河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (6): 710-715.doi: 10.3969/j.issn.1007-3205.2025.06.014

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超声指标联合血清胎盘蛋白-13对迟发型胎儿宫内生长受限的预测价值研究

  

  1. 河北省保定市第一中心医院超声二科，河北 保定 071000

  • 出版日期:2025-06-25 发布日期:2025-07-04
  • 作者简介:孔亚荣（1985-），女，河北保定人，河北省保定市第一中心医院主治医师，医学学士，从事彩色多普勒超声诊断研究。
  • 基金资助:
    保定市科技计划项目(2441ZF220)

Study on the predictive value of ultrasound indicators combined with serum placental protein-13 for late-onset intrauterine growth restriction of fetuses

  1. The Second Department of Ultrasound, the First Central Hospital of Baoding City, Hebei Province, Baoding 071000, China

  • Online:2025-06-25 Published:2025-07-04

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摘要： 目的 研究超声评估静脉导管血流参数（S波、D波、A波）联合胎盘蛋白-13检测对迟发型胎儿宫内生长受限（fetal intrauterine growth restriction，FGR）的预测价值。
方法 选取2022年12月—2023年12月于我院妇产科分娩的130例孕晚期孕妇，其中晚发型FGR 42例（观察组），正常88例（对照组），晚发型FGR患者根据脐动脉、子宫动脉的血流特点分为Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组。比较观察组、对照组静脉导管血流速度（S波、D波、A波）、血清胎盘蛋白-13水平，分析不同亚组晚发型FGR患者的各项指标差异，采用受试者工作特征曲线（receiver operating characteristic，ROC）曲线分析静脉导管血流速度（S波、D波、A波）、血清胎盘蛋白-13对于晚发型FGR的预测价值。
结果 观察组S波［（55.84±8.46） cm/s vs. （60.67±7.78） cm/s］、D波［（42.89±6.64） cm/s vs. （48.38±7.47） cm/s］、A波［（23.35±4.58） cm/s vs. （31.68±4.45） cm /s］以及血清胎盘蛋白-13［（0.98±0.15） cm/s vs. （1.15±0.18） cm/s］均低于对照组（P＜0.05）。不同亚型孕妇静脉导管血流速度（S波、D波、A波）、血清胎盘蛋白-13水平差异有统计学意义，其中随着分级的增加，S波、D波、A波以及血清胎盘蛋白-13水平呈增加趋势（P＜0.05）。Logistic回归分析显示，静脉导管血流速度（S波、D波、A波）、血清胎盘蛋白-13是导致孕晚期FGR的影响因素(P＜0.05)。ROC曲线分析显示，S波、D波、A波、血清胎盘蛋白-13预测FGR的AUC分别为0.766（95%CI：0.672~0.861）、0.765（95%CI：0.663~0.862）、0.751（95%CI：0.653~0.856）、0.816（95%CI：0.717~0.916），联合预测FGR的AUC为0.875（95%CI：0.793~0.952），各项指标联合预测FGR的AUC高于单独预测（P＜0.05）。
结论 静脉导管血流速度（S波、D波、A波）与胎盘蛋白-13均与FGR的发生、发展关联密切，联合检测可提高FGR的预测效能。


关键词: 胎儿生长迟缓, 超声, 胎盘蛋白-13

Abstract: Objective To study the value of ultrasound evaluation of blood flow parameters (S wave, D wave, A wave) combined with placenta protein-13 detection in the prediction of late-onset intrauterine growth restriction (FGR). 
Methods A total of 130 pregnant women who gave birth in the Department of Obstetrics and Gynecology of our hospital from December 2022 to December 2023 were selected, including 42 patients with late-onset FGR (observation group) and 88 patients with normal FGR (control group). According to the blood flow characteristics of umbilical artery and uterine artery, the patients with late-onset FGR were divided into group Ⅰ, group Ⅱ, group Ⅲ and group Ⅳ. The blood flow velocity (S wave, D wave, A wave) and serum placenta protein-13 levels of intravenous catheter were compared between the observation group and the control group, and the differences of various indexes in patients with late-onset FGR in different subgroups were analyzed. The predictive value of intravenous catheter blood flow velocity (S wave, D wave, A wave) and serum placenta protein-1 for late-onset FGR was analyzed by receiver operating characteristic (ROC) curve. 
Results The S wave ［(55.84±8.46） cm/s vs. （60.67±7.78） cm/s］, D wave ［(42.89±6.64） cm/s vs. （48.38±7.47） cm/s］, A wave ［(23.35±4.58） cm/s vs. （31.68±4.45） cm/s］ and serum placental protein-13 ［(0.98±0.15） cm/s vs. （1.15±0.18） cm/s］ in the observation group were lower than those in the control group (P＜0.05). There were significant differences in blood flow velocity (S wave, D wave, A wave) and serum placental protein-13 levels in different subtypes of pregnant women, and the levels of S wave, D wave, A wave and serum placental protein-13 showed an increasing trend with the increase of grade (P＜0.05). Logistic regression analysis showed that intravenous catheter blood flow velocity (S wave, D wave, A wave) and serum placenta protein-13 were the influential factors of FGR in late pregnancy (P＜0.05). ROC curve analysis showed that the area under the ROC curve (AUC) of S wave, D wave, A wave and serum placenta protein-13 for predicting FGR was 0.766 (95%CI: 0.672-0.861), 0.765 (95%CI: 0.663-0.862), 0.751 (95%CI: 0.653-0.856) and 0.816 (95%CI: 0.717-0.916), respectively, the AUC of combined prediction for FGR was 0.875 (95%CI: 0.793-0.952), and the AUC of combined prediction for FGR was higher than that of single prediction (P＜0.05). 
Conclusion The intravenous catheter blood flow velocity (S wave, D wave, A wave) and placenta protein-13 are closely related to the occurrence and development of FGR, and the combined detection can improve the prediction efficiency of FGR. 


Key words: fetal growth retardation, ultrasound, placentin-13

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