子宫动脉血流参数联合血清β-HCG、P、E2预测复发性流产再次妊娠孕妇流产的价值研究

Study on the Value of Uterine Artery Blood Flow Parameters Combined with Serumβ-HCG,P and E2 in Predicting Abortion in Pregnant Women with Recurrent Spontaneous Abortion Re-Pregnancy

目的:探讨子宫动脉血流参数[搏动指数(PI)、阻力指数(RI)、收缩期/舒张期血流速度(S/D)]联合血清β-人绒毛膜促性腺激素(β-HCG)、孕酮(P)、雌二醇(E_(2))预测复发性流产(RSA)再次妊娠孕妇流产的价值。方法:选取2021年1月~2022年10月安徽省妇幼保健院收治的RSA再次妊娠孕妇145名(RSA组),另选取同期我院145名健康孕妇(对照组),根据妊娠结局将RSA再次妊娠孕妇分为流产组(65例)和活产组(80例)。检测血清β-HCG、P、E_(2)水平,并采用经阴道超声检测子宫动脉血流参数。多因素Logistic回归分析影响RSA再次妊娠孕妇流产的因素,受试者工作特征(ROC)曲线分析子宫动脉血流参数联合血清β-HCG、P、E_(2)预测RSA再次妊娠孕妇流产的价值。结果:RSA组PI、RI、S/D高于对照组,血清β-HCG、P、E_(2)水平低于对照组(P<0.05)。流产组PI、RI、S/D高于活产组,血清β-HCG、P、E_(2)水平低于活产组(P<0.05)。多因素Logistic回归分析显示年龄增加、PI、RI、S/D升高为RSA再次妊娠孕妇流产的独立危险因素,β-HCG、P、E_(2)升高为独立保护因素(P<0.05)。子宫动脉血流参数联合血清β-HCG、P、E_(2)预测RSA再次妊娠孕妇流产的曲线下面积为0.941,高于单一指标预测(P<0.05)。结论:RSA再次妊娠孕妇PI、RI、S/D升高和血清β-HCG、P、E_(2)降低,与流产发生密切相关。子宫动脉血流参数联合血清β-HCG、P、E_(2)对RSA再次妊娠孕妇流产的预测价值较高。

Objective:To investigate the value of uterine artery blood flow parameters[pulsation index(PI),resistance index(RI),systolic/diastolic blood flow velocity(S/D)]combine with serumβ-human chorionic gonadotropin(β-HCG),progesterone(P)and estradiol(E_(2))in predicting abortion in pregnant women with recurrent spontaneous abortion(RSA)re-pregnancy.Methods:145 pregnant women with RSA re-pregnancy(RSA group)who were admitted to Anhui Maternal and Child Health Hospital from January 2021 to October 2022 were selected,and 145 healthy pregnant women(control group)in our hospital during the same period were selected,pregnant women with RSA re-pregnancy were divided into abortion group(65 cases)and live birth group(80 cases)according to the pregnancy outcome.The levels of serumβ-HCG,P and E_(2) were detected,and the uterine artery blood flow parameters were detected by transvaginal ultrasound.The factors affecting of abortion in pregnant women with RSA re-pregnancy were analyzed by multivariate Logistic regression analysis,the value of uterine artery blood flow parameters combined with serumβ-HCG,P and E_(2) in predicting abortion in pregnant women with RSA re-pregnancy were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of PI,RI and S/D in RSA group were higher than those in control group,and the levels of serumβ-HCG,P and E_(2) were lower than those in control group(P<0.05).PI,RI and S/D in abortion group were higher than those in live birth group,and serumβ-HCG,P and E_(2) levels were lower than those in live birth group(P<0.05).Multivariate logistic regression analysis showed that increased age,PI,RI,and S/D were independent risk factors for abortion in pregnant women with RSA re-pregnancy,and increasedβ-HCG,P,and E_(2) were independent protective factors(P<0.05).The area under the curve of uterine artery blood flow parameters combined with serumβ-HCG,P and E_(2) to predict abortion in pregnant women with RSA re-pregnancy was 0.941,which was higher than that predicted by single index(P<0.05).Conclusion:The increase of PI,RI and S/D and the decrease of serumβ-HCG,P and E_(2) in pregnant women with RSA re-pregnancy are closely relate to the occurrence of abortion.Uterine artery blood flow parameters combine with serumβ-HCG,P and E_(2) have a higher predictive value for abortion in pregnant women with RSA.