| 刘耘利,刘彦红,暴络宁,等.子宫动脉血流超声多普勒分析对复发性流产的评估价值[J].安徽医药,2023,27(4):778-781. |
| 子宫动脉血流超声多普勒分析对复发性流产的评估价值 |
| The value of uterine artery flow ultrasound Doppler analysis in the evaluation of recurrent miscarriage |
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| DOI：10.3969/j.issn.1009-6469.2023.04.033 |
| 中文关键词: 流产，习惯性 子宫动脉血流 超声多普勒 预测价值 |
| 英文关键词: Miscarriage, habitual Uterine artery flow Ultrasound Doppler Predictive value |
| 基金项目:中国疾病预防控制中心妇幼保健中心妇幼保健分子遗传医学研究专项计划( Fy-ZX-ZD-0193) |
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| 中文摘要: |
| 目的探讨子宫动脉血流的超声多普勒对复发性流产( RSA)的评估价值。方法选取 2020年 6月至 2021年 6月于珠海市妇幼保健院就诊的 96例有至少 2次流产史的孕早期女性(早孕组)根据妊娠 28周内是否流产分为流产组( 28例)与未流产组( 68例)。另见同期的 96例无流产史的孕早期女性作为对照组。比较，三组年龄、孕周、体质量指数、血清睾酮( T)、雌二醇(E2)、促黄体生成素( LH)、促卵泡生成素( FSH)、绒毛膜促性腺激素(β-HCG)、孕酮( P)水平、血流搏动指数(PI)阻力指数( RI)及收缩期峰值流速与舒张末期峰值流速的比值( S/D)。采用 Pearson相关法分析血清指标与子宫动脉血流参数的、相关性。绘制 PI、RI、S/D及三者联合预测 RSA的价值。结果流产组、未流产组与对照组年龄、孕周、体质量指数、血清 T、E2、LH的比较，差异无统计学意义( P>0.05)。流产组血清 β-HCG、P水平低于未流产组与对照组，同时未流产组低于对照组，差异有统计学意义( P<0.05)。流产组 PI、RI、S/D(2.79±0.47、0.96±0.22、8.55±1.78)高于未流产组( 2.37±0.41、0.81±0.18、7.34±1.59)与对照组 |
| 英文摘要: |
| Objective To investigate the value of ultrasound Doppler of uterine artery flow for the assessment of recurrent miscarriage (RSA).Methods A total of 96 women with a history of at least 2 miscarriages in early pregnancy (early pregnancy group) attending the Zhuhai Center for Maternal and Child Health Care from June 2020 to June 2021 were divided into a miscarriage group (28 cases) and a nonmiscarriage group (68 cases) according to whether they miscarried within 28 weeks of gestation. Another 96 women withno history of miscarriage in early pregnancy during the same period were considered the control group. The age, gestational week, bodymass index, serum testosterone (T), estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), chorionic gonadotropin (β-HCG), progesterone (P) level, pulsatility index (PI), resistance index (RI) and the ratio of peak systolic flow rate to peak end-diastolic flow rate (S/D) were compared among the three groups. The correlation between serum indices and uterine artery flow parameters wasanalyzed by the Pearson correlation method. The values of PI, RI, and S/D and the combination of the three were plotted to predict RSA.Results There was no statistically significant difference in age, gestational week, body mass index, serum T, E2, or LH between themiscarriage group, the nonmiscarriage group and the control group (P > 0.05). Serum β -HCG and P levels in the miscarriage groupwere lower than those in the nonmiscarriage group and the control group, while those in the nonmiscarriage group were lower than thosein the control group, with statistically significant differences (P < 0.05). PI, RI, S/D were higher in the miscarriage group (2.79±0.47,0.96±0.22, 8.55±1.78) than in the nonmiscarriage group (2.37±0.41, 0.81±0.18, 7.34±1.59) versus the control group (2.02±0.35, 0.67±0.16, 6.47±1.33), while the nonmiscarriage group was higher than the control group, and the difference was statistically significant (P < 0.05). Serum β-HCG and P were significantly negatively correlated with the uterine artery flow parameters PI, RI, and S/D (P < 0.05). The area under the ROC curve for PI, RI, and S/D to predict RSA was 0.80 [95%CI(0.68, 0.92)], 0.64 [95%CI(0.63, 0.83)], the 0.79 [95%CI (0.65, 0.90)]. The area under the ROC curve for the combined prediction of RSA was the highest at 0.91 [95%CI(0.74,0.99)],which had the highest predictive value for RSA.Conclusion Transvaginal Doppler ultrasound can detect uterine artery blood flow parameters well, reflecting trophoblast invasion ability and uteroplacental blood perfusion, which can effectively predict the risk of RSA,is simple and easy to perform, and has some guiding value for the prediction and treatment of RSA. |
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