诊断学理论与实践 ›› 2023, Vol. 22 ›› Issue (04): 374-378.doi: 10.16150/j.1671-2870.2023.04.007
收稿日期:
2023-02-15
出版日期:
2023-08-25
发布日期:
2023-12-18
通讯作者:
曾敏 E-mail:基金资助:
GONG Xiaoping, CAO Yunyun, WANG Haifei, WANG Guanjie, ZENG Min()
Received:
2023-02-15
Online:
2023-08-25
Published:
2023-12-18
摘要:
目的: 建立低危人群妊娠11~40周子宫动脉平均搏动指数(mean pulsatility index,mPI)的正常参考值范围,并进行前瞻性验证。方法: 收集2019年01月至2023年07月于我院建卡并于11~40周行超声检查,测量两侧子宫动脉超声参数搏动指数(pulsatility index,PI)及舒张早期是否有切迹,随访至妊娠结局,并收集孕妇基本临床资料和胎儿出生信息。结果: 本研究共纳入1 365例正常妊娠结局的低危人群,另纳入同期104例妊娠结局不良者用于验证该参考范围,包括妊娠高血压(41例)及胎儿生长受限(23例)等。随着其孕周增加,mPI呈逐渐下降的趋势,孕20周前呈快速下降(孕11周、20周时mPI第95百分位分别为2.35、1.54),随后下降缓慢,至孕32周后mPI趋于稳定(孕32周、39周时mPI第95百分位数分别为0.91、0.87)。随着孕周的增加,两侧子宫动脉舒张早期切迹的检出率呈逐渐下降的趋势,孕11~15周检出率为69.20%,孕21~25周检出率为27.01%,之后趋于稳定,孕36~40周降至6.31%。受试者操作特征曲线分析结果显示,相应孕周mPI≥第95百分位预测妊娠期高血压疾病的灵敏度为30.11%,特异度为93.21%;预测胎儿生长受限的灵敏度为61.9%,特异度为92.85%。结论: 建立低危人群妊娠11~40周子宫动脉mPI的正常参考值范围,用于前瞻性排除妊娠高血压、胎儿生长受限具有一定价值。
中图分类号:
曹云云, 龚晓萍, 王海飞, 王冠杰, 曾敏. 妊娠11~40周子宫动脉平均搏动指数参考值范围的建立及验证[J]. 诊断学理论与实践, 2023, 22(04): 374-378.
GONG Xiaoping, CAO Yunyun, WANG Haifei, WANG Guanjie, ZENG Min. Establishment and verification of reference range of parameters related to uterine artery measured by ultrasound at 11~40 weeks of pregnancy[J]. Journal of Diagnostics Concepts & Practice, 2023, 22(04): 374-378.
表1
低危人群孕妇人口统计学特征 (N=1 365)
Characteristics | Data |
---|---|
Age (y) | 31.07±3.65 |
Primiparous (n/%) | 733(53.70) |
Prepregnant BMI (kg/cm2) | 21.56±2.69 |
Fetal sex (n/%) | |
Female | 645(47.30) |
Male | 720(52.70) |
Delivery way (n/%) | |
Vaginal delivery | 718(52.60) |
Cesarean section | 647(47.40) |
Birth weight (g) | 3319±345 |
Gestational age (w) | 39.20±0.95 |
表2
孕11~40周低危人群子宫动脉mPI不同百分位数分布情况
GA(w) | mPI | ||
---|---|---|---|
5 th | 50 th | 95 th | |
11 | 1.18 | 1.75 | 2.35 |
12 | 1.04 | 1.61 | 2.26 |
13 | 0.99 | 1.59 | 2.20 |
14 | 0.96 | 1.45 | 1.94 |
15 | 0.88 | 1.30 | 1.91 |
16 | 0.82 | 1.24 | 1.77 |
17 | 0.81 | 1.21 | 1.74 |
18 | 0.79 | 1.19 | 1.70 |
19 | 0.75 | 1.10 | 1.69 |
20 | 0.73 | 1.04 | 1.54 |
21 | 0.72 | 0.99 | 1.41 |
22 | 0.68 | 0.82 | 1.31 |
23 | 0.57 | 0.77 | 1.29 |
24 | 0.55 | 0.74 | 1.27 |
25 | 0.55 | 0.72 | 1.10 |
26 | 0.52 | 0.69 | 1.09 |
27 | 0.49 | 0.68 | 1.04 |
28 | 0.47 | 0.68 | 0.95 |
29 | 0.46 | 0.67 | 0.95 |
30 | 0.43 | 0.67 | 0.93 |
31 | 0.43 | 0.67 | 0.92 |
32 | 0.43 | 0.65 | 0.91 |
33 | 0.43 | 0.65 | 0.90 |
34 | 0.41 | 0.65 | 0.90 |
35 | 0.38 | 0.65 | 0.89 |
36 | 0.35 | 0.65 | 0.88 |
37 | 0.35 | 0.64 | 0.88 |
38 | 0.34 | 0.64 | 0.87 |
39 | 0.33 | 0.64 | 0.87 |
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