彩超下胎儿脐动脉、母体子宫动脉血流动力学参数与早发型重度子痫前期围生儿预后的相关性

Correlation of hemodynamic parameters of fetal umbilical artery and maternal uterine artery under color Doppler ultrasound with perinatal prognosis of patients with early-onset severe preeclampsia

目的探讨彩超下胎儿脐动脉、母体子宫动脉血流动力学参数与早发型重度子痫前期患者围生儿预后的相关性。方法对新密市妇幼保健院126例早发型重度子痫前期患者的临床资料进行回顾性分析,根据围生儿预后事件分为不良组(n=33)与良好组(n=93)。分别比较两组患者胎儿脐动脉和母体子宫动脉的收缩末期最大血流速度和舒张末期最大血流速度之比(S/D)、搏动指数(PI)及阻力指数(RI)。以受试者工作特征(ROC)曲线描述上述指标应用于早发型重度子痫前期患者围生儿预后的预测效能。结果不良组胎儿脐动脉S/D、PI、RI及母体子宫动脉S/D、PI、RI水平均明显高于良好组(P均<0.05),其预测围生儿预后不良事件的截断值分别为2.59、1.12、0.67、2.35、1.11、0.47。结论胎儿脐动脉和母体子宫动脉S/D、PI、RI与早发型重度子痫前期患者围生儿不良事件密切相关,其检测可用于临床围生儿不良预后防治。

Objective To investigate the correlation of hemodynamic parameters of fetal umbilical artery and maternal uterine artery under color Doppler ultrasound with perinatal prognosis of patients with early-onset severe preeclampsia. Methods The clinical data of 126 patients with earlyonset severe preeclampsia in Xinmi Maternal and child Health Hospital were retrospectively analyzed,and the patients were divided into poor group( n = 33) and good group( n = 93) according to prognosis events of perinatal infants. The ratio of maximum end-systolic blood flow velocity and maximum enddiastolic blood flow velocity( S/D),pulsatility index( PI) and resistance index( RI) of fetal umbilical artery and maternal uterine artery were compared between the two groups. The receiver operating characteristics( ROC) curve was used to describe the predictive efficacy of the above indicators in the prognosis of perinatal infants of patients with with early-onset severe preeclampsia. Results The levels of fetal umbilical artery S/D,PI and RI and maternal uterine artery S/D,PI and RI in poor group were significantly higher than those in good group( P all < 0. 05),and the cutoff values of predicting the adverse prognosis events of perinatal infants were 2. 59, 1. 12, 0. 67, 2. 35, 1. 11 and 0. 47.Conclusions Fetal umbilical artery and maternal uterine artery S/D,PI and RI are closely correlated with adverse events of perinatal infants of patients with early-onset severe preeclampsia,and their detection can be used for the prevention and treatment of clinical adverse prognosis of perinatal infants.