[1]李转平,党苗苗,李萌萌.彩色多普勒超声监测妊娠期高血压疾病患者子宫动脉血流动力学参数临床价值研究[J].陕西医学杂志,2021,50(9):1098-1101,1105.[doi:DOI:10.3969/j.issn.1000-7377.2021.09.014]
　LI Zhuanping,DANG Miaomiao,LI Mengmeng.Clinical value of color Doppler ultrasound monitoring uterine artery hemodynamic parameters in patients with hypertensive disorder complicating pregnancy[J].,2021,50(9):1098-1101,1105.[doi:DOI:10.3969/j.issn.1000-7377.2021.09.014]
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彩色多普勒超声监测妊娠期高血压疾病患者子宫动脉血流动力学参数临床价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
50
期数:
2021年9期
页码:
1098-1101,1105
栏目:
临床研究
出版日期:
2021-09-05

文章信息/Info

Title:
Clinical value of color Doppler ultrasound monitoring uterine artery hemodynamic parameters in patients with hypertensive disorder complicating pregnancy
作者:
李转平1; 党苗苗1; 李萌萌2
(1.铜川市人民医院南院超声医学科,陕西 铜川 727000; 2.西安大兴医院儿科,陕西 西安 710016)
Author(s):
LI Zhuanping; DANG Miaomiao; LI Mengmeng
(Department of Ultrasound Medicine,South Branch of Tongchuan People's Hospital,Tongchuan 727000,China)
关键词:
妊娠期高血压疾病;  彩色多普勒超声;  子宫动脉;  血流动力学;  妊娠结局
Keywords:
Hypertensive disorder complicating pregnancy;  Color Doppler ultrasound;  Uterine artery;  Hemodynamics;  Pregnancy outcome
分类号:
R 445.1
DOI:
DOI:10.3969/j.issn.1000-7377.2021.09.014
文献标志码:
A
摘要:
目的:探究彩色多普勒超声监测妊娠期高血压疾病(HDCP)患者子宫动脉血流动力学参数的临床价值。方法:选择行产前检查单胎HDCP孕妇120例作为HDCP组,选择同期正常妊娠无合并症的孕妇100例作为对照组。又将HDCP孕妇分为妊娠期高血压组、轻度子痫前期组和重度子痫前期组。采用彩色多普勒超声测定并比较各组孕妇子宫动脉阻力指数(RI)、搏动指数(PI)和收缩-舒张流速比值(S/D)。分析子宫动脉血流动力学参数对HDCP的预测价值。比较HDCP组与对照组不良妊娠结局发生情况。分析孕妇子宫动脉血流动力学参数与不良妊娠结局的相关性。结果:HDCP组孕妇子宫动脉PI、RI、S/D值显著高于对照组(均P<0.05)。重度子痫前期组和轻度子痫前期组患者PI、RI、S/D值高于妊娠期高血压组,且重度子痫前期组患者上述指标值高于轻度子痫前期组(均P<0.05)。子宫动脉PI、RI、S/D预测HDCP的曲线下面积(AUC)为0.707、0.666、0.718,预测重度子痫前期的AUC为0.813、0.870、0.887。HDCP组不良妊娠结局发生率高于对照组(41.67%与7.00%,P<0.05)。Logistic多因素分析显示,在矫正孕妇年龄、孕前高危因素暴露史、既往不良孕产史等因素后,子宫动脉PI、RI、S/D与不良妊娠结局相关(OR=1.394、1.292、1.425,均P<0.05)。结论:HDCP孕妇存在子宫动脉血流动力学异常,在孕早中期采用彩色多普勒超声监测子宫动脉血流动力学参数对诊断或预测HDCP具有一定临床价值,可为早期预防或治疗提供参考。
Abstract:
Objective:To explore the clinical value of color Doppler ultrasound monitoring uterine artery hemodynamic parameters in patients with hypertensive disorder complicating pregnancy(HDCP).Methods:120 singleton pregnant women with HDCP who underwent prenatal examinations were selected as HDCP group,and 100 normal pregnant women without complications during the same period were selected as control group.HDCP pregnant women were divided into gestational hypertension group,mild preeclampsia group and severe preeclampsia group.The RI,PI and S/D of uterine artery were measured by color Doppler ultrasound and compared between groups.The predictive value of uterine artery hemodynamic parameters for HDCP was analyzed.Adverse pregnancy outcomes were compared between HDCP group and control group.The correlation between uterine artery hemodynamic parameters and adverse pregnancy outcomes was analyzed.Results:The PI,RI and S/D of uterine artery in HDCP group were significantly higher than those in control group(all P<0.05).The PI,RI and S/D of severe preeclampsia group and mild preeclampsia group were higher than those of gestational hypertension group,and the above indexes of severe preeclampsia group were higher than those of mild preeclampsia group(all P<0.05).The AUC of PI,RI and S/D in predicting HDCP were 0.707,0.666 and 0.718,and those in predicting severe preeclampsia were 0.813,0.870 and 0.887.The incidence of adverse pregnancy outcomes in HDCP group was higher than that in control group(41.67% vs.7.00%,P<0.05).Logistic multivariate analysis showed that PI,RI and S/D of uterine artery were correlated with adverse pregnancy outcomes after correcting factors such as age,history of exposure to high-risk factors before pregnancy and previous history of adverse pregnancy and delivery(OR=1.394,1.292,1.425,all P<0.05).Conclusion:Pregnant women with HDCP have uterine arterial hemodynamic abnormalities.Color Doppler ultrasound monitoring of uterine artery hemodynamics in the first and second trimesters of pregnancy has a certain clinical value in the diagnosis or prediction of HDCP,which can provide reference for early prevention or treatment.

