摘要
目的 探索三维能量多普勒超声(3D-PD)指标评估胎盘血流灌注以预测治疗性早产,指导临床早发现、早监测、早干预,实现孕产期全程个性化管理。方法 纳入2022年1—11月在福建医科大学附属漳州市医院规律产检的孕早期单胎孕妇348例,根据分娩孕周,分为早产组(31例)和足月组(317例),分析两组3D-PD测得的胎盘血管化指数(VI)、流量指数(FI)、血管化流量指数(VFI)指标的差异。采用受试者工作特征(ROC)曲线分析不同指标预测治疗性早产的诊断效能,并采用多因素Logistic回归分析影响因素。结果 早产组胎盘VI、FI、VFI均低于足月组(P <0.05)。VI、VFI预测治疗性早产的曲线下面积(AUC)相近且均大于FI,VI、VFI的灵敏度分别为70.97%、70.97%,特异度分别为89.91%、83.91%,其中VI、FI、VFI截断值分别为9.094、27.199、3.085。多因素Logistic回归分析显示,VI是导致治疗性早产的独立影响因素(P <0.001)。结论 孕早期胎盘3D-PD指标能够为早期预测治疗性早产提供量化指标,指导临床早期对高危孕妇进行干预,降低早产的发生率、病死率,改善围生期结局。
Objective To explore reliable three-dimensional power Doppler ultrasound(3D-PD) markers to evaluate placental blood perfusion in order to predict therapeutic preterm labor,so that guide clinical early detection,early prevention and early intervention,and realize personalized management of pregnancy and perinatal period.Methods A total of 348 singleton pregnant women in the first trimester were enrolled from January to November 2022 in Zhangzhou Affiliated Hospital of Fujian Medical University.According to the gestational age,they were divided into preterm group(31 cases) and term group(317 cases).The placental vascularization index(VI),flow index(FI),vascularization flow index(VFI)measured by 3D-PD in two groups was analyzed.Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of different indicators in predicting therapeutic preterm birth,and multivariate Logistic regression analysis was used to analyze the influencing factors.Results The placental VI,FI and VFI in the preterm group were lower than those in the full-term group(P<0.05).The area under the curve(AUC)of VI and VFI was similar to and greater than FI.The sensitivity of VI and VFI were 70.97% and 70.97%,and the specificity was 89.91% and 83.91%,respectively.The truncation values of VI,FI and VFI were 9.094,27.199 and 3.085,respectively.Multivariate Logistic regression analysis showed that VI was an independent factor leading to therapeutic preterm birth(P<0.001).Conclusions 3P-PD may be able to provide quantitative indicators for early prediction of therapeutic preterm birth,guide early clinical intervention for high-risk pregnant women,reduce the incidence and mortality of preterm birth,and improve the perinatal outcome.
作者
陈碧容
黄淑铉
陈宝泉
陈顺姬
杨舒萍
CHEN Birong;HUANG Shuxuan;CHEN Baoquan;CHEN Shunji;YANG Shuping(Department of Ultrasound,Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China)
出处
《中国医药指南》
2024年第19期43-46,共4页
Guide of China Medicine
关键词
孕早期
治疗性早产
三维能量多普勒超声
胎盘血流灌注
围生期
妊娠结局
Early pregnancy
Therapeutic preterm birth
Three-dimensional power doppler ultrasound
Placental blood perfusion
Perinatal period
Pregnancy outcome
