脐血管及华通胶面积与胎儿生长受限相关性研究

Correlation study of umbilical vessels and Wharton’s jelly area with fetal growth restriction

目的:探讨脐血管及华通胶横截面积与胎儿生长受限(FGR)的相关性,为FGR的发病机制及临床诊疗提供依据。方法:收集2020年8月至2021年12月于安徽医科大学第一附属医院分娩的孕妇新生儿脐带105条,其中FGR 35例,正常对照组70例,取最细段脐带组织进行Masson染色,采用数码显微镜进行显微摄像并分析比较脐带各组成部分变化与FGR的相关性。结果:FGR组的脐带横截面积、华通胶面积、脐静脉横截面积均显著低于对照组,差异有统计学意义(P<0.05),两组的脐动脉横截面积、脐静脉壁厚、脐动脉壁厚比较差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,华通胶面积(aOR=0.368,P=0.001)及脐静脉横截面积(aOR=0.250,P<0.001)与FGR发病独立负相关。结论:脐静脉及华通胶面积减少与FGR显著相关,这可能是FGR的发病机制之一。

Objective:To investigate the correlation of umbilical vessels and Wharton’s jelly area with fetal growth restriction(FGR),and to provide a basis for the development of the mechanism of FGR and clinical management.Methods:During the period from August 2020 to December 2021,105 umbilical cords were collected from the fetus of pregnant women delivered in the First Affiliated Hospital of Anhui Medical University, including 35 cases with fetal growth restriction and 70 cases of normal control group.The thinnest section of the umbilical cord tissue was taken for Masson staining.Microscope images were obtained by a digital microscope and the correlation of changes in the components of the umbilical cord with FGR was analyzed.Results:The cross-sectional area of the umbilical cord, Wharton’s jelly, and umbilical vein were significantly lower in the FGR group than those in the control group(P<0.05).The cross-sectional area of the umbilical artery, the wall thickness of the umbilical vein and umbilical artery were not significantly different between the two groups(P>0.05).Multivariate logistic regression analysis showed that the cross-sectional area of Wharton’s jelly(aOR=0.368,P=0.001) and umbilical vein(aOR=0.250,P<0.001) were independently associated with FGR.Conclusion:The area of umbilical vein and Wharton’s jelly was negatively correlated with the onset of fetal growth restriction, which may be one of the pathogenic mechanisms of fetal growth restriction.