本文選題：高血壓 + 妊娠性　； 參考：《中國臨床醫(yī)學影像雜志》2017年04期

【摘要】：目的:探討多項臨床數(shù)據(jù)及子宮動脈血流動力學指標在妊娠高血壓疾病(PIH)患者不良結局預測中的價值。方法:選擇2016年5月—2016年8月西北婦女兒童醫(yī)院有完整隨訪資料的中晚孕期PIH患者87例,收集常規(guī)臨床數(shù)據(jù),應用常規(guī)經腹超聲檢查檢測雙側子宮動脈血流動力學指標,并對孕婦進行隨訪,以隨訪期發(fā)生子癇、胎兒宮內窘迫以及提前終止妊娠等為不良結局。根據(jù)妊娠最終結局將患者分為良性結局組和不良結局組,采用Logistic回歸數(shù)據(jù)統(tǒng)計方法,篩選PIH患者不良結局的危險因素。結果:隨訪期有63例PIH患者(72.4%)出現(xiàn)不良結局。與良性結局組比較,不良結局組中重度子癇前期所占比例增加顯著(58.7%vs 20.8%,P=0.003),且雙側子宮動脈舒張早期切跡的比例顯著增加(39.7%vs 16.7%,P=0.042);隨訪期出現(xiàn)不良結局的孕婦其晚孕期搏動指數(shù)(PI)、阻力指數(shù)(RI)、收縮期血流速度與舒張末期血流速度比值(S/D)較良性結局組均顯著增加(P0.05)。以PI取值0.97預測不良結局的敏感度為50.8%,特異度為83.8%;以RI取值0.51預測不良結局的敏感度為63.5%,特異度為70.8%;以S/D取值2.1預測PIH不良結局的敏感度為65.1%,特異度為70.8%;多因素Logistic回歸分析顯示,RI0.51可做為PIH不良結局的獨立預測因子(OR=4.224,P=0.006)。結論 :PIH可造成子宮動脈血流動力學多項指標不同程度的改變,子宮動脈血流動力學參數(shù)異常對于預測PIH不良結局有一定的意義,其中RI可做為PIH不良結局的獨立預測因子。
[Abstract]:Objective: to investigate the value of multiple clinical data and uterine artery hemodynamic indexes in predicting adverse outcomes in patients with pregnancy-induced hypertension (PIH).Methods: 87 PIH patients with complete follow-up data from May 2016 to August 2016 in Northwest Women's and Children's Hospital were selected. Routine clinical data were collected and hemodynamic indexes of bilateral uterine arteries were detected by routine transabdominal ultrasonography.The adverse outcomes were eclampsia, fetal distress and early termination of pregnancy.According to the final outcome of pregnancy, the patients were divided into benign outcome group and bad outcome group. Logistic regression data were used to screen the risk factors of adverse outcome of PIH patients.Results: during the follow-up period, 63 patients with PIH (72.4%) had adverse outcomes.Compared with the benign outcome group,The proportion of moderate to severe preeclampsia increased significantly in poor outcome group (58.7 vs 20.8), and the ratio of early diastolic notch of bilateral uterine artery increased significantly, and 39.7% vs 16.7g / P 0.042%; the late pregnancy pulsatility index (Pi), resistance index (RI) and resistance index (RI) of pregnant women with poor outcome during follow-up were significantly increased.The ratio of systolic velocity to end diastolic velocity (S / D) was significantly higher than that of benign outcome group (P 0.05).The sensitivity and specificity of predicting adverse outcome with Pi value 0.97 were 50.8 and 83.8 respectively; the sensitivity of 0.51 with RI value was 63.5 and the specificity was 70.8; the sensitivity with S / D value of 0.97 was 65.1 and the specificity was 70.8 with RI value 0.51; with multiple factors, the sensitivity of predicting adverse outcome of PIH was 65.1 and the specificity was 70.8 by using Pi value of 0.97; the sensitivity of 0.51 with RI value of 0.51 was 63.5 and the specificity was 70.8.Logistic regression analysis showed that RI0.51 could be used as an independent predictor of PIH adverse outcome.Conclusion the abnormal parameters of uterine artery hemodynamics can be used to predict the adverse outcome of PIH, and RI can be used as an independent predictor of adverse outcome of PIH.
【作者單位】： 第四軍醫(yī)大學附屬西京醫(yī)院超聲科;辛辛那提大學醫(yī)學中心;西北婦女兒童醫(yī)院;
【分類號】：R445.1;R714.246

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