孕期子宫动脉超声参数动态分析与子痫前期风险的相关性研究

储华; 陆艳; 刘明松

doi:10.16766/j.cnki.issn.1674-4152.002645

孕期子宫动脉超声参数动态分析与子痫前期风险的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.002645

湖州市妇幼保健院超声科，浙江湖州 313000

基金项目:

浙江省医药卫生科技计划项目 2021KY1084

浙江省湖州市科学技术局项目 2019GYB15

详细信息

通讯作者:
储华, E-mail: chuhua501@163.com

中图分类号: R714.245 R445.1
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出版历程
- 收稿日期: 2021-12-14
- 网络出版日期: 2022-11-29

The correlation between the dynamic analysis of uterine artery ultrasound parameters during pregnancy and the risk of preeclampsia

Department of Ultrasound, Huzhou Maternal and Child Health Hospital, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的动态分析孕期患者子宫动脉超声参数及其与子痫前期发生风险的相关性。方法纳入2020年1月—2021年10月湖州市妇幼保健院接受子宫动脉超声检查的60例子痫前期患者为子痫前期组，另纳入同期接受子宫动脉超声检查的60例未发生子痫前期的孕妇为对照组。动态分析2组患者孕期子宫动脉超声参数及其与孕期孕妇子痫前期的相关性。结果 2组孕妇随孕期的延长RI值、PI值、S/D值均降低，且对照组RI值、PI值、S/D值均低于子痫前期组(均P＜0.05)；Pearson相关系数分析显示，孕11~16周及孕20~24周RI值、PI值、S/D值与孕妇子痫前期风险呈正相关(r=0.602、0.774、0.638；r=0.809、0.833、0.608，均P＜0.05)；多因素logistic回归分析显示，孕11~16周及孕20~24周高RI值、高PI值、高S/D是孕期孕妇子痫前期的危险因素(OR=2.463、1.239、1.599；OR=1.643、1.568、1.741，均P < 0.05)；ROC曲线分析显示，孕11~16周子宫动脉超声参数预测价值(AUC为0.965)高于孕20~24周子宫动脉超声参数(AUC为0.885，P＜0.05)。结论随着孕期的延长孕妇子宫动脉RI、PI、S/D指标逐渐降低，与孕妇子痫前期发生风险呈正相关，并可作为孕妇子痫前期发生风险的预测指标。
- 孕期 /
- 子宫动脉 /
- 超声 /
- 动态分析 /
- 子痫前期
Abstract: Objective To dynamically analyse the ultrasound parameters of uterine arteries and their correlation with the risk of preeclampsia in pregnant patients. Methods A total of 60 cases of preeclampsia patients who received uterine artery ultrasonography in Huzhou Maternity and Children ' s Health Hospital from January 2020 to October 2021 were included in the preeclampsia group, and 60 patients who received uterine artery ultrasonography during the same period without preeclampsia were included as the control group. The ultrasound parameters of the uterine artery during pregnancy and their correlation with preeclampsia during pregnancy were dynamically analysed. Results The RI value, PI value and S/D value of pregnant women in both groups decreased with the prolongation of pregnancy, and the RI value, PI value and S/D value of the control group were lower than those of the preeclampsia group (all P < 0.05). Pearson correlation coefficient analysis showed that the RI value, PI value and S/D value at 11-16 weeks of pregnancy and 20-24 weeks of pregnancy were positively correlated with the risk of preeclampsia (r=0.602, 0.774, 0.638; r=0.809, 0.833, 0.608, all P < 0.05). Multivariate logistic regression analysis showed that high RI value, high PI value and high S/D value at 11-16 weeks of pregnancy and 20-24 weeks of pregnancy were the risk factors of preeclampsia in pregnant women (OR=2.463, 1.239, 1.599; OR=1.643, 1.568, 1.741, all P < 0.05). ROC curve analysis showed that the predictive value of uterine artery ultrasound parameters at 11-16 weeks of gestation (AUC was 0.965) was higher than the uterine artery ultrasound parameters at 20-24 weeks of gestation (AUC was 0.885, P < 0.05). Conclusion The RI, PI and S/D index of the uterine artery in pregnant women decrease with the prolongation of pregnancy, which is positively correlated with the risk of preeclampsia in pregnant women, and can be used as a predictor of the risk of preeclampsia in pregnant women.
- Pregnancy /
- Uterine artery /
- Ultrasound /
- Dynamic analysis /
- Preeclampsia

