胎盘病理、胎盘血流在胎儿生长受限中检测意义观察

摘要/Abstract

摘要： 目的探究胎盘病理、胎盘血流在胎儿生长受限（FGR）中的检测意义。方法选择2022年5月—2023年3月于北京大学第一医院宁夏妇女儿童医院及银川市妇幼保健院被确诊为FGR的90例孕妇为研究组,另取同期于上述医疗机构就诊的90例健康孕妇为对照组,在孕32周时对两组孕妇开展胎盘血流动态监测,记录上述时间点胎盘血流搏动指数（PI）、血流阻力指数（RI）和脐动脉收缩期峰值与舒张末期流速比值（S/D）并进行组间比较,而后按照研究组孕妇胎盘血流灌注病理结果将其分为A组（胎盘血流灌注不良,21例）和B组（胎盘血流灌注正常,69例）,比较两亚组孕妇PI、RI、S/D差异,采用Pearson相关性分析的方式探究FGR孕妇PI、RI、S/D的相关性,并通过绘制受试者曲线的方式计算PI、RI、S/D对FGR的诊断效能。结果研究组孕妇的PI、RI、S/D均显著高于对照组（P<0.05）;A组孕妇的PI、RI、S/D均显著高于B组（P<0.05）;Pearson相关性分析显示,FGR孕妇的PI值与其RI值和S/D值均呈现明显的正相关性（r=0.435,P<0.05;r=0.432,P<0.05）,同时FGR孕妇的RI值与其S/D值也呈现明显的正相关性（r=0.781,P<0.05）;通过绘制ROC曲线方式,分别计算PI、RI以及S/D对FGR的诊断效能,其AUC分别为0.674（95% CI=0.589~0.759,P<0.05）、0.901（95% CI=0.854~0.949,P<0.05）、0.727（95% CI=0.648~0.806,P<0.05）。结论 FGR孕妇的胎盘血流较健康孕妇会出现显著的改变,将PI、RI以及S/D值应用于FGR孕妇的诊断鉴别中效能较好,而FGR孕妇的胎盘病理会出现明显变化,其PI、RI以及S/D值也会随之出现变化。

关键词: 胎盘病理, 胎盘血流, 胎儿生长受限, 诊断鉴别, 检测意义

Abstract: Objective To explore the significance of placental pathology and blood flow in the detection of fetal growth restriction (FGR). Methods From May 2022 to March 2023, 90 pregnant women who were diagnosed with FGR in the First Hospital of Peking University Ningxia Women's and Children's Hospital and Yinchuan Maternal and Child Health Hospital were selected as the study group, and 90 healthy pregnant women who were treated at the same time in the above-mentioned medical institutions were selected as the control group. Placental blood flow dynamic monitoring was performed on the two groups of pregnant women at 32 weeks of gestation, and the pulsation index (PI) of placental blood flow at the above time points was recorded The blood flow resistance index (RI) and the ratio of systolic peak to end diastolic flow velocity (S/D) of umbilical artery were compared between groups. Then, according to the pathological results of placental blood perfusion of pregnant women in the study group, they were divided into group A (placental blood perfusion was poor, n=21) and group B (placental blood perfusion was normal, n=69). The differences of PI, RI, S/D values of pregnant women in the two subgroups were compared. Pearson correlation analysis was used to explore the PI, RI The correlation of S/D value, and the diagnostic efficacy of PI, RI, S/D value on FGR was calculated by drawing the subject curve. Results The PI, RI, S/D values of pregnant women in the study group were significantly higher than those in the control group (P<0.05). The PI, RI and S/D values of pregnant women in group A were significantly higher than those in group B (P<0.05). Pearson correlation analysis showed that the PI value of FGR pregnant women was significantly positively correlated with their RI value and S/D value (r=0.435, P<0.05; r=0.432, P<0.05), and the RI value of FGR pregnant women was also significantly positively correlated with their S/D value (r=0.781, P<0.05). The diagnostic efficacy of PI, RI and S/D values on FGR was calculated by drawing ROC curves. The AUC was 0.674 (95% CI=0.589~0.759, P<0.05), 0.901 (95% CI=0.854~0.949, P<0.05) and 0.727 (95% CI=0.648~0.806, P<0.05), respectively. Conclusion The placental blood flow of FGR pregnant women will change significantly compared with that of healthy pregnant women. It is better to apply PI, RI and S/D values to the diagnosis and differentiation of FGR pregnant women. The placental pathology of FGR pregnant women will change significantly, and the PI, RI and S/D values will also change.

Key words: placental pathology, placental blood flow, fetal growth restriction, diagnosis and differentiation, detection significance

中图分类号:

R714.51

王会, 文玉军. 胎盘病理、胎盘血流在胎儿生长受限中检测意义观察[J]. 中华养生保健, 2023, 41(24): 170-174.

WANG Hui, WEN Yu-jun. Significance of Placental Pathology and Blood Flow Detection in Fetal Growth Restriction[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(24): 170-174.

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