changes of fetal renal artery blood flow parameters in fetuses with isolated borderline oligohydramnios(IBO)in the middle and third trimesters by Doppler ultrasound,and to assess its correlations with maternal and infant pregnancy outcomes.Methods Twenty-seven IBO fetuses(IBO group)and 27 gestational age-matched normal fetuses(control group)from April to October 2019 in the Second Xiangya Hospital of Central South University underwent prenatal ultrasound examination during the middle and third trimesters.Renal artery blood flow parameters,including renal artery pulsatility index(RAPI),volume corrected renal artery pulsatility index(vcRAPI)and pregnancy outcomes were measured and compared between the two groups.Once diagnosed IBO,patients were recommended to the obstetric clinic for consultation and intervention.The correlation between RAPI,vcRAPI measured before intervention and prepartum amniotic fluid volume and pregnancy outcomes was analyzed,the ROC curve was plotted to find the better predictor.Results The vcRAPI of the IBO group was higher than that of the control group(P=0.015).In the IBO group,the vcRAPI measured before intervention was higer in those fetuses who were still IBO before delivery(P=0.048).In the IBO group,the correlation of the vcRAPI measured before intervention and IBO before delivery was statistically significant(OR=2.41,95%CI=1.06-5.43,P=0.035).The ROC curve showed that the sensitivity of vcRAPI to IBO was 0.67,the specificity was 0.75(P=0.002).Conclusions Compared with RAPI,The vcRAPI may reflect the increase in fetal renal artery perfusion resistance of IBO group more timely.The higher vcRAPI before intervention in the IBO group have difficulty in recovering amniotic fluid volume before delivery.Increased vcRAPI is a better predictor of IBO before delivery.
作者
邓妍
徐冉
曾施
金莹
陈附丽
Deng Yan;Xu Ran;Zeng Shi;Jin Ying;Chen Fuli(Department of Ultrasonography,the Second Xiangya Hospital of Central South University,Changsha 410011,China;Department of Urology,the Second Xiangya Hospital of Central South University,Changsha 410011,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2021年第6期537-542,共6页
Chinese Journal of Ultrasonography
基金
国家自然科学基金青年项目(81501497,81871372)。
关键词
超声检查
特发性羊水偏少
肾动脉
肾脏体积校正搏动指数
搏动指数
Ultrasonography
Isolated borderline oligohydramnios
Renal artery
Volume corrected renal artery pulsatility index
Amniotic fluid index
