【摘要】 目的:探讨脐动脉(UA)超声参数联合同型半胱氨酸(Hcy)和D-二聚体指标在胎儿生长受限(FGR)中的诊断价值。方法:选取2020年6月至2023年6月唐山市妇幼保健院收治的87例FGR孕妇纳入FGR组,同期选取109例正常孕妇纳入正常对照组。应用彩色多普勒超声检测正常对照组和FGR组胎儿UA参数,收集孕妇血清,检测血清中Hcy和D-二聚体水平,采用受试者工作特征(ROC)曲线下面积(AUC)分析UA超声参数血流搏动指数(PI)、阻力指数(RI)、收缩期峰值血流速度与舒张末期血流速度比值(S/D)联合Hcy、D-二聚体对FGR的诊断价值。结果:FGR组的UA超声参数中PI、RI、S/D及Hcy及D-二聚体均高于正常对照组,差异有统计学意义(t=6.325、7.380、8.455、5.267、7.686,P<0.05)。ROC曲线分析,PI、RI、S/D、Hcy、D-二聚体单独诊断FGR的AUC分别为0.742、0.749、0.805、0.702和0.792,联合诊断AUC值均显著高于单独诊断的AUC,差异有统计学意义(Z=2.978、0.190、0.128、0.231、0.141,P<0.05)。结论:FGR中UA超声参数与Hcy、D-二聚体水平均有显著变化,可用于筛查FGR,两者合筛查效能更为显著。更多还原

【Abstract】 Objective: To explore the diagnostic value of ultrasound parameters of umbilical artery(UA) combined with homocysteine(Hcy) and D-dimer in fetal growth restriction(FGR). Methods: A total of 87 pregnant women with FGR who admitted to Tangshan Maternal and Child Health Care Hospital from June 2020 to June 2023 were included in the FGR group, and 109 normal pregnant women were included in the normal control group during the same period. Color Doppler ultrasound was used to measure UA parameters of fetal in normal control group and FGR group. The serums of pregnant women were collected to detect Hcy and D-dimer levels. The area under curve(AUC) of receiver operating characteristic(ROC) curve was used to analyze the diagnostic value of UA ultrasound parameters, which included pulsation index(PI), resistance index(RI), systolic/diastolic(S/D), combined with Hcy and D-dimer for FGR. Results: The PI, RI, S/D, Hcy and D-dimer levels of UA ultrasound parameters of FGR group were significantly higher than these of normal control group, and the differences were statistically significant(t=6.325, 7.380, 8.455, 5.267,7.686, P<0.05). The ROC analysis indicated that AUC values of PI, RI, S/D, Hcy and D-dimer were respectively 0.742, 0.749, 0.805,0.702 and 0.792 in alone diagnosing FGR. The AUC value of combined diagnosis was significantly higher than the alone diagnosis of each indicator, and the differences were statistically significant(Z=2.978, 0.190, 0.128, 0.231, 0.141, P<0.05). Conclusion: UA ultrasound parameters, Hcy and D-dimer levels show significant changes in FGR, and all of them can be used to screen FGR. The effectiveness of the combined screening is more significant.更多还原