S/D值在子痫前期患者妊娠结局预测中的价值

The value of S/D value in predicting pregnancy outcome of patients with preeclampsia

目的探讨脐血流收缩期血流峰速/舒张末期血流谷速值在子痫前期患者不良妊娠结局预测中的价值。方法598例子痫前期孕产妇(患者组)、240名健康孕产妇(对照组)均于孕28周—30周行腹部彩超检查,检测胎儿脐血流收缩期血流峰速/舒张末期血流谷速值,统计两组不良妊娠结局发生率,并比较不同妊娠结局子痫前期患者组与对照组的检测结果。采用线性回归分析及受试者工作特征曲线探讨脐血流收缩期血流峰速/舒张末期血流谷速值在子痫前期患者不良妊娠结局预测中的价值。结果患者组不良妊娠结局发生率显著高于对照组(P<0.01);不良妊娠结局患者组脐血流收缩期血流峰速/舒张末期血流谷速值>良好妊娠结局患者组>对照组,组间两两比较差异有统计学意义(P<0.01)。进行线性回归分析得到回归方程:Y=0.234+0.489X;绘制受试者工作特征曲线显示,脐血流收缩期血流峰速/舒张末期血流谷速值预测子痫前期不良妊娠结局的曲线下面积为0.902,最佳阈值取2.375时,可以得到理想的敏感度、特异度,分别为0.965、0.911。结论子痫前期患者胎儿脐血流收缩期血流峰速/舒张末期血流谷速值升高,可能预示着不良妊娠结局高风险,可将其动态监测用于子痫前期患者不良妊娠结局风险的预测。

Objective To explore the value of cord blood flow systolic peak velocity/diastolic valley velocity(S/D)value in predicting pregnancy outcome of patients with preeclampsia.Methods 598 pregnant women with preeclampsia(the patients group),240 healthy pregnant women(the control group)underwent abdominal color ultrasound examination at 28-30 weeks of admission,and the fetal umbilical blood flow S/D value was calculated.The incidence of adverse pregnancy outcome in both groups was compared,and examination result of the patients with different pregnancy outcomes group and control group were compared.Linear regression analysis and receiver operating characteristic curve(ROC)were used to explore the value of cord blood flow S/D value in predicting adverse pregnancy outcomes in patients with preeclampsia.Results The incidence of adverse pregnancy outcomes in the patient group was significantly higher than that in the control group(P<0.01).The cord blood flow S/D value of the patients in the adverse pregnancy outcome group>good pregnancy outcome patient group>control group,the difference between groups was statistically significant(P<0.01).The regression equation was obtained by linear regression analysis:Y=0.234+0.489x.The receiver operating characteristic curve(ROC)showed that the area under curve(AUC)of cord blood flow S/D value predicting adverse pregnancy outcome in preeclampsia was 0.902.When the optimal threshold was 2.375,the ideal sensitivity and specificity could be obtained,which were 0.965 and 0.911 respectively.Conclusions Elevated fetal cord blood flow S/D value in preeclampsia patients may indicate a high risk of adverse pregnancy outcomes.Dynamic monitoring can be used to predict the risk of adverse pregnancy outcomes in preeclampsia patients.Conclusions Elevated fetal cord blood flow S/D value in preeclampsia patients may indicate a high risk of adverse pregnancy outcomes.Dynamic monitoring can be used to predict the risk of adverse pregnancy outcomes in preeclampsia patients.