摘要
目的探讨超声微血管成像技术在妊娠期高血压孕晚期孕妇胎盘血流灌注监测及妊娠结局预测中的应用价值。方法回顾性选取150例妊娠期高血压孕晚期孕妇作为研究组,另选取同期150例孕检正常的孕晚期孕妇作为对照组,2组孕妇均接受超声微血管成像检查,记录收缩期峰值流速与舒张末期血流速度比值(S/D)、搏动指数(PI)、阻力指数(RI)、胎盘血管化指数(VI)以及新生儿出生1 min时Apgar评分。根据病情严重程度的不同,将研究组孕妇进一步分为轻度组63例、中度组49例和重度组38例;根据是否发生不良妊娠结局,将研究组孕妇进一步分为预后不良组47例和预后良好组103例。绘制受试者工作特征(ROC)曲线,分析各指标对妊娠期高血压孕妇不良妊娠结局的预测价值。结果研究组S/D、PI、RI高于对照组,VI、新生儿Apgar评分低于对照组,差异有统计学意义(P<0.05);不同病情严重程度妊娠期高血压孕妇的S/D、PI、RI、VI、新生儿Apgar评分比较,差异有统计学意义(P<0.05);预后不良组S/D、PI、RI高于预后良好组,VI、新生儿Apgar评分低于对照组,差异有统计学意义(P<0.05)。ROC曲线分析结果显示,S/D、PI、RI、VI、新生儿Apgar评分预测不良妊娠结局的曲线下面积(AUC)分别为0.741、0.700、0.738、0.774、0.680(P<0.05)。结论妊娠期高血压孕妇孕晚期胎盘血流灌注显著减少,超声微血管成像监测相关参数VI能够有效辅助临床评估妊娠结局。
Objective To investigate the application value of ultrasound microvascular imaging in monitoring placental blood perfusion and predicting pregnancy outcomes in late pregnancy with pregnancy-induced hypertension.Methods A retrospective analysis was conducted in 150 pregnant women with pregnancy-induced hypertension in late gestation(study group),and another 150 pregnant women with normal pregnancy outcomes in late gestation during the same period were selected as control group.Both groups underwent ultrasound microvascular imaging,and the peak systolic velocity to end diastolic velocity ratio(S/D),pulsatility index(PI),resistance index(RI),vascularization index(VI)of the placenta,and the Apgar score at 1 minute after birth were recorded.Based on the severity of the disease,the study group was further divided into mild group(63 cases),moderate group(49 cases),and severe group(38 cases).According to the occurrence of adverse pregnancy outcomes,the study group was further divided into poor prognosis group(47 cases)and good prognosis group(103 cases).Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of each indicator for adverse pregnancy outcomes in pregnant women with pregnancy-induced hypertension.Results The S/D,PI,and RI were higher in the study group than in the control group,while the VI and Apgar scores were lower in the study group(P<0.05).There were statistically significant differences in S/D,PI,RI,VI,and Apgar scores among pregnant women with different severities of pregnancy-induced hypertension(P<0.05).The S/D,PI,and RI were higher in the poor prognosis group than in the good prognosis group,while the VI and Apgar scores were lower in the poor prognosis group(P<0.05).ROC curve analysis showed that the areas under the curve(AUCs)for predicting adverse pregnancy outcomes by S/D,PI,RI,VI,and Apgar scores were 0.741,0.700,0.738,0.774,and 0.680,respectively(P<0.05).Conclusion Placental blood perfusion decreases significantly in late pregnancy with pregnancy-induced hypertension,and ultrasound microvascular imaging parameters,especially VI,can effectively assist in clinically assessing pregnancy outcomes.
作者
努尔古丽·艾依提
迪丽拜尔·安外尔
唐雪莲
Nuerguli·AIYITI;Dilibaier·ANWAIER;TANG Xuelian(Department of Ultrasound Medicine,the Second People′s Hospital of Kashgar Prefecture of Xinjiang Uyghur Autonomous Region,Kashgar,Xinjiang,844000;Department of Gynecology,the Second People′s Hospital of Kashgar Prefecture of Xinjiang Uyghur Autonomous Region,Kashgar,Xinjiang,844000)
出处
《实用临床医药杂志》
CAS
2024年第20期82-85,91,共5页
Journal of Clinical Medicine in Practice
基金
新疆维吾尔自治区喀什地区应用技术研究与开发计划项目(KS2021076)。
关键词
超声微血管成像
妊娠期高血压
孕晚期
胎盘血流灌注
妊娠结局
ultrasound microvascular imaging
pregnancy-induced hypertension
late pregnancy
placental blood perfusion
pregnancy outcome