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图 1 2组孕妇孕11~16周RI值、PI值、S/D值比较

Figure 1. Comparison of RI value, PI value and S/D value between the two groups during 11 - 16 weeks of pregnancy

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图 2 2组孕妇孕20~24周RI值、PI值、S/D值比较

Figure 2. Comparison of RI, PI and S/D values between the two groups at 20 - 24 weeks of gestation

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图 3 不同孕周子宫动脉超声参数预测子痫前期发生风险的ROC曲线

Figure 3. ROC curve of uterine artery ultrasound parameters predicting the risk of preeclampsia at different gestational weeks

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表 1 2组孕妇临床资料比较

Table 1. Comparison of clinical data between two groups of pregnant women

项目	对照组(n=60)	子痫前期组(n=60)	统计量	P值
年龄(x±s，岁)	24.57±5.60	26.61±5.98	1.929^a	0.056
吸烟[例(%)]	2(3.33)	3(5.00)	＜0.001^b	0.999
饮酒[例(%)]	3(5.00)	4(6.67)	＜0.001^b	0.999
BMI(x±s)	25.53±3.28	24.69±3.05	1.453^a	0.149
受孕方法[例(%)]			1.034^b	0.309
自然受孕	57(95.00)	59(98.33)
人工受孕	3(5.00)	1(1.67)
经产妇[例(%)]	27(45.00)	25(41.67)	0.136^a	0.713
胎次(x±s，次)	1.47±0.31	1.42±0.28	0.927^a	0.356
RI_(11~16周)值(x±s)	0.64±0.09	0.70±0.06	3.842^a	< 0.001
PI_(11~16周)值(x±s)	1.93±0.42	2.34±0.50	4.895^a	< 0.001
S/D_(11~16周)值(x±s)	0.54±0.13	0.68±0.15	5.279^a	< 0.001
RI_(20~24周)值(x±s)	0.56±0.12	0.62±0.14	2.402^a	0.018
PI_(20~24周)值(x±s)	1.30±0.16	1.62±0.37	6.126^a	< 0.001
S/D_(20~24周)值(x±s)	0.46±0.21	0.57±0.20	3.011^a	0.003
HR(x±s，次/min)	85.58±6.80	87.26±8.86	1.165^a	0.246
MAP(x±s，mm Hg)	86.34±10.25	88.75±10.30	1.285^a	0.201
注：^a为t值, ^b为χ²值。1 mm Hg=0.133 kPa。

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表 2 不同孕周子宫动脉超声参数与子痫前期风险的相关性

Table 2. Correlation between uterine artery ultrasound parameters at different gestational weeks and the risk of preeclampsia

项目	11~16周			20~24周
项目	r值	95% CI	P值	r值	95% CI	P值
RI值	0.602	0.496~0.703	< 0.001	0.809	0.758~0.856	< 0.001
PI值	0.774	0.714~0.830	< 0.001	0.833	0.778~0.886	< 0.001
S/D值	0.638	0.545~0.723	< 0.001	0.608	0.503~0.699	< 0.001

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表 3 相关变量赋值表

Table 3. Related variable assignment table

变量	赋值方法
是否发生子痫前期	是=1，否=0
RI_(11~16周)值	以实际值赋值
PI_(11~16周)值	以实际值赋值
S/D_(11~16周)值	以实际值赋值
RI_(20~24周)值	以实际值赋值
PI_(20~24周)值	以实际值赋值
S/D_(20~24周)值	以实际值赋值

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表 4 孕期子痫前期风险的影响因素分析

Table 4. Analysis of factors influencing the risk of preeclampsia during pregnancy

变量	B	SE	Wald χ²	P值	OR值	95% CI
RI_(11~16周)值	0.901	0.389	5.383	0.020	2.463	2.150~2.775
PI_(11~16周)值	0.214	0.068	10.065	0.002	1.239	1.085~1.415
S/D_(11~16周)值	0.469	0.213	4.832	0.028	1.599	1.052~2.030
RI_(20~24周)值	0.497	0.234	4.492	0.034	1.643	1.638~2.601
PI_(20~24周)值	0.450	0.127	12.615	＜0.001	1.568	1.223~1.810
S/D_(20~24周)值	0.554	0.165	11.225	0.001	1.741	1.259~2.007

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