The diagnostic value of S/D ratio of umbilical artery blood flow combined with maternal serum CX3CL1 and HIF-1α in fetal distress
Objective To investigate the diagnostic value of the maximum systolic/diastolic blood flow velocity(S/D)ratio of the um-bilical artery,serum chemokine C-X3-C ligand 1(CX3CL1),and serum hypoxia inducible factor-1α(HIF-1α)for fetal distress(FD).Meth-ods A total of 128 pregnant women who delivered in our hospital from May 2020 to May 2022 and experienced FD were collected as the study subjects(FD group);according to the neonatal Apgar score,the FD group was separated into a mild distress group of 74 cases and a severe dis-tress group of 54 cases,and 78 healthy pregnant women who underwent regular prenatal examinations and delivered in our hospital during the same period and did not experience FD were regarded as the normal group;Ultrasound was applied to detect the S/D ratio of umbilical artery blood flow;ELISA was applied to detect serum levels of CX3CL1 and HIF-1α;Pearson method was applied to analyze the correlation between the serum CX3CL1,HIF-1α levels of FD pregnant women and the S/D ratio of umbilical artery blood flow;ROC curve was applied to analyze the diagnostic value of serum CX3CL1,HIF-1α levels and umbilical artery blood flow S/D ratio for severe fetal distress.Results The umbili-cal artery blood flow resistance index(RI),pulsatility index(PI),S/D value,serum CX3CL1 and HIF-1α levels in FD group were obviously higher than those in the normal group(P<0.05);the RI value,PI value,S/D value,serum CX3CL1 and HIF-1α levels of pregnant women in the severe distress group were obviously higher than those in the mild distress group(P<0.05);in FD group,serum CX3CL1 and HIF-1α were posi-tively correlated with the S/D ratio of umbilical artery blood flow(r=0.531,0.489,P<0.05).The AUC of umbilical artery blood flow S/D ratio,se-rum CX3CL1,HIF-1α and three items of combined diagnosis of severe fetal distress was 0.870,0.802,0.731 and 0.941,respectively.The sen-sitivity of combined diagnosis was 87.04%,and the specificity was 90.54%,the combination of the three were better than the S/D ratio of um-bilical artery blood flow,serum CX3CL1 and HIF-1α separately diagnosed(Z combination-S/D=2.775,Z combination-CX3CL1=3.998,Z combination-HIF-1α=4.925,all P<0.05).Conclusions The S/D ratio of umbilical artery blood flow,serum CX3CL1 and HIF-1α levels in FD pregnant women are in-creased,and the serum CX3CL1 and HIF-1α levels are positively correlated with the S/D ratio of umbilical artery blood flow.The combination of the three has higher value in diagnosing severe fetal distress.
Fetal distressS/D ratio of umbilical artery blood flowChemokine C-X3-C ligand 1Hypoxia inducible factor-1α
NETL
NSTL
万方数据
维普
