子宫动脉、胎儿脐动脉和大脑中动脉血流频谱对妊娠高血压的价值

The value of uterine artery,fetal umbilical artery and middle cerebral artery blood flow spectrum in the diagnosis of pregnancy-induced hypertension syndrome

目的探讨子宫动脉、胎儿脐动脉(UA)及大脑中动脉(MCA)血流频谱对妊娠高血压综合征(PIH)的价值。方法选取我院产检的孕妇219例,均行子宫动脉、胎儿脐动脉和大脑中动脉血流频谱检测,根据临床诊断将孕妇分为研究组(PIH孕妇)41例和对照组(正常妊娠孕妇)178例。比较子宫动脉、胎儿UA、MCA血流频谱的搏动指数(PI)、阻力指数(RI)、收缩期与舒张期流速比(S/D)对PIH的诊断价值。结果研究组子宫动脉的PI、RI、S/D明显高于对照组,研究组的PI、RI、S/D、有V型缺口波阳性率明显高于对照组,差异有统计学意义;ROC曲线分析显示,PI、RI、S/D、有V型缺口波阳性率诊断PIH的AUC分别为0.935、0.905、0.899、0.920,敏感度和特异度分别为:PI阳性率为92.7%、94.4%,RI阳性率87.8%、93.3%,S/D阳率为85.4%、94.4%,有V型缺口波阳性率为90.2%、93.8%。研究组UA的PI、RI、S/D明显高于对照组,研究组MCA、MCA/UA的PI、RI、S/D明显低于对照组,差异有统计学意义(P<0.05)。结论采用超声检测子宫动脉、UA、MCA的血流频谱,可早期预测PIH,为临床诊断和治疗提供参考。

Objective To explore the value of blood flow spectrum of uterine artery,fetal umbilical artery(UA)and middle cerebral artery(MCA)in the diagnosis of pregnancy-induced hypertension syndrome(PIH).Methods A total of 219 pregnant women who were examined in our hospital from May 2017 to February 2019 were selected for uterine artery,fetal umbilical artery,and middle cerebral artery blood flow spectrum detection.Pregnant women were divided into study groups(PIH pregnant women)based on clinical diagnosis,(41 cases)and the control group(normal pregnant women,178 cases).The diagnostic value of pulsation index(PI),resistance index(RI),and systolic and diastolic flow rate(S/D)of uterine artery,fetal UA,and MCA blood flow spectrum were compared.Results The PI,RI,and S/D of the uterine artery in the study group were significantly higher than those in the control group.The PI,RI,S/D,and V-notch wave positive rates in the study group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05);ROC curve analysis showed that the AUC for PIH diagnosis of PI,RI,S/D,and V-notch wave positive rates were 0.935,0.905,0.899,and 0.920,respectively.The sensitivity and specificity were PI positive rates.The positive rates were 92.7%,94.4%,RI positive rates were 87.8%,93.3%,S/D positive rates were 85.4%,94.4%,and V-notch wave positive rates were 90.2%,93.8%.The PI,RI,and S/D of the UA in the study group were significantly higher than those of the control group,and the PI,RI,and S/D of the MCA and MCA/UA in the study group were significantly lower than those of the control group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the AUC of PI,RI,and S/D for MCA/UA diagnosis of PIH were 0.995,0.955,and 0.867,respectively.The sensitivity and specificity were PI was 100%,93.3%,and RI was 90.2%,92.7%,S/D was 65.9%,90.4%.Conclusion Ultrasound detection of blood flow spectrum of uterine arteries,UA and MCA can predict PIH early and provide reference for clinical diagnosis and treatment.