GDM孕妇孕晚期胎儿脐动脉超声参数、血清FFA及PL在FGR诊断中的应用

Application of Ultrasonic Parameters of Fetal Umbilical Artery,Serum FFA and PL in the Diagnosis of FGR in GDM Pregnant Women in Late Pregnancy

本研究探讨妊娠糖尿病(GDM)孕妇孕晚期胎儿脐动脉(UA)彩超指标、血清游离脂肪酸(FFA)、磷脂(PL)与胎儿生长受限(FGR)的关系。选取确诊的113例GDM且伴有FGR孕妇作为FGR组,另外选取同期妊娠的120例GDM孕妇作为对照组;彩色多普勒超声检测两组胎儿UA的血流参数,并检测血清FFA、PL水平,受试者操作特征(ROC)曲线分析各项参数诊断GDM孕妇FGR的价值。FGR组的血清FFA、PL水平均显著高于对照组(P<0.05);血清FFA、PL水平诊断FGR的AUC值分别为0.842、0.738;FGR组胎儿脐动脉S/D、PI、RI值均显著高于对照组(P<0.05);脐动脉S/D、PI、RI诊断FGR的AUC值分别为0.827、0.719、0.757;FGR组的血清FFA、PL与S/D值、PI、RI呈正相关(P<0.05)。GDM伴FGR胎儿UA的血流参数发生明显改变,孕妇血清的FFA、PL水平增高,孕晚期检测上述指标对于评估FGR有一定的价值,同时S/D值、PI、RI与新生儿出生时缺氧有关。

This study investigated the relationship between fetal umbilical artery(UA)color Doppler ultrasound,serum free fatty acids(FFA),phospholipids(PL)and fetal growth restriction(FGR)in pregnant women with gestational diabetes mellitus(GDM)in late pregnancy.113 pregnant women with GDM who were diagnosed with FGR were selected as the FGR group,and the other 120 pregnant women with GDM who were pregnant during the same period were selected as the control group.Color Doppler ultrasonography was used to detect the blood flow parameters of the fetuses UA in the two groups,and the serum levels of FFA and PL.The receiver operating curve analyzed the value of various parameters in the diagnosis of FGR in pregnant women with GDM.The levels of serum FFA and PL in FGR group were significantly higher than those in control group(P<0.05).The AUC values of serum FFA and PL levels in the diagnosis of FGR were 0.842 and 0.738,respectively.The S/D,PI and RI of fetal umbilical artery in FGR group were significantly higher than those in control group(P<0.05).The AUC values of umbilical artery S/D,PI,and RI in the diagnosis of FGR were 0.827,0.719,and 0.757,respectively.Serum FFA,PL in FGR group were positively correlated with S/D,PI and RI(P<0.05).The blood flow parameters of the fetus UA with GDM and FGR changed significantly,and the serum FFA and PL levels of pregnant women increased.The detection of the above indicators in the late pregnancy has a certain value for evaluating FGR.At the same time,S/D value,PI and RI are related to hypoxia at birth.