胎儿大脑中动脉和脐动脉阻力指标检测在妊娠期糖尿病胎儿监测中的临床价值

Fetal middle cerebral artery and umbilical artery resistance index in the gestational diabetes test the clinical value of fetal monitoring

目的:探讨胎儿大脑中动脉(MCA)和脐动脉(UA)阻力指标检测对妊娠期糖尿病(GDM)围生期胎儿监测的价值。方法:运用彩色多普勒超声(CDFI)检测206例正常妊娠和156例GDM妇女孕32周后胎儿MCA和UA的阻力指数(RI)、搏动指数(PI)及收缩期/舒张期比值(S/D),计算MCA-PI/UA-PI的比值。结果:GDM孕妇中血糖控制不理想的胎儿UA-PI值比正常妊娠者明显升高(P<0.01),UA-S/D值较正常者高(P<0.05);MCA-PI、RI值在血糖控制不理想时下降明显,与正常组比较,差异有统计学意义(P<0.01);MCA-S/D值下降,与正常组相比,差异有统计学意义(P<0.05);MCA-PI/UA-PI在GDM组明显低于正常组(P<0.01),MCA-PI/UA-PI<1者均为发生GDM血糖控制不理想者。结论:GDM患者胎儿MCA和UA阻力指标有明显变化,二者结合对GDM胎儿监测具有重要的临床价值,其判断胎儿宫内缺氧与否符合率最高,误诊率最低,值得在临床上广泛应用。

Objective：To research the value of perinatal fetal monitoring fetal middle cerebral artery （MCA） and umbilical artery （UA） resistance index detection of gestational diabetes mellitus （GDM）.Methods：Using color Doppler ultrasound （CDFI） detected 206 cases of normal pregnancy and 156 cases of pregnant women with gestational diabetes 32 weeks after the fetal MCA and UA resistance index （RI）,pulsatility index （PI） and systolic/diastolic ratio （S/D）,The ratio calculated MCA-PI/UAPI.Results：GDM was not ideal blood glucose control in pregnant women of fetal UA-PI values were significantly higher than in normal pregnancy （P〈0.01）,UA-S/D values were higher than normal （P〈0.05）;MCA-PI,RI values decreased blood glucose control was not ideal,and the normal group significantly different （P〈0.01）;MCA-S/D was decreased,compared with the normal group were significantly different （P〈0.05）;MCA-PI/UA-PI in the GDM group was lower than the normal group （P〈0.01）,MCA-PI/UA-PI 1 there of in the event of GDM were not ideal blood sugar control.Conclusion：GDM patients with fetal MCA and UA resistance index significantly change,a combination of both fetal monitoring of GDM has important clinical value,the judge found fetal hypoxia or the highest rate,the lowest rate of misdiagnosis,it is widely used in clinical practice.