宫颈超声弹性成像对早产的诊断价值

Exploration of the diagnostic value of cervical ultrasound elastography of pregnant women for their premature delivery

目的:探讨宫颈超声弹性成像对早产的诊断价值。方法:回顾性收集2017年3月-2019年5月本院产前检测的孕妇96例,根据临床诊断分为早产组(先兆早产或早产26例)和正常组(70例),比较两组宫颈超声弹性成像参数并利用受试者工作特征曲线(ROC)分析对早产的预测价值,采用logistic回归分析孕妇早产的影响因素。结果:早产组宫颈长度(CL)低于正常组,弹性比较指数(ECI)、宫颈内口应变率(ES)、宫颈外口应变率(IS)高于正常组(均P<0.05);ROC曲线分析,CL、ECI、ES、IS联合预测早产的的曲线下面积(AUC)为0.896,高于CL的0.775、ECI的0.746、ES的0.705,IS的0.784(P<0.05);二元logistic分析,孕妇年龄>30岁、自然流产史、人工流产史、CL≤3.37 cm、ECI>3.23%、ES>0.48%、IS>0.31%均为孕妇早产的独立危险因素(P<0.05)。结论:宫颈超声弹性成像参数联合诊断有助于预测早产,对临床应用有一定指导价值。

Objective:To explore the diagnostic value of cervical ultrasound elastography of pregnant women for their premature delivery.Methods:A total of 96 pregnant women undergoing prenatal examination were enrolled as the research objects between March 2017 and May 2019.According to the situation of premature delivery by clinical diagnosis,these women were divided into group A(26 cases with premature delivery or threatened premature)and group B(70 cases with normal delivery).The parameters of cervical ultrasound elastography of the women were compared between the two groups,and their predictive value for premature delivery was analyzed by receiver operating characteristic(ROC)curve.The influencing factors of premature delivery of the women were analyzed by Logistic regression analysis.Results:The cervical length(CL)of the women in group A was significantly lower than that of the women in group B,and the elastic comparison index(ECI),the internal strain rate(IS),the cervical external strain rate(ES)of the women in group A were significantly higher than those of the women in group B(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the combined values of CL,ECI,ES and IS for predicting preterm birth was 0.896,which was significantly higher than that(0.775)of the value of CL,that(0.746)of the value of ECI,that(0.705)of the value of ES,and that(0.784)of the value of IS(P<0.05).Binary logistic analysis showed that age>30 years old,history of spontaneous abortion,history of induced abortion,CL≤3.37cm,ECI>3.23%,ES>0.48%,IS>0.31%of the pregnant women were the independent risk factors for their premature delivery(P<0.05).Conclusion:The combined parameters of cervical ultrasound elastography is conducive to the diagnosis of premature delivery of the pregnant women,which is of certain guidance value for clinical application.