复发性流产患者子宫动脉血流的超声多普勒变化

Doppler Assessment of Uterine Blood Flow in Recurrent Spontaneous Abortions

目的:探讨复发性流产(RSA)患者子宫动脉血流超声的血流参数及频谱波形的特征。方法:共纳入87例早孕妇女,其中有RSA史妇女41例,无流产史早孕妇女(对照组)46例,所有对象均行阴道超声多普勒测量子宫动脉血流参数,测量指标有:收缩期峰值流速/舒张末期流速(S/D)、搏动指数(PI)、阻力指数(RI)。随访妊娠结局,排除无流产史妇女中发生难免流产者。根据受试者工作曲线(ROC)比较各参数诊断价值,另将子宫动脉波形进行分类,同时比较RSA组和对照组波形的分布差异。结果:正常对照组排除难免流产7例后为39例。RSA组患者平均年龄29.7±3.4岁,正常对照组28.2±4.2岁。RSA组的子宫动脉S/D、PI、RI分别为6.98±1.67、1.46±0.12、0.84±0.04;正常对照组分别为5.30±1.05、1.31±0.15、0.81±0.12。RSA组的子宫动脉S/D与PI均高于对照组,差异有统计学意义,RI值组间差异无统计学意义(P>0.05)。ROC曲线下面积三者均>0.8,其中以PI最大;血流频谱波形A、0型的发生率较对照组高。结论:RSA患者的S/D、PI明显高于正常早孕妇女,高阻力血流波形发生率明显高于正常早孕妇女。

Objective： To explore uterine artery Doppler index and flow velocity waveforms （FVWs） in women with recurrent spontaneous abortions （RSA）. Methods： A study was conducted with 87 women in earlypregnancy, 41 women with recurrent pregnancy loss and 46 women with no history of abortion. Pregnancy outcome was followed, excluding inevitable abortion happens in women without a history of abortion （7 women）.Transvaginal ultrasonography associated with Doppler flow was performed to calculate the S/D, RI, and PI and analyze the uterine artery FVWs. Results： The women with RSA had a significantly higher uterine artery S/Dand PI than those in the control respectively, as well as a higher incidence of FVWs of type A and type 0. Conclusion： Compared with the control, a higher S/D, RI, and PI and a higher incidence of FVW of the type Aand type 0 and thus a higher uterine artery impedance were found among women with RSA.