子宫动脉多普勒阻力指数及搏动指数预测异常妊娠结局的价值

The predictive value of abnormal pregnancy outcome with uterine artery doppler resistance indices and pulsatility indices

目的应用ROC曲线评价子宫动脉多普勒较高阻力指数(RI)、较低RI、平均RI、较高搏动指数(PI)、较低PI、平均PI预测异常妊娠结局的价值。方法定群分析妊娠期高血压疾病80例,并随访至产后,以妊娠异常结局即早产、小于孕龄儿(SGA)、剖宫产为"金标准",绘制子宫动脉血流多普勒参数不同RI及PI对异常结局的ROC曲线下面积(AUC),并进行比较。结果子宫动脉多普勒不同RI、PI参数均能预测异常妊娠结局的早产、小于孕龄儿(P<0.05),且ROC曲线下面积差异无统计学意义(P>0.05)。各参数预测剖宫产的AUC差异均无统计学意义(P>0.05)。结论与子宫动脉多普勒不同PI组一样,妊娠期高血压疾病晚期子宫动脉多普勒较高RI、较低RI、平均RI预测早产,小于孕龄儿等不良结局的能力均无明显差别。

Objective To assess the predictive value of abnormal pregnancy outcome with higher, lower and mean uterine artery Doppler resistance indices and pulsatility indices by receiver operating characteristic curves （ROC）. Methods A cohort study included 80 patients of hypertensive disorder complicating pregnancies, all the patients were followed up to postnatal, and drawed ROC for the adverse pregnancy outcome of small-for-gestational-age （SGA）, newborns premature birth, cesarean section with the gold standard by uterine artery blood flow parameters. The parameters of the test included the lower, mean, higher UtA-RI and lower, mean, higher UtA-PI, then calculated the area under ROC curve （AUC） and compared them. Results The lower,mean, higher UtA-RI and lower,mean, higher UtA-PI could predict adverse outcome of pregnancy, such as premature birth, SGA （ P 〈 0. 05 ）. There were no statistically significant differences in the receiver operating characteristic curves （ P 〉 0. 05 ）. The areas under the curve （AUC） for ROC curves in the prediction of cesarean section by the lower, mean and higher uterine artery Doppler PI and RI were shown no statistically significant differences （P 〉 0. 05 ）. Conclusion As well as uterine artery Doppler pulsatility indices, Performance of UtA-RI in predicting abnormal pregnancy outcome of prematlrre birth and SGA was no different for the lower, higher or mean RI of the two UtAs in the patients of late hypertensive disorder complicating pregnancies.