子宫螺旋动脉血流超声检测结合血清孕酮检测对先兆流产患者妊娠结局的预测作用
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摘要
目的:探讨子宫螺旋动脉血流超声检测结合血清孕酮检测对先兆流产患者妊娠结局的预测作用。方法:回顾性分析2017年3月-2018年3月于本院行产前检查的孕5～8周孕妇检查资料300例,根据其临床诊断分为正常妊娠组(n=150)及先兆流产组(n=150),其中先兆流产组中又细分保胎成功组(n=98)和保胎失败组(n=52),所有孕妇同时抽取血清检测其孕酮值,并行子宫螺旋动脉血流超声检测其搏动指数(PI)、阻力指数(RI)及收缩末期峰值/舒张末期峰值(S/D)情况,并进行比较。观察随访6个月后的妊娠结局,分析上述检测方法对妊娠结局的预测情况。结果:三组血清孕酮值由高至低排列为正常妊娠组>保胎成功组>保胎失败组(P<0.01);三组PI及RI值由高到低排序均为保胎失败组>保胎成功组>正常妊娠组(P<0.05),正常妊娠组S/D值明显低于其他两组(P<0.05),而保胎成功组及保胎失败组S/D值比较,差异无统计学意义(P>0.05);联合检测灵敏度为85.58%,特异度为97.65%,准确率为95.8%。结论:通过子宫螺旋动脉血流超声检测结合血清孕酮检测对于先兆流产患者结局有较为准确的预测作用,能为先兆流产治疗方式的选择提供有效的数据支撑。
Objective:To investigate the predictive effect of uterine spiral arterial blood flow ultrasound combined with serum progesterone test on pregnancy outcome in patients with threatened abortion.Method:A retrospective analysis of 300 cases of pregnant women's 5-8 weeks examination data from March 2017 to March2018 in our hospital.They were divided into normal pregnancy group(n=150)and threatened abortion group(n=150)according to their clinical diagnosis.The threatened abortion group divided into the prevent miscarriages success group(n=98)and the prevent miscarriages failure group(n=52).All patients were simultaneously serum-tested for progesterone value,pulsatile index(PI),resistance index(RI),and end-systolic peak/enddip peak(S/D)measuredby uterine spiral artery blood flow ultrasound were compared.The pregnancy outcome after 6 months of follow-up were observed,the prediction of pregnancy outcomes by the above test methods were analyzed.Result:The serum progesterone levels of the three groups were ranked from high to low as thenormal pregnancy group>the prevent miscarriages success group>the prevent miscarriages failure group(P<0.01).The PI and RI of the three groups were ranked from low to high as the prevent miscarriages failure group>the prevent miscarriages success group>the normal pregnancy group(P<0.05).The S/D of the normal pregnancy group was significantly lower than that of the other two groups(P<0.05),but there was no significant difference in the S/D between the prevent miscarriages success group and the prevent miscarriages failure group(P>0.05).The combined detection sensitivity was 85.58%,the specificity was 97.65%,and the accuracy was 95.8%.Conclusion:Ultrasound detection of uterine spiral artery blood flow combined with serum progesterone detection has a more accurate predictive effect on the outcome of patients with threatened abortion,and can provide effective data support for the choice of treatment methods for threatened abortion.
Objective:To investigate the predictive effect of uterine spiral arterial blood flow ultrasound combined with serum progesterone test on pregnancy outcome in patients with threatened abortion.Method:A retrospective analysis of 300 cases of pregnant women's 5-8 weeks examination data from March 2017 to March2018 in our hospital.They were divided into normal pregnancy group(n=150)and threatened abortion group(n=150)according to their clinical diagnosis.The threatened abortion group divided into the prevent miscarriages success group(n=98)and the prevent miscarriages failure group(n=52).All patients were simultaneously serum-tested for progesterone value,pulsatile index(PI),resistance index(RI),and end-systolic peak/enddip peak(S/D)measuredby uterine spiral artery blood flow ultrasound were compared.The pregnancy outcome after 6 months of follow-up were observed,the prediction of pregnancy outcomes by the above test methods were analyzed.Result:The serum progesterone levels of the three groups were ranked from high to low as thenormal pregnancy group>the prevent miscarriages success group>the prevent miscarriages failure group(P<0.01).The PI and RI of the three groups were ranked from low to high as the prevent miscarriages failure group>the prevent miscarriages success group>the normal pregnancy group(P<0.05).The S/D of the normal pregnancy group was significantly lower than that of the other two groups(P<0.05),but there was no significant difference in the S/D between the prevent miscarriages success group and the prevent miscarriages failure group(P>0.05).The combined detection sensitivity was 85.58%,the specificity was 97.65%,and the accuracy was 95.8%.Conclusion:Ultrasound detection of uterine spiral artery blood flow combined with serum progesterone detection has a more accurate predictive effect on the outcome of patients with threatened abortion,and can provide effective data support for the choice of treatment methods for threatened abortion.
