摘要
Abstract
Objective:To explore the predictive value of ultrasound blood flow parameters combined with biochemical indicators in late pregnancy for perinatal adverse outcome of patients with preeclampsia.Methods:152 pregnant women with late pregnancy preeclampsia who had a routine pregnancy examination and intended to give birth in our hospital from February 2020 to June 2022 were selected as the research objects,and the uterine artery ultrasound blood flow parameters and biochemical indicators were examined.The clinical outcome of perinatal infants was recorded from outpatient reexamination and hospitalization observation to the end of pregnancy,and they were divided into good group and bad group on this basis.The ultrasonic blood flow parameters of uterine artery in late pregnancy[systolic/diastolic flow velocity ratio(S/D),resistance index(RI),pulsatility index(PI)]and biochemical indicators(uric acid,alanine aminotransferase)were compared between the two groups.Logistic regression was used to analyze the influencing factors of adverse perinatal outcomes of preeclampsia patients,and the receiver operating characteristic(ROC)was drawn to analyze the predictive value of ultrasonic blood flow parameters combined with biochemical indicators on adverse perinatal outcomes of preeclampsia patients.Results:Among 152 cases of late pregnancy with preeclampsia,60 cases had poor perinatal outcomes and 92 cases had good outcomes.The PI,S/D,RI,uric acid and alanine aminotransferase of uterine artery in the poor group were higher than those in the good group(P＜0.05).Prepregnancy body mass index(BMI)in the poor group were higher than that in the good group(P＜0.05).Logistic regression analysis showed that prepregnancy BMI,uric acid,alanine aminotransferase and uterine artery PI,S/D and RI of uterine artery were all risk factors for adverse perinatal outcomes in patients with preeclampsia(P＜0.05).ROC curve analysis showed that the sensitivity,specificity and area under the curve(AUC)of late pregnancy uterine artery ultrasound blood flow parameters PI,S/D,RI combined with biochemical indicators uric acid and alanine aminotransferase in combination predicting perinatal adverse outcome of preeclampsia patients were 71.67％,80.22％and 0.861 respectively,and the specificity and AUC of combined prediction were higher than those of single prediction(P＜0.05),but there was no significant difference between the sensitivity of combined prediction and single prediction(P＞0.05).Conclusion:Uterine artery ultrasound blood flow parameters PI,S/D,RI,uric acid and alanine aminotransferase are higher in patients with adverse perinatal outcome of preeclampsia in the late pregnancy,and they were all risk factors for adverse perinatal outcome of preeclampsia patients.In addition,uterine artery ultrasound blood flow parameters PI,S/D,RI,uric acid and alanine aminotransferase have certain predictive value for the adverse perinatal outcome of patients with preeclampsia,but the combined predictive value of the five is higher.关键词
超声血流参数/生化指标/孕晚期/先兆子痫/围生儿/不良结局Key words
ultrasonic blood flow parameters/biochemical indicators/late pregnancy/preeclampsia/perinatal infants/adverse out-come