参考文献/References:

[1] Jennifer LJ,Torri DM,Melinda BD,et al.Short-term risk of cardiovascular readmission following a hypertensive disorder of pregnancy[J].Heart,2018,104(14):1187-1194.
[2] Danielle LW,Susan PW,Alison MF,et al.Sleep-disordered breathing in hypertensive disorders of pregnancy:A BMI-matched study[J].J Sleep Res,2018,27(10):1123-1125.
[3] 宋娟利.复方丹参注射液联合硫酸镁治疗妊娠期高血压疾病及对患者微炎症状态、肾功能的影响[J].陕西中医,2016,37(4):406-407.
[4] 侯雅莉,杜会英,谢 垒,等.可溶性ST2、NT-proBNP在妊娠期高血压疾病检测的临床意义[J].中国急救复苏与灾害医学杂志,2020,15(1):87-90.
[5] 王益群.妊娠期高血压疾病相关影响因素及对妊娠结局影响的研究[J].中华全科医学,2015,13(4):602-604.
[6] 李晓菲,吴青青,王 琪,等.妊娠中晚期子宫-胎盘-胎儿循环与妊娠期高血压疾病进展程度的相关研究[J].中国妇产科临床杂志,2013,14(2):123-127.
[7] 李 荆,曹小娟,韦庆深,等.超声监测妊娠早期母体-胎盘循环预测妊娠期高血压疾病的临床研究[J].实用医学杂志,2014,30(16):2601-2603.
[8] Philips EM,Trasande L,Kahn LG,et al.Early pregnancy bisphenol and phthalate metabolite levels,maternal hemodynamics and gestational hypertensive disorders[J].Hum Reprod,2019,34(2):365-373.
[9] 李笑天,张晓磊.妊娠期高血压疾病再认识及其防治策略[J].上海医学,2019,10(6):78-79.
[10] 周美芳.早发型子痫前期血清胎盘生长因子与子宫动脉血流、分娩孕周及新生儿出生体重的关系[J].中国计划生育学杂志,2019,27(1):107-110.
[11] 郭海健,何金懋,赵雅文.超声心动图检查对子痫前期患者母胎损伤程度的评价作用[J].中华高血压杂志,2019,27(10):84-87.
[12] 杨 孜,张为远.妊娠期高血压疾病诊治指南(2015)[J].中华妇产科杂志,2015,50(10):721-728.
[13] 张 展,刘 慧,石 瑛.Th17细胞/Treg细胞免疫平衡在正常妊娠维持与子痫前期发病中的作用[J].中华围产医学杂志,2016,19(1):73-76.
[14] 张 丽,赵莉娜,彭 静,等.子痫前期孕妇血清白细胞介素17、和肽素及血小板内皮细胞黏附分子1水平检测及临床意义[J].陕西医学杂志,2020,49(11):1515-1518,1526.
[15] 郑 琴,胡小秋.孕中期子宫动脉收缩期与舒张期流速比值和血清维生素D水平对重度子痫前期的预测及诊断价值[J].中华高血压杂志,2020,28(11):73-75.
[16] 温玉玲,郁 丁.妊娠期高血压疾病患者子宫螺旋动脉特征的超声评估及其与胎盘缺氧损伤的相关性[J].海南医学院学报,2017,23(23):3259-3262,3266.
[17] 马 强,蔺 莉,梁雪静,等.彩色多普勒超声在妊娠期高血压孕妇子宫动脉血流动力学参数监测中的意义及对母婴结局影响[J].中国生育健康杂志,2019,30(6):524-529.
[18] 陈志伟,阳建军.超声检测母体子宫动脉及胎儿脐动脉血流参数对妊娠期高血压的诊疗价值[J].中国计划生育学杂志,2018,26(6):77-79.
[19] 蒋永悟.妊娠期高血压患者尿蛋白和血常规水平分析及对妊娠结局的影响[J].陕西医学杂志,2019,48(1):128-130.
[20] Vestgaard M,Sbjrnsdóttir B,Ringholm L,et al.White coat hypertension in early pregnancy in women with pre-existing diabetes:Prevalence and pregnancy outcomes[J].Diabetologia,2019,62(12):2188-2199.
[21] Shen GF,Huang YJ,Jiang LX,et al.Ultrasound prediction of abnormal infant development in hypertensive pregnant women in the second and third trimester[J].Sci Rep,2017,7:40429.
[22] 柴国路,许 培,陈兢思,等.高龄产妇妊娠并发症及妊娠结局分析[J].中国妇产科临床杂志,2019,20(6):506-509.

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备注/Memo

备注/Memo:
基金项目:陕西省重点研发计划项目(2017ZDXM-SF-020)
更新日期/Last Update: 2021-09-06