肾动脉与大脑中动脉血流阻力指标比值对妊娠期糖尿病胎儿宫内缺氧的预测价值

目的 研究胎儿肾动脉(RA)与大脑中动脉(MCA)血流阻力指标比值预测妊娠期糖尿病(GDM)胎儿宫内缺氧的价值.方法 选取2013年8月至2015年2月来我院就诊并被确诊为GDM的孕妇58例作为观察组,选择同期145例正常妊娠孕妇作为对照组.应用脉冲多普勒技术测量两组胎儿MCA及RA血流阻力指标,如阻力指数(RI)、搏动指数(PI)和S/D值,计算RA与MCA阻力指标的比值.结果 观察组胎儿RA的PI值、RI值、S/D值均高于对照组,MCA的PI值、RI值、S/D值均低于对照组,差异均有统计学意义(P<0.05);观察组胎儿阻力指数比值(RIRA/MCA)、搏动指数比值(PIRA/MCA)及S/D比值(S/DRA/MCA)均高于对照组,差异均有统计学意义(P<0.05);以上指标分别大于1.15、1.33、1.41时预测胎儿宫内缺氧的特异性和敏感性分别为92%、90%.结论 RA、MCA血流阻力指标比值预测胎儿宫内缺氧有重要的临床价值.

Predictive value of resistant parameter ratios of renal artery and middle cerebral artery in fetal intrauterine hypoxia in gestational diabetes mellitus

Objective To study resistant parameter ratios of renal artery (RA) and middle cerebral artery (MCA) in predicting fetal intrauterine hypoxia in gestational diabetes mellitus (GDM). Methods Fifty-eight pregnant women diagnosed with GDM treated in our hospital from August, 2013 to February, 2015 were selected as the observa-tion group, and 145 healthy pregnant women were selected as the control group. The MCA and RA blood flow resistant index (RI), pulsatility index (PI) and systolic/diastolic (S/D) ratio were measured by Putsed Doppler, and the resistant pa-rameter ratios of RA and MCA were calculated. Results The RI, PI and S/D of fetal RA in the observation group were significantly higher than those in the control group, and the RI, PI and S/D of fetal MCA in the observation group were significantly lower than those in the control group (P<0.05). The ratios of RIRA/MCA, PIRA/MCA and S/DRA/MCA in the obser-vation group were significantly higher than those in the control group (P<0.05). At RIRA/MCA>1.15, PIRA/MCA>1.33 and S/DRA/MCA>1.41, the specificity and sensitivity for predicting fetal intrauterine hypoxia was 92%and 90%, respectively. Conclusion Resistant parameter ratios of RA to MCA have significant clinical values in predicting intrauterine hypoxia.