引文
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[13]聂磊.探讨孕早期血清雌二醇、孕酮及人绒毛促性腺激素水平预测在先兆流产诊断中的应用价值[J].中国妇幼保健,2017,32(1):110-112.
[14]张华,张红英,袁宁霞,等.探讨黄体酮对孕妇黄体功能不全所致的先兆流产的治疗效果[J].陕西医学杂志,2016,45(4):425-426.
[15]夏蓉,王宏宇.血清CA125和孕酮监测对早期妊娠先兆流产结局的临床意义[J].广东医学,2016,37(z1):55-56.
[16]温玉玲,郁丁.妊娠期高血压疾病患者子宫螺旋动脉特征的超声评估及其与胎盘缺氧损伤的相关性[J].海南医学院学报,2017,23(23):3259-3262,3266.
[17]韩清,王英华,薛亚丽,等.子宫螺旋动脉血流参数与孕妇血清胎盘生长因子对早发型子痫前期预测[J].中国超声医学杂志,2016,32(2):153-156.
[18]楼公先,张文瑾.血清孕酮检测联合子宫B超检查预测早期先兆流产预后的价值[J].中国妇幼保健,2017,32(21):5269-5271.
[19]王新月.早期先兆流产患者子宫螺旋动脉血流与早期妊娠结局的研究[D].郑州:郑州大学,2017.
[20]穆晓荣,李玲俐.血清孕酮联合子宫螺旋动脉血流检测对先兆流产妊娠结局的预测作用[J].中国计划生育学杂志,2018,26(3):202-205.
[2]王娟.血清孕酮、β-hCG联合检测在早期先兆流产临床诊断中的价值[J].中国妇幼保健,2017,32(16):3885-3886.
[3]陈英,李静云,何英.子宫螺旋动脉RI值对不全流产和完全流产的诊断价值[J].江苏医药,2018,44(3):275-278.
[4]刘玉蓉,邹晓燕.先兆流产不同妊娠结局妇女超声、血清孕酮、雌二醇检查结果比较[J].医学综述,2016,22(11):2250-2253.
[5]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:48-50.
[6]韩清,王英华,薛亚丽,等.子宫螺旋动脉血流参数与孕妇血清胎盘生长因子对早发型子痫前期预测[J].中国超声医学杂志,2016,32(2):153-156.
[7]谢萍.黄体酮疗法治疗先兆流产对妊娠期合并症及围生儿结局的影响[J].医学综述,2016,22(2):356-358.
[8]于淼淼.血清孕酮联合β-hCG检测对于诊断早期先兆流产的意义[J].中国妇幼保健,2016,31(15):3122-3124.
[9]蒋苏梅.血清孕酮、人绒毛膜促性腺激素、雌二醇水平联合检测对预测早期先兆流产结局的临床意义探讨[J].中国妇幼保健,2016,31(9):1937-1939.
[10]王宝金,王新月,付喜玲,等.彩色多普勒超声监测子宫螺旋动脉血流与早期先兆流产预后的关系[J].中国全科医学,2017,20(9):1132-1135.
[11]张小亮,郑兴亚,王悦,等.经阴道彩色多普勒超声对早孕期先兆流产的诊断及预后评估价值[J].影像研究与医学应用,2018,2(14):177-180.
[12]钟万霖,罗鸣,邹婕,等.能量多普勒评价先兆流产保胎治疗效果的临床应用[J].蚌埠医学院学报,2016,41(3):372-373.
[13]聂磊.探讨孕早期血清雌二醇、孕酮及人绒毛促性腺激素水平预测在先兆流产诊断中的应用价值[J].中国妇幼保健,2017,32(1):110-112.
[14]张华,张红英,袁宁霞,等.探讨黄体酮对孕妇黄体功能不全所致的先兆流产的治疗效果[J].陕西医学杂志,2016,45(4):425-426.
[15]夏蓉,王宏宇.血清CA125和孕酮监测对早期妊娠先兆流产结局的临床意义[J].广东医学,2016,37(z1):55-56.
[16]温玉玲,郁丁.妊娠期高血压疾病患者子宫螺旋动脉特征的超声评估及其与胎盘缺氧损伤的相关性[J].海南医学院学报,2017,23(23):3259-3262,3266.
[17]韩清,王英华,薛亚丽,等.子宫螺旋动脉血流参数与孕妇血清胎盘生长因子对早发型子痫前期预测[J].中国超声医学杂志,2016,32(2):153-156.
[18]楼公先,张文瑾.血清孕酮检测联合子宫B超检查预测早期先兆流产预后的价值[J].中国妇幼保健,2017,32(21):5269-5271.
[19]王新月.早期先兆流产患者子宫螺旋动脉血流与早期妊娠结局的研究[D].郑州:郑州大学,2017.
[20]穆晓荣,李玲俐.血清孕酮联合子宫螺旋动脉血流检测对先兆流产妊娠结局的预测作用[J].中国计划生育学杂志,2018,26(3):202-205.