广西医学2024，Vol.46Issue(3)：361-365,5.DOI:10.11675/j.issn.0253-4304.2024.03.06
正常胎儿脐静脉血流量Z评分模型的构建及其对小于胎龄儿围生期不良结局的预测价值
Establishment of Z-score model of umbilical venous blood flow in normal fetuses and its predictive value on perinatal adverse outcome in small for gestational age fetuses
摘要
Abstract
Objective To establish the Z-score model of umbilical venous blood flow(Quv)in normal fetuses,and to explore the predictive value of this model on perinatal adverse outcome in small for gestational age fetuses(SGA).Methods(1)A total of 862 normal fetuses from 18 to 40 weeks were enrolled to establish the model.The intra-abdominal Quv measured by abdominal ultrasound was taken as the dependent variable,gestational age was taken as the independent variable,and the regression analysis was used to obtain the best fitting equation of mean and standard deviation of Quv,after then the Quv Z-score model of normal fetuses was established according to the equation(Z score=[actual Quv measured value-fitting Quv mean value]/fitting Quv standard deviation).(2)In addition,53 normal fetuses(the normal group)and 109 SGA were enrolled,and SGA was assigned to adverse outcome group(n=50)or non-adverse outcome group(n=59)according to the presence of perinatal adverse outcome.The established model was used to obtain Quv Z score of fetuses in the 3 groups.The receiver operating characteristic curve was drawn to analyze the efficiency of normal fetuses'Quv Z score for predicting SGA perinatal adverse outcome.Results(1)Quv positively correlated with gestational age in normal fetuses(P<0.05),and the best fitting equations of mean and standard deviation of Quv relative to gestational age were all linear equations.The Quv Z-score model of normal fetuses was obtained according to the equations as follows:Z score=(Quv+346.069-20.754×gestational age)/(-51.320+4.075×gestational age).Quv Z score of fetuses in the normal group presented as normal distribution,and did not change with the gestational age.(2)Fetuses'Quv Z scores were successively increased in the adverse outcome,non-adverse outcome,and normal groups(P<0.05).(3)Area under the curve of normal fetuses'Quv Z score for predicting SGA perinatal adverse outcome was 0.843,and the sensitivity,specificity,positive predictive value,and negative predictive value were 74.0%,86.4%,82.2%,and 76.4%based on the optimal cut-off value of-2.06,respectively.Conclusion The established normal fetuses'Quv Z-score model can eliminate effects of gestational age,exerting favorable clinical applicability.Normal fetuses'Quv Z score is relatively sensitive indicator for predicting SGA perinatal adverse outcome.关键词
腹部超声/脐静脉血流量/Z评分/小于胎龄儿/围生期不良结局/预测价值Key words
Abdominal ultrasound/Umbilical venous blood flow/Z score/Small for gestational age fetuses/Perinatal adverse outcome/Predictive value分类
医药卫生引用本文复制引用
黄欢,黎新艳,庞彩英,韦慧,莫宇宁,张春艳,胡慧云,谭玲..正常胎儿脐静脉血流量Z评分模型的构建及其对小于胎龄儿围生期不良结局的预测价值[J].广西医学,2024,46(3):361-365,5.基金项目
国家自然科学基金(82060322) （82060322）
广西自然科学基金(2020GXNSFAA297066) （2020GXNSFAA297066）
广西医疗卫生适宜技术开发与推广应用项目(S2018096) （S2018096）
