| 摘要: |
| 目的 探讨超声脐血流收缩期最大血流峰值/舒张期最小血流峰值(S/D)、脑胎盘率(CPR)联合血清胎盘生长因子(PLGF)、可溶性血管内皮因子受体-1(sFlt-1)预测胎儿生长受限(FGR)的临床价值。方法 选取2021年5月-2023年5月在本院经超声确诊为FGR的孕晚期孕妇46例作为FGR组,并选取同期46例胎儿发育正常的孕晚期孕妇作为非FGR组。 收集两组临床相关资料、均完善超声检查,记录S/D、大脑中动脉和脐动脉搏动指数,计算CPR；抽取空腹静脉血,检测血清PLGF、sFlt-1,比较两组孕妇临床相关资料及指标水平差异,多因素Logistic回归分析影响FGR发生的因素,ROC曲线分析超声指标和血清指标单项及联合预测FGR的临床价值。结果 FGR组合并妊娠高血压占比高于非FGR组(P<0.05)；FGR组超声指标S/D高于非FGR组、CPR低于非FGR组(P<0.05)；血清指标PLGF水平低于非FGR组,sFlt-1水平高于非FGR组(P<0.05)。多因素Logistic回归分析结果显示,超声指标S/D、CPR和血清指标PLGF、sFlt-1均为影响FGR发生的独立因素(P<0.05)。ROC曲线分析显示,超声指标S/D、CPR和血清指标PLGF、sFlt-1单项预测FGR发生的AUC分别为0.783、0.835、0.874、0.841,多项指标联合预测FGR发生的AUC为0.990,高于单项预测价值。结论 超声指标S/D、CPR,血清指标PLGF、sFlt-1单项均具有较好的预测价值,而联合检测价值更高。 |
| 关键词: 脐血流收缩期最大血流峰值/舒张期最小血流峰值 脑胎盘率 胎盘生长因子 可溶性血管内皮因子受体-1 胎儿生长受限 |
| DOI： |
| 投稿时间：2023-09-04修订日期：2024-03-21 |
| 基金项目: |
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| Clinical predictive value of ultrasonic S/D and CPR combined with serum PLGF and sFlt-1 for fetal growth restriction |
| luoliping,lixuexia |
| () |
| Abstract: |
| Objective To explore the clinical predictive value of ultrasonic peak systolic velocity/end diastolic velocity (S/D) and cerebroplacental ratio (CPR) combined with serum placental growth factor (PLGF) and soluble vascular endothelial factor receptor-1 (sFlt-1) for fetal growth restriction (FGR). Methods A total of 46 late pregnant women with FGR confirmed by ultrasound and 46 late pregnant women with normal fetal development in the hospital were enrolled as FGR group and non-FGR group between May 2021 and May 2023, respectively. The clinical data in the two groups were collected to complete ultrasound examinations. S/D, pulsatility index of middle cerebral artery and umbilical artery were recorded, and CPR was calculated. The fasting venous blood was collected to detect serum PLGF and sFlt-1. The differences in clinical data and the above indexes between the two groups were compared. The influencing factors of FGR were analyzed by multivariate Logistic regression analysis. The clinical predictive value of ultrasound indexes, serum indexes and combined detection for FGR was analyzed by ROC curves. Results The proportion of gestational hypertension in FGR group was higher than that in non-FGR group (P<0.05). S/D in FGR group was greater than that in non-FGR group, while CPR was lower than that in non-FGR group (P<0.05). The level of serum PLGF was lower than that in non-FGR group, while sFlt-1 was higher than that in non-FGR group (P<0.05). The results of multivariate Logistic regression analysis showed that S/D, CPR, PLGF and sFlt-1 were all independent influencing factors of FGR (P<0.05). ROC curves analysis showed that AUC values of S/D, CPR, PLGF and sFlt-1 for predicting FGR were 0.783, 0.835, 0.874 and 0.841, respectively. AUC of combined detection was 0.990, greater than that of single index. Conclusion S/D, CPR, PLGF and sFlt-1 all have good predictive value for FGR, but the combined detection has higher predictive value. |
| Key words: Cord peak systolic velocity/end diastolic velocity Cerebroplacental ratio Placental growth factor Soluble vascular endothelial factor receptor-1 Fetal growth restriction |
