胎儿头围比值联合肺-肝信号强度比预测胎儿肺发育不良的应用价值

Value of CVR combined with LLSIR in predicting fetal pulmonary dysplasia

目的 探讨胎儿头围比值(cystic volume ratio, CVR)联合肺-肝信号强度比(lung liver signal intensity ratio, LLSIR)预测胎儿肺发育不良的价值及与预后关联性研究。方法 回顾性分析2018年1月—2020年2月许昌市立医院收治的86例胎儿肺发育不良患儿(观察组)及86例健康胎儿(对照组)的临床资料,比较两组、不同预后患儿CVR、LLSIR,采用logistic回归方程分析CVR、LLSIR与肺发育不良关系,采用接收者操作特征(ROC)曲线及曲线下面积(AUC)分析CVR、LLSIR预测肺发育不良及预后的效能,采用Pearson分析CVR、LLSIR与Apgar评分的相关性。结果 观察组CVR高于对照组,LLSIR低于对照组(P<0.05);CVR、LLSIR均与肺发育不良显著相关(P<0.05);CVR预测肺发育不良AUC为0.868,截断值为>1.61,LLSIR预测肺发育不良AUC为0.897,截断值为<1.05,CVR+LLSIR预测肺发育不良AUC为0.905(P<0.05);预后不良者CVR高于预后良好者,LLSIR、Apgar评分低于预后良好者(P<0.05);CVR与Apgar评分呈负相关,LLSIR与Apgar评分呈正相关(P<0.05);CVR预测预后的AUC为0.684,截断值为>1.89,LLSIR预测预后的AUC为0.796,截断值为<0.82,CVR+LLSIR预测预后的AUC为0.899(P<0.05)。结论 CVR、LLSIR与胎儿肺发育不良及预后效果有关,具有较高的预测价值,有望成为预测胎儿肺发育不良及预后的一个新方法。

Objective To investigate cystic volume ratio(CVR) and lung to head ratio(LLSIR) in the prediction of fetal pulmonary dysplasia and the relationship between CVR and prognosis. Methods The clinical data of 86 cases of fetal pulmonary dysplasia(observation group) and 86 healthy fetuses(control group) in our hospital from January 2018 to February 2020 were analyzed retrospectively. CVR and LLSIR were compared between the two groups with different prognosis. The relationship between CVR, LLSIR and pulmonary dysplasia was analyzed by logistic regression equation. The receiver operating characteristic(ROC) curve and area under curve(AUC) were used to analyze CVR Pearson was used to analyze the correlation between CVR, LLSIR and Apgar score. Results The CVR of the observation group was higher than that of the control group, and the LLSIR was lower than that of the control group(P<0.05);CVR and LLSIR were significantly associated with lung dysplasia(P<0.05);CVR predicted lung dysplasia AUC was 0.868, and the cut-off value was> 1.61, LLSIR predicted lung dysplasia AUC was 0.897, cut-off value was <1.05, CVR + LLSIR predicted lung dysplasia AUC was 0.905(P<0.05);Poor prognosis CVR was higher than good prognosis, LLSIR, Apgar score was lower than good prognosis(P<0.05);CVR was negatively correlated with Apgar score, LLSIR was positively correlated with Apgar score(P<0.05);CVR predicted AUC was 0.684, cutoff value was> 1.89, LLSIR predicted prognosis was AUC 0.796, cutoff The value is <0.82, and the predicted AUC of CVR + LLSIR is 0.899(P<0.05). Conclusion CVR and LLSIR are related to fetal pulmonary dysplasia and prognosis. They have high predictive value and are expected to be a new method to predict fetal pulmonary dysplasia and prognosis.