诊断学理论与实践2023，Vol.22Issue(6)：550-554,5.DOI:10.16150/j.1671-2870.2023.06.006
自身免疫相关复发性流产子宫动脉及子宫内膜超声参数分析
Analysis of uterine blood flow parameters in immune-related recurrent spontaneous abortion
摘要
Abstract
Objective:To analyze the uterine artery and endometrial blood flow parameters by in patients with au-toimmune-related recurrent spontaneous abortion(RSA)for providing clinical referene.Methods:A total of 48 patients with more than 2 consecutive miscarriages from March 2021 to March 2022 were selected.Transvaginal three-dimensional ultrasound were used to measure endometrial thickness,endometrial volume,hemodynamic parameters of the endometrium[vascularization index(VI)and vascularization flow index(VFI)],and blood flow parameters[resistance index(RI),pulsatil-ity index(PI),and peak systolic to lowest diastolic velocity ratio(S/D)]of bilateral uterine arteries were assessed in 6-9 days after ovulation.According to the autoimmune-related indexes(antinuclear antibody,anti-cardiolipin antibody、,beta 2 glycoprotein Ⅰ,anti-double strand DNA antibody),patients were divided into observation group and control group.Pa-tients with all negative results were classified as non-autoimmune-related RSA(control group),while those with one or more abnormal indexes were considered RSA(observation group).Ultrasonographic parameters were compared between the two groups,and receiver operating characteristic(ROC)curves were used to evaluate the predictive value of ultrasonographic parameters for autoimmune-related RSA.Results:Autoimmune-related RSA accounted for 25%of clinically recurrent mis-carriages.The VI and VFI values in the observation group were lower than those in the control group(P=0.005,0.017).The average levels of PI and RI of bilateral uterine arteries in the observation group were significantly higher than those in the control group(P≤0.001,0.001).There was no statistical difference in endometrial thickness and endometrial volume be-tween the two groups.ROC curve analysis showed that uterine artery PI>2.895,RI>0.885,endometrial VI<1.518%,and VFI<0.140 predicted autoimmune-related RSA with area under the curve(AUC)values of 0.738,0.746,0.809,0.774,re-spectively.Conclusions:Compared to other RSA cases,patients with autoimmune-related RSA have increased uterine ar-tery PI and RI values and reduced endometrial blood flow perfusion.Clinicians should be vigilant in screening for autoim-mune-related indexes in such patients during clinical ultrasound examinations.关键词
复发性流产/免疫/子宫动脉/血管形成指数/血管形成-血流指数Key words
Recurrent spontaneous abortion/Immunity/Uterine artery/Vascularization index/Vascularization flow index分类
医药卫生引用本文复制引用
孔晓晓,陈萍,牛建梅,吕明丽,王慧..自身免疫相关复发性流产子宫动脉及子宫内膜超声参数分析[J].诊断学理论与实践,2023,22(6):550-554,5.基金项目
上海交通大学附属国际和平妇幼保健院院内课题(YN201810) （YN201810）
