超声检测胎儿MCA联合UA及右心室Tei指数诊断胎儿宫内缺氧效果

Diagnostic efficacy of the indexes values of fetal middle cerebral artery and umbilical artery examined by ultrasound combined with the fetal right ventricular myocardial performance index value for the fetal intrauterine hypoxia

目的:探讨超声检测胎儿大脑中动脉(MCA)联合脐动脉(UA)及右心室心肌做功(Tei)指数诊断胎儿宫内缺氧的价值。方法:选择2020年1月-2022年12月在本院住院分娩的108例产妇临床资料,根据出生后胎儿是否发生宫内缺氧分为缺氧组(n=32)和正常组(n=76),记录产妇一般资料,彩色多普勒超声仪检测胎儿MCA、UA血流收缩期/舒张期(S/D)值、阻力指数(RI)和搏动指数(PI),右心室等容收缩时间(ICT)、等容舒张时间(IRT)和射血时间(ET),计算右心室Tei指数,Kappa一致性分析胎儿MCA、UA指标联合右心室Tei指数诊断胎儿宫内缺氧的价值。结果:缺氧组胎儿MCA的S/D值(3.27±0.88)、RI值(0.67±0.06)和PI值(1.58±0.39)均低于正常组(4.65±1.27、0.80±0.11、1.93±0.22),胎儿UA的S/D值(3.82±0.18)、RI值(0.86±0.21)和PI值(1.71±0.25)均高于正常组(2.54±0.31、0.63±0.17、0.95±0.22),胎儿右心室Tei指数(0.57±0.08)高于正常组(0.41±0.07)(均P<0.05)。MCA、UA指标联合右心室Tei指数诊断胎儿宫内缺氧的敏感度87.5%,特异度75.0%,Kappa值为0.550。结论:胎儿超声MCA联合UA及右心室Tei指数可提高诊断胎儿宫内缺氧的敏感度,一致性较高,可为临床诊断胎儿宫内缺氧提供参考指标。

Objective:To explore the diagnostic efficacy of the indexes values of fetal middle cerebral artery(MCA) and umbilical artery(UA) examined by ultrasound combined with the fetal right ventricular myocardial performance(Tei) index value for the fetal intrauterine hypoxia(FIH).Methods:The clinical data of 108 women who had delivered in hospital between January 2020 and December 2022 were selected in this study.According to presence or absence of FIH,the fetuses of these women were divided into study group(32 fetuses with FIH) and control group(76 fetuses without FIH).The general data of the women in the two groups were recorded.The values of MCA and UA indexes,such as peak systolic velocity/end diastolic velocity(S/D),and resistance index(RI),and pulsatility index(PI),and the values of the right ventricular isovolumetric contraction time(ICT),the isovolumic relaxation time(IRT),and the ejection time(ET) of the fetuses in the two groups were examined by color Doppler ultrasound.The right ventricular Tei index of the fetuses in the two groups was calculated.Kappa consistency analysis was used to analyze the value of the MCA and UA indexes combined with the right ventricular Tei index of the fetuses for diagnosing their FIH.Results:The values of S/D(3.27±0.88),RI(0.67±0.06),and PI(1.58±0.39) of MCA of the fetuses in the study group were significantly lower than those(4.65±1.27,0.80±0.11,and 1.93±0.22) of the fetuses in the control group.The values of S/D(3.82±0.18),RI(0.86±0.21),and PI(1.71±0.25) of UA of the fetuses in the study group were significantly higher than those(2.54±0.31,0.63±0.17,and 0.95±0.22) of the fetuses in the control group.The fetal right ventricular Tei index value(0.57±0.08) of the fetuses in the study group was significantly higher than that(0.41±0.07)of the fetuses in the control group(all P<0.05).The sensitivity and the specificity of the MCA and UA indexes combined with the right ventricular Tei index of the fetuses for diagnosing their FIH were87.5% and 75.0%,and Kappa value of which was 0.550.Conclusion:The indexes of fetal MCA and UA examined by ultrasound combined with the fetal right ventricular Tei index for diagnosing their FIH can improve the diagnostic sensitivity,with high consistency,and which can provide the reference indexes for the clinical diagnosis of FIH.