母体凝血功能及胎儿脐血流相关参数预测特发性胎儿生长受限价值

The value of maternal coagulation function and umbilical cord blood flow parameters for predicting idiopathic fetal growth restriction

目的:分析母体凝血功能及胎儿脐血流相关参数对特发性胎儿生长受限(IFGR)的预测价值;方法:选择2014年1月—2017年12月本院IFGR病例(IFGR组,47例),同期产检且胎儿发育符合正常胎龄的病例作为对照组(55例),比较两组母体血细胞比容(HCT)、血红蛋白(Hb)、纤维蛋白原(Fbg)、纤溶酶原(Plg)、凝血酶原时间(PT)、凝血酶时间(TT)、抗凝血酶(AT III)、D二聚体(D D)以及脐动脉搏动指数(PI)、阻力指数(RI)及收缩期最大血流速度与舒张末期血流速度比值(S/D)差异,分析各指标对IFGR的预测效能。结果:IFGR组Fbg及Plg值均高于对照组,AT III低于对照组(P<0.05),两组HCT、Hb、PT、TT、D D比较无差异,IFGR组脐动脉血流PI、RI及S/D值均高于对照组(均P<0.05)。对IFGR有预测价值(P<0.001)。结论:IFGR母体部分凝血指标及脐血流参数可能发生异常改变,脐血流参数,尤其是RI能较好地预测IFGR发生。

Objective:To analyze the value of maternal coagulation function and umbilical cord blood flow parameters for predicting idiopathic fetal growth restriction(IFGR)of pregnant women.Methods:47 women with IFGR were selected in study group,and 55 normal pregnant women were selected in control group.The levels of maternal hematocrit(HCT),hemoglobin(Hb),fibrinogen(Fbg),plasminogen(Plg),prothrombin time(PT),thrombin time(TT),antithrombin(AT III),d dipolymer(D D),umbilical artery pulsation index(PI)and resistance index(RI),and the ratio of maximum blood flow velocity in systole to that in end diastole(S/D)of women were compared between the two groups.The value of above indicators for predicting IFGR of pregnant women was analyzed.Results:The levels of Fbg and Plg of women in the study group were significant higher than those of women in the control group,and AT III level was significant lower(P<0.05).There were no statistically significant difference in levels of HCT,Hb,PT,TT,and D D of women between the two groups(P>0.05).The values of umbilical artery blood flow PI,RI,and S/D of women in the study group were significant higher than those of women in the control group(P<0.05).The IFGR can be predicted by PI,RI and S/D values of fetal umbilical artery(P<0.001).Conclusion:Some maternal coagulation indexes and umbilical cord blood flow parameters of women with IFGR may be abnormally changed.The umbilical cord blood flow parameters,especially RI value,can better predict the occurrence of IFGR.