| 引用本文： |
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顾玮,周晔,周雷平,等.子宫动脉血流指数在妊娠期肝内胆汁淤积症的预测价值[J].同济大学学报（医学版）,2015,36(3):48-53. [点击复制]
- GU Wei,ZHOU Ye,ZHOU Lei-ping,et al.Uterine artery blood flow indexes in prediction of intrahepatic cholestasis of pregnancy[J].同济大学学报（医学版）,2015,36(3):48-53. [点击复制]
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| 摘要: |
| 目的 探讨子宫动脉血流值在妊娠期肝内胆汁淤积症中的预测价值。方法 2012年4月至2013年6月在我院产科建卡登记的1917例孕妇,于孕11~14周及孕22~24周时使用多普勒彩色超声诊断仪检测其双侧子宫动脉收缩期与舒张期流速比(systolic to diastolic velocity ratio; S/D)、搏动指数(pulsation index; PI)、阻力指数(resistance index; RI)和血流频谱中的舒张早期切迹等4项指标,并随访至产后,按照妊娠结局分为对照组(1482例)及妊娠期肝内胆汁淤积症ICP组(26例)。应用双变量相关法找到妊娠期肝内胆汁淤积症的有效预测指标,并分析各子宫动脉血流阻力指数与妊娠结局的关系；再应用ROC曲线及约登指数评判各指标的预测价值并确定子宫动脉血流阻力的预测界值。结果 1917例孕妇中诊断为妊娠期肝内胆汁淤积症者共26例,ICP的发生率为1.36%。分别将S/D值、PI值、RI值及舒张早期切迹作为ICP的预测方法均具有统计学意义(P＜0.05),且其预测界值分别为2.12、0.82及0.58。另外,孕中期各子宫动脉血流阻力指数大小与新生儿体质量呈负相关,舒张早期V形切迹的出现与出生孕周及新生儿体质量均呈负相关,差异有统计学意义(P＜0.05)。结论 运用子宫动脉血流指标(包括PI值、RI值、S/D值和舒张早期V形切迹)用于预测妊娠期肝内胆汁淤积症,具有很好的临床应用价值。 |
| 关键词: 妊娠期肝内胆汁淤积症 预测 多普勒超声检查 子宫动脉血流指数 |
| DOI：10.16118/j.1008-0392.2015.03.011 |
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| 基金项目:上海市卫生局基金(20114146) |
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| Uterine artery blood flow indexes in prediction of intrahepatic cholestasis of pregnancy |
| GU Wei,ZHOU Ye,ZHOU Lei-ping,LIN Jing |
| (Dept.of Gynecology and Obstetrics, International Peace Maternal and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China;Dept.of Ultrasonography, International Peace Maternal and Child Health Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200030, China) |
| Abstract: |
| Objective To evaluate the uterine artery blood flow indexes in prediction of intrahepatic cholestasis of pregnancy(ICP). Methods A total of 1917 pregnant women who were registered in our hospital from April 2012 to June 2013 were included in the study. The systolic to diastolic velocity ratio(S/D) , pulsation index(PI), resistance index(RI) and early diastolic notch of blood flow spectrum of bilateral uterine arteries were measured in 11-14 and 22-24 weeks of pregnancy by the Color Doppler ultrasonography and were followed up till postpartum. The correlation between ICP and uterine artery blood flow indexes was analyzed, and the cut-off values in ROC curve of blood flow indexes for predicting ICP was evaluated by Youden index.Results Among 1917 pregnant women, 26 cases developed ICP(ICP group) with an incidence rate of 1.36%, and 1482 cases without any pregnant complications served as control group. Adapting 2.12(S/D), 0.82(PI), 0.58(RI) in the second trimester as cut-off values for prediction of ICP, the Youden index of these three indexes was 0.41,0.42 and 0.41, respectively. The uterine artery blood flow resistance in the second trimester was negatively correlated with the newborn birth weight and the early diastolic notch in the second trimester negatively was correlated with the newborn birth weight and gestational weeks at delivery (P＜0.05). Conclusion Indexes of uterine artery blood flow (PI, RI, S/D and early diastolic notch) present a good clinical application value for the prediction of ICP. |
| Key words: intrahepatic cholestasis of pregnancy prediction Doppler Ultrasound indexes of uterine artery blood flow |
