子宫动脉超声及血清学指标联合预测子痫前期的研究

Uterine Artery Ultrasound and Serological Markers Combined Predictive Preeclampsia

目的研究子宫动脉超声及血清学指标联合预测子痫前期的价值。方法2017年3月—2018年3月,在该院例行产检的低风险初产妇530名,孕妇孕周均在24~28周之间。采集孕妇的子宫动脉超声参数(搏动指数与阻力指数值),并使用酶联免疫吸附试验法测定孕妇的血清学指标(血清胎盘生长因子与可溶性血管内皮生长因子受体-1),分析孕妇的最终妊娠结局,并比较正常孕妇与子痫前期孕妇的各项指标情况。结果530例孕妇均在该院分娩,正常妊娠分娩有468名,病例组62例,其中子痫前期32例。比较两组孕妇的各项指标,正常孕妇的sFlt-1(65.6±200.1)pg/mL,RI(0.50±0.06)与PI值(0.81±0.16)均低于子痫前期孕妇的sFlt-1(1927.8±100.6)pg/mL,RI(0.72±0.06)与PI值(1.56±0.34)(t=18.766,8.398,6.321,P<0.05),正常孕妇的PLGF值(304.3±46.5)pg/ml高于子痫前期孕妇的PLGF值(239.5±37.7)pg/mL(t=4.387,P<0.05)。子宫动脉超声两项指标联合血清学两项指标预测子痫前期,效果优于子宫动脉超声单独预测与血清学指标单独预测(P<0.05)。结论孕妇的PLGF,sFlt-1,RI与PI值单独预测子痫前期,诊断价值较低,联合预测子痫前期,诊断价值较好。

Objective to study the value of uterine artery ultrasound and serological markers in predicting preeclampsia.Methods from March 2017 to March 2018,530 cases of low-risk primipara were examined in our hospital,the gestational weeks were between 24 weeks and 28 weeks.The ultrasonic parameters of uterine artery(pulsatility index and resistance index)were collected and the serum levels of placental growth factor and soluble vascular endothelial growth factor receptor-1 were measured by enzyme-linked immunosorbent assay(Elisa).The final pregnancy outcome of pregnant women was analyzed and the indexes of normal pregnant women and preeclampsia pregnant women were compared.Results All 530 pregnant women were delivered in our hospital.There were 468 normal pregnancies and 62 cases in the case group,including 32 cases of preeclampsia.The sFlt-1 and PI values of normal pregnant women(65.6±200.1)pg/mL,RI and PI(0.81±0.16)were lower than those of preeclampsia pregnant women(1 927.8±100.6)pg/mL,RI(0.72±0.06)and PI(1.56±0.34)(t=18.766~8.398/6.321)P<The PLGF value of normal pregnant women(304.3±46.5)pg/ml was higher than that of preeclampsia women(239.5±37.7)pg/mL(t=4.387,P<0.05).Two indexes of uterine artery ultrasound combined with two indexes of serology to predict preeclampsia were better than those of uterine artery alone and serological indexes(P<0.05).Conclusion the value of PLGF,sFlt-1,RI and PI in predicting preeclampsia alone is lower,and the diagnostic value of combined prediction of preeclampsia is better.