子宫动脉血流频谱联合e-Flow胎盘血流在妊娠期高血压103例中的应用价值

Application value of uterine artery flow spectrum combined with e-Flow placental flow in 103 cases of hypertension during pregnancy

目的研究e-Flow胎盘血流结合子宫动脉血流频谱在妊娠期高血压疾病中的应用价值。方法回顾性分析2021年5月至2023年2月邯郸市中心医院103例纳入时无高血压,后随访出现妊娠期高血压孕妇作为妊娠期高血压组,选择产检正常且无高血压的110例正常孕妇作为健康组。收集妊娠期高血压组未出现高血压时以及健康组的子宫动脉血流频谱和e-Flow胎盘血流数据,获得子宫动脉阻力指数、搏动指数、收缩期峰值与舒张末期流速比值(S/D),舒张早期切迹与胎盘血管图像;采用受试者操作特征曲线(ROC曲线)分析各指标单独以及联合预测妊娠期高血压的价值。结果妊娠期高血压组搏动指数、阻力指数及S/D值高于健康组(P<0.05)。子宫动脉舒张早期切迹存在率方面,妊娠期高血压组相较于健康组更高(P<0.05)。妊娠期高血压组三级绒毛动脉计数少于健康组[(2.34±0.48)个比(4.36±0.53)个,P<0.05]。ROC曲线显示,搏动指数、阻力指数、S/D、三级绒毛动脉计数联合检查对妊娠期高血压的灵敏度、特异度为74.80%、93.30%,预测价值高于单独检查。结论子宫动脉血流频谱联合e-Flow胎盘血流能有效预测妊娠期高血压发生,可作为临床早期疾病评估的有效检查方式。

Objective To study the application value of uterine artery flow spectrum combined with e-Flow placental flow in hypertensive diseases during pregnancy.Methods A retrospective analysis was performed on 103 patients from Handan Central Hospital from May 2021 to February 2023 who were not hypertensive at the time of admission and were followed up with hypertension during pregnancy as the gestational hypertension group,and 110 normal pregnant women who were not hypertensive during normal pregnancy and childbirth were selected as the healthy group.Uterine artery flow spectrum and e-Flow placental flow data were collected in the hypertensive group during pregnancy and the healthy group,and uterine artery pulsation index,resistance index,ratio of peak systolic to end-diastolic flow velocity(S/D),early diastolic notch and placental blood vessel images were obtained.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of each indicator alone and in combination for gestational hypertension.Re⁃sults The pulsatility index,resistance index and S/D value of the gestational hypertension group were higher than those of the healthy group(P<0.05).The presence rate of uterine artery diastolic notch in gestational hypertension group was higher(P<0.05).The count of tertiary villous arteries was lower in the gestational hypertension group than the healthy group(2.34±0.48 vs.4.36±0.53,P<0.05).The ROC curve showed that the sensitivity and specificity of pulsatility index,resistance index,S/D and tertiary villus artery count combined examination for gestational hypertension were 74.80%and 93.30%,respectively,with the predictive value higher than the examination with each indicator alone.Conclusion Examination of uterine artery blood flow spectrum combined with e-Flow placental blood flow can effectively predict gestational hypertension,which is of great value in early clinical assessment of the disease.