孕中期子宫动脉血流评分与平均动脉压检测对妊娠期高血压的预测价值

Predictive value of uterine artery blood flow score and mean arterial pressure in the second trimester of pregnancy for gestational hypertension

目的探讨孕中期超声检测子宫动脉血流联合平均动脉压(MAP)检测对妊娠期高血压(HDCP)的预测效能。方法选取2021年4月至12月于三明市第一医院接受产前检查的86例产妇,随访至妊娠终止,按HDCP的诊断标准,将发生HDCP的31例产妇划定为观察组,未发生HDCP的55例产妇为正常妊娠组。对所有产妇施以孕中期超声检查,比较两组孕中期的子宫动脉搏动指数(PI)、子宫动脉阻力指数(RI)与MAP。绘制受试者工作曲线(ROC),探究3项指标单独与联合检测对HDCP的预测价值。结果观察组患者PI、RI以及MAP均高于正常妊娠组,差异有统计学意义(P<0.05)。ROC结果显示,PI、RI、MAP三者联合检测的曲线下面积(AUC)为0.913,高于三者单独检测(0.784、0.871、0.783)。结论孕中期对子宫动脉血流评分与MAP进行联合检测可有效提高HDCP诊断准确率,对于临床早发现、早预防、及时治疗HDCP具有重要意义。

Objective To investigate the predictive efficacy of uterine arterial blood flow combined with mean arterial pressure(MAP)detection by ultrasound in the second trimester of pregnancy in gestational hypertension(HDCP).Methods A total of 86 puerperae who received prenatal examinations in Sanming First Hospital from April to December 2021 were selected and followed up until termination of pregnancy.According to the diagnostic criteria of HDCP,31 puerperae with HDCP were assigned to the observation group.The 55 puerperae without HDCP were normal pregnancy group.Mid-trimester ultrasonography was performed on all puerperae,and the uterine artery pulsatility index(PI),uterine artery resistance index(RI)and MAP in the second trimester of the two groups were compared,the receiver operating characteristic(ROC)was drawm to explore the predictive value of three indicators alone or in combination of HDCP.Results The PI,RI and MAP in the observation group were higher than those in the normal pregnancy group,the differences were statistically significant(P<0.05).The ROC results showed that the area under the curve(AUC)of the combined detection of PI,RI and MAP was 0.913,which was higher than that of the three alone(0.784,0.871,0.783).Conclusion The combined detection of uterine artery blood flow score and MAP in the second trimester can effectively improve the diagnostic accuracy of HDCP,and is of great significance for clinical early detection,early prevention and timely treatment of HDCP.