摘要
目的:探讨超声多普勒测量脑-胎盘-子宫比率(CPUR)在预测晚发型胎儿生长受限(FGR)中的效能.方法:选择2020 年5 月至2021 年5 月在香港大学深圳医院接受产前检查的 1255 例单胎妊娠孕妇,孕35～37 +6周进行胎儿生长和超声多普勒测量.新生儿出生体质量＜第10 百分位数的孕妇为FGR组.分别和联合分析子宫动脉(UtA)、脐动脉(UA)和胎儿大脑中动脉(MCA)的搏动指数(PI),通过ROC曲线分析CPUR、脑-胎盘比率(CPR)、脑-子宫比率(C-UtA)对晚发型胎儿FGR预测价值,评估其预测晚发型FGR的敏感度、阳性和阴性预测值.结果:CPUR、CPR、C-UtA、平均UtA-PI在FGR组的曲线下面积值(AUC)为0.88、0.86、0.84、0.72.在一定的截断值和87%以上特异度下,CPUR、CPR、C-UtA、平均 UtA-PI 对预测 FGR 的敏感度分别为 43.2%、46.6%、39.8%和23.9%;CPUR、CPR、C-UtA、平均UtA-PI、UA-PI对预测FGR的阳性预测值分别为 90.5%、71.9%、83.3%、63.6%、5.2%.结论:CPUR预测晚发型FGR的综合效能较CPR、C-UtA、平均UtA-PI更好,可更有效提高临床FGR的检出率,以降低FGR风险.
Abstract
Objective:To evaluate the efficacy of cerebral-placental-uterine ratio(CPUR)in predicting late-on-set fetal growth restriction(FGR).Methods:From May 2020 to May 2021,1255 women with singleton pregnancy who underwent prenatal examinations at the University of Hong Kong Shenzhen Hospital were selected for fetal growth and Doppler measurements at 35-37 +6 weeks of gestation.Pregnant women with birth weight of newbo-rns＜the 10th percentile were the FGR group.The pulsatility index(PI)of uterine artery(UtA),umbilical artery(UA)and fetal middle cerebral artery(MCA)were analyzed separately and in combination.ROC curve was used to analyze the cerebral-placental-uterine ratio(CPUR),cerebral-placental ratio(CPR),cerebral-uterine ratio(C-UtA)for predicting late-onset FGR;and to evaluate the sensitivity,positive and negative predictive value and of CPUR in the prediction of late-onset FGR.Results:The area under the curve(AUC)of CPUR,CPR,C-UtA and mean UtA-PI for FGR grope were 0.88,0.86,0.84 and 0.72.Under certain cut-off values and 87% specificity,the specificity of CPUR,CPR,C-UtA and mean UtA-Pifor predicting FGR group was 43.2%,46.6%,39.8% and 23.9%,respectively.The positive predictive values of CPUR,CPR,C-UtA and mean UtA-PI,UA-PI for predicting FGR group were 90.5%,71.9%,83.3%,63.6%and 5.2%,respectively.Conclusions:CPUR is more effective in predicting late onset FGR than CPR,C-UtA and mean UtA-PI.It can effectively increase the detection rate of fetal growth restrictionand reduce the FGR risk.
基金项目
深圳科技创新委员会基础研究项目(JCYJ20210324114610028)
维普
万方数据