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    胎儿脐动脉与大脑中动脉血流频谱预测晚孕期胎儿窘迫的临床价值比较

    Clinical value of color Doppler ultrasound detection of blood flow frequency spectrum of fetal middle cerebral artery and umbilical artery for predicting fetal distress in late pregnancy

      摘要
    • 摘要:
      目的比较彩色多普勒超声检测胎儿脐动脉（UA）和大脑中动脉（MCA）血流动力学指标对于预测晚孕期胎儿窘迫的临床价值。
      方法选取晚孕期孕妇为研究对象，分为胎儿窘迫组（n=80）和无胎儿窘迫组（n=200）。胎儿窘迫组中40例检测UA指标胎儿脐动脉收缩期峰值流速/舒张末期流速（S/D）值、阻力指数（RI）、搏动指数（PI），40例检测MCA指标RI、PI；无胎儿窘迫组中100例检测UA指标S/D值、RI、PI，100例检测MCA指标RI、PI。
      结果胎儿窘迫组病人UA指标RI、PI和S/D值均明显高于无胎儿窘迫组（P < 0.01）；胎儿窘迫组病人MCA指标RI和PI均明显低于无胎儿窘迫组（P < 0.01）。UA和MCA指标对于胎儿窘迫的检出率分别为85.0%（34/40）和67.5%（27/40），检出率差异有统计学意义（P < 0.05）；UA和MCA指标对于胎儿窘迫的误诊率分别为9.0%（9/100）和2.0%（2/100），差异有统计学意义（P < 0.05）。
      结论UA和MCA指标在胎儿窘迫的预测方面，均具有重要的临床价值；UA指标对于胎儿窘迫的检出率要高于MCA指标，但其误诊率也高于MCA指标。

       

      Abstract:
      ObjectiveTo compare the clinical value of color Doppler ultrasound detection of fetal umbilical artery (UA) and middle cerebral artery (MCA) hemodynamics in predicting fetal distress in late pregnancy.
      MethodsPregnant women in late pregnancy were selected and randomly divided into fetal distress group(n=80) and non-fetal distress group(n=200).UA indexes including systolic and diastolic velocity ratio (S/D), resistance index(RI) and blood flow pulsation index(PI) were detected in 40 patients, and MCA indexes including RI and PI were detected in other 40 patients from fetal distress group.UA indexes including S/D, RI and PI were detected in 100 patients, and MCA indexes including RI and PI were detected in other 100 patients from non-fetal distress group.
      ResultsUA indexes including S/D, RI and PI in fetal distress group were significantly higher than those in non-fetal distress group(P < 0.01), and MCA indexes including RI and PI in fetal distress group were significantly lower than those in non-fetal distress group (P < 0.01).The detection rates of UA and MCA indexes for fetal distress were 85.0% (34/40) and 67.5% (27/40), respectively, and the difference of which was statistically significant(χ2=6.05, P < 0.05).The misdiagnosis rates of UA and MCA indexes for fetal distress were 9.0% (9/100) and 2.0% (2/100), respectively, and the difference of which was statistically significant (χ2=4.71, P < 0.05).
      ConclusionsBoth UA and MCA indexes have important clinical values in the prediction of fetal distress.The detection rate of UA index for fetal distress is higher than that of MCA index, but the misdiagnosis rate of UA index is also higher than that of MCA index.

       

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