超声测定脐动脉PI、RI、S/D联合血清HIF-1α、FE3对胎儿宫内窘迫的诊断价值及与患儿病情严重程度的关联性

doi:10.3969/j.issn.1007-3205.2021.12.015

河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (12): 1437-1441.doi: 10.3969/j.issn.1007-3205.2021.12.015

超声测定脐动脉PI、RI、S/D联合血清HIF-1α、FE3对胎儿宫内窘迫的诊断价值及与患儿病情严重程度的关联性

四川省达州市中医结合医院超声科，四川达州 635000

出版日期:2021-12-25 发布日期:2021-12-27
作者简介:杨昕宇（1977-），女，四川巴中人，四川省达州市中西医结合医院副主任医师，医学学士，从事产前超声诊断研究。
基金资助:
四川省卫生和计划生育科研课题资助项目（18PJ025）

Value of ultrasound measurement of umbilical artery PI, RI, S/D combined with serum HIF-1α, FE3 in the diagnosis of fetal distress and its correlation with the severity of the disease

Department of Ultrasound, Dazhou Hospital of Traditional Chinese Medicine, Sichuan Province, Dazhou 635000, China

Online:2021-12-25 Published:2021-12-27

摘要/Abstract

摘要： 目的探讨超声测定脐动脉（perfusion index，PI）、阻力指数（resistance index，RI）、收缩末期最大血流速度/舒张末期最大血流速度（maximum end-systolic blood flow velocity/maximum end-diastolic blood flow velocity，S/D）联合血清缺氧诱导因子1α（hypoxia inducible factor 1α，HIF-1α）、游离雌三醇（free estriol，FE3）对胎儿宫内窘迫（fetal distress，FD）的诊断价值及与患儿病情严重程度的关联性。
方法选取我院发生FD的孕妇100例作为观察组，另选取无FD的健康孕妇30例作为对照组，均行超声检查及血清HIF-1α、FE3测定。比较两组PI、RI、S/D、HIF-1α、FE3水平，受试者工作特征曲线（receiver operating characteristic curve，ROC）及ROC下面积（area under ROC，AUC）分析PI、RI、S/D、HIF-1α、FE3对FD的诊断价值，Pearson相关性分析PI、RI、S/D与HIF-1α、FE3相关性，采用Logistic回归方程分析FD患儿病情程度影响因素。
结果观察组PI、FE3低于对照组，RI、S/D、HIF-1α高于对照组（P＜0.05）；FD孕妇超声测定脐动脉PI与FE3呈正相关关系，与HIF-1α呈负相关关系，RI、S/D与FE3呈负相关关系，与HIF-1α呈正相关关系（P＜0.05）；ROC曲线显示，各指标联合诊断AUC最大，为0.930，最佳敏感度、特异度分别为91.00%、83.33%；Logistic回归分析显示，妊娠高血压疾病、妊娠期糖尿病、脐动脉PI、RI、S/D及血清HIF-1α、FE3水平均为FD患儿病情程度影响因素（P＜0.05）。
结论 FD孕妇超声测定脐动脉PI、RI、S/D与血清HIF-1α、FE3表达相关，各指标联合可提高FD诊断效能，指导临床治疗及预后评估。

关键词: 胎儿窘迫, 脐动脉, 脉动指数, 阻力指数

Abstract: Objective To investigate the value of ultrasound measurement of umbilical artery PI, RI, S/D combined with serum hypoxia inducible factor 1α(HIF-1α), free estriol(FE3) in the diagnosis of fetal distress(FD) and its correlation with the severity of the disease in children.
Methods A total of 100 pregnant women with FD in our hospital were selected as the observation group, and 30 healthy pregnant women without FD were selected as the control group. All patients underwent ultrasound examination and serum HIF-1α and FE3 determinations. The levels of PI, RI, S/D, HIF-1α, and FE3 were compared between two groups. Receiver operating characteristic curve(ROC) and area under ROC(AUC) were used to analyze the diagnostic value of PI, RI, S/D, HIF-1α, and FE3 for FD. Pearson correlation analysis was performed to analyze the correlation of PI, RI and S/D with HIF-1α and FE3. Logistic regression equation was used to analyze the influencing factors of FD children′s condition.
Results PI and FE3 in the observation group were lower than those in the control group, and RI, S/D and HIF-1α were higher than those in the control group(P＜0.05). In pregnant women with FD, umbilical artery PI measured by ultrasound was positively correlated with FE3, and negatively correlated with HIF-1α. RI and S/D were negatively correlated with FE3 and positively correlated with HIF-1α(P＜0.05). ROC curve showed that the AUC of combined detection of all indicators was the largest, and the optimal sensitivity and specificity were 91.00% and 83.33% respectively. Logistic regression analysis showed that pregnancy-induced hypertension, gestational diabetes mellitus, umbilical artery PI, RI, S/D and serum HIF-1α and FE3 levels were all factors influencing the severity of FD(P＜0.05).
Conclusion The ultrasound measurement of umbilical artery PI, RI, S/D in pregnant women with FD is related to the expression of serum HIF-1α and FE3. The combination detection of these indicators can improve the diagnostic efficiency of FD, and guide clinical treatment and prognosis evaluation.

Key words: fetal distress, umbilical artery, pulsation index, resistance index

杨昕宇, 叶茜, 郭江. 超声测定脐动脉PI、RI、S/D联合血清HIF-1α、FE3对胎儿宫内窘迫的诊断价值及与患儿病情严重程度的关联性[J]. 河北医科大学学报, 2021, 42(12): 1437-1441.

YANG Xin-yu, YE Qian, GUO Jiang. Value of ultrasound measurement of umbilical artery PI, RI, S/D combined with serum HIF-1α, FE3 in the diagnosis of fetal distress and its correlation with the severity of the disease[J]. Journal of Hebei Medical University, 2021, 42(12): 1437-1441.

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超声测定脐动脉PI、RI、S/D联合血清HIF-1α、FE3对胎儿宫内窘迫的诊断价值及与患儿病情严重程度的关联性

Value of ultrasound measurement of umbilical artery PI, RI, S/D combined with serum HIF-1α, FE3 in the diagnosis of fetal distress and its correlation with the severity of the disease

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