生长因子联合子宫动脉血流参数预测妊娠期高血压患者胎儿生长受限的价值

Value of growth factor combined with uterine artery flow parameters in predicting fetal growth restriction during pregnancy in patients with hypertension

  • 摘要:
    目的 探讨生长因子联合子宫动脉血流参数预测妊娠期高血压患者胎儿生长受限(FGR)的价值。
    方法 选取妊娠期高血压女性102例,根据是否出现FGR分为研究组(FGR, n=62)和对照组(非FGR, n=40)。比较2组血管内皮生长因子(VEGF)、胎盘生长因子(PLGF)水平以及收缩期的最大血流速度(S)及舒张期末期的血流速度(D)比值(S/D)、阻力指数(RI)、搏动指数(PI)。分析影响妊娠期高血压患者发生FGR的相关因素。
    结果 研究组血清PLGF、VEGF水平低于对照组,差异有统计学意义(P < 0.05)。研究组S/D、PI及RI指标水平高于对照组,差异有统计学意义(P < 0.05)。血清PLGF及VEGF水平升高是妊娠期高血压患者发生FGR的独立保护因素(P < 0.05); S/D、PI及RI升高是妊娠期高血压患者发生FGR的独立危险因素(P < 0.05)。受试者工作特征(ROC)曲线结果显示, PLGF、VEGF、S/D、PI、RI及联合预测妊娠期高血压患者发生FGR的曲线下面积(AUC)分别为0.813、0.881、0.883、0.909、0.831及0.952。
    结论 PLGF、VEGF联合S/D、PI、RI预测妊娠期高血压发生FGR的价值较好。

     

    Abstract:
    Objective To investigate the value of growth factor combined with uterine artery blood flow parameters in predicting fetal growth restriction (FGR) in the pregnancy in patients with gestational hypertension.
    Methods A total of 102 women with gestational hypertension were selected and divided into study group (FGR, n=62) and control group (non-FGR, n=40) according to whether FGR occurred. The levels of vascular endothelial growth factor (VEGF) and placental growth factor (PLGF), as well as the ratio of maximum blood flow velocity during systole (S) to end-diastolic blood flow velocity (D) (S/D), resistance index (RI) and pulsation index (PI) were compared between the two groups. The related factors affecting the occurrence of FGR in patients with gestational hypertension were analyzed.
    Results The levels of serum PLGF and VEGF in the study group were significantly lower than those in the control group (P < 0.05). The levels of S/D, PI and RI in the study group were significantly higher than those in the control group (P < 0.05). Increased levels of serum PLGF and VEGF were independent protective factors for FGR in patients with hypertensive pregnancy (P < 0.05); increased S/D, PI and RI were independent risk factors for FGR in patients with hypertensive pregnancy (P < 0.05). The results of receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of PLGF, VEGF, S/D, PI, RI and combined prediction of FGR in patients with pre-pregnancy hypertension were 0.813, 0.881, 0.883, 0.909, 0.831 and 0.952, respectively.
    Conclusion PLGF and VEGF combined with S/D, PI and RI have a good value in predicting the occurrence of FGR in hypertensive pregnancy.

     

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