多普勒超声联合血清FE3、ACTA预测孕妇羊水过少并胎儿窘迫

doi:10.7517/issn.1674-0475.210724

摘要/Abstract

摘要： 选取224例羊水过少孕妇作为观察组，60例羊水正常孕妇作为对照组，探讨多普勒超声测定肾动脉（RA）、大脑中动脉（MCA）、脐动脉（UA）阻力指数，以及血清游离雌三醇（FE3）、激活素A （ACTA）水平，对孕妇羊水过少并胎儿窘迫预测价值及临床意义。结果显示，观察组RA和UA阻力指数、血清ACTA水平高于对照组，羊水量、MCA阻力指数及血清FE3水平低于对照组（P<0.05）；羊水过少孕妇RA和UA阻力指数、血清ACTA水平与羊水量呈负相关，MCA阻力指数、血清FE3水平与羊水量呈正相关；上述指标联合预测胎儿窘迫的AUC最大，为0.918（P<0.05）。说明多普勒超声测定RA、MCA、UA阻力指数结合血清FE3、ACTA水平检测对羊水过少孕妇并胎儿窘迫有较高预测价值。

关键词: 多普勒超声, 肾动脉, 大脑中动脉, 脐动脉, 胎儿窘迫

Abstract: A total of 224 cases of oligohydramnios pregnant women were selected as the observation group, and 60 cases of normal amniotic fluid pregnant women were selected as the control group. The predictive value and clinical significance of renal artery (RA), middle cerebral artery (MCA), umbilical artery (UA) resistance index were measured by Doppler ultrasound, and serum free estriol (FE3), activin A (ACTA) in pregnant women with oligohydramnios and fetal distress were studied. The results showed that RA,UA resistance index, serum ACTA levels in observation group were higher than those in control group, while amniotic fluid volume, MCA resistance index and serum FE3 level were lower than those of the control group (P<0.05). In oligohydramnios, RA, UA resistance index and serum ACTA levels were negatively correlated with amniotic fluid volume, while MCA resistance index and serum FE3 levels were positively correlated with amniotic fluid volume. The AUC of the above indicators combined to predict fetal distress was 0.918 (P<0.05).These results indicate that Doppler ultrasonography determination of RA, MCA and UA resistance index combined with serum FE3 and ACTA levels has a high predictive value for fetal distress in oligohydramnios pregnant women.

Key words: Doppler ultrasound, renal artery, middle cerebral artery, umbilical artery, fetal distress

路炜, 牛占杰, 孟腾腾, 单倩倩. 多普勒超声联合血清FE3、ACTA预测孕妇羊水过少并胎儿窘迫[J]. 影像科学与光化学, 2022, 40(1): 38-42.

LU Wei, NIU Zhanjie, MENG Tengteng, Shan Qianqian. Prediction of Oligohydramnios and Fetal Distress by Doppler Ultrasound Combined with Serum FE3 and ACTA[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(1): 38-42.

参考文献

[1] 李建敏, 李娜, 周玲, 等. 超声脐动脉血流联合血清β-HCG, 胎心监护预测胎儿宫内窘迫的价值[J]. 中国医师杂志, 2020, 22(2):295-298.
[2] 吴巧, 田瑞, 司利华. 脐绕颈胎儿临产前三条动脉血流动力学参数的联合检测对胎儿窘迫发生的预测价值[J]. 河北医学, 2017, 23(7):1128-1132.
[3] 常贝, 李倩, 贾红娥. 多普勒超声检测UA、MCA阻力指数联合Tei指数预测胎儿窘迫的价值[J]. 中国现代医学杂志, 2019, 29(22):63-67.
[4] 王蓉蓉. 血清Free-β-HCG、PAPP-A、uE3联合NT在孕早期胎儿染色体异常筛查中的价值分析[J]. 中国优生与遗传杂志, 2019, 27(7):777-779, 787.
[5] Zhao H J, Chang H M, Zhu H, et al. Bone morphogenetic protein 2 promotes human trophoblast cell invasion by inducing activin a production[J]. Endocrinology, 2018, 159(7):2815-2825.
[6] 张蓓, 闫辉波. 孕妇血雌三醇及脐动脉血流S/D比值检查对胎儿窘迫诊断的价值[J]. 血栓与止血学, 2019, 25(1):23-26.
[7] 田学琴, 马丽红. 胎膜未破与胎膜早破残留羊水过少对围生期结局的影响[J]. 宁夏医科大学学报, 2020, 42(2):172-174.
[8] 李艳川, 张雅, 张矛, 等. 羊水过少与胎儿窘迫以及胎盘组织水通道蛋白9和凋亡蛋白Caspase7表达的关系[J]. 中国妇幼保健, 2018, 33(24):5976-5979.
[9] Niesłuchowska-Hoxha A, Cnota W, Czuba B, et al. A retrospective study on the risk of respiratory distress syndrome in singleton pregnancies with preterm premature rupture of membranes between 24⁺⁰ and 36⁺⁶ weeks, using regression analysis for various factors[J]. BioMed Research International, 2018, 2018(1):7162478.
[10] 赵金菊, 骆学东. 胎儿动脉MCA、MCA与UA的阻力指标在高血压产妇母婴结局预测价值[J]. 内蒙古医科大学学报, 2019, 41(4):354-356, 359.
[11] 张婷婷, 唐胜利, 谢雷, 等. 足月妊娠激活素A和急性胎儿窘迫的关联关系探讨[J]. 安徽医药, 2019, 23(12):2471-2475.
[12] 蒋婷婷, 王伟, 高继生, 等. 缺氧缺血性脑病早产儿血清tau蛋白、激活素A、神经特异性烯醇化酶的水平变化及临床意义[J]. 中国医药导报, 2018, 15(27):78-81.
[13] 李力敏, 辛素芳, 冯卿, 等. 激活素-A和环氧化酶-2联合检测诊断早产儿脑损伤的应用价值分析[J]. 中国妇幼保健, 2019, 34(6):1286-1288.
[14] 赵咏梅, 张传英, 陈俭辉, 等. 唐氏筛查指标在子痫前期筛查中的应用及妊娠结局分析[J]. 标记免疫分析与临床, 2019, 26(12):2089-2092, 2144.
[15] Leathersich S J, Vogel J P, Tran T S, et al. Acute tocolysis for uterine tachysystole or suspected fetal distress[J]. The Cochrane Database of Systematic Reviews, 2018, 7(7):CD009770.
[16] 胡诗婉, 唐倩. 人绒毛膜促性激素β亚基和游离雌三醇水平对妊娠并发症和妊娠结局的预测作用[J]. 贵州医科大学学报, 2020, 45(5):600-604, 610.
[17] 石莉, 洪燕, 符小艳, 等. 超声结合血清学筛查Dandy-Walker综合征效果[J]. 中国计划生育学杂志, 2020, 28(12):2071-2073, 2138.
[18] 陈霏, 王碧. 血清游离雌三醇和脂联素水平与妊娠糖尿病孕晚期发生胎儿窘迫的相关性研究[J]. 现代检验医学杂志, 2019, 34(6):101-104.