多普勒超声检测UA、MCA 阻力指数联合 Tei 指数预测胎儿窘迫的价值

Diagnosis value of the Doppler ultrasonography detecting the fetal UA and MCA combined with the Tei index in fetal distress

摘要:

目的 探讨多普勒超声检测胎儿脐动脉（UA）、大脑中动脉（MCA）阻力指数（RI）联合心肌 做功指数（Tei 指数）预测胎儿窘迫的价值。方法 选取2016 年5 月—2018 年5 月延安大学附属医院收治 的161 例孕妇，分为窘迫组85 例和对照组76 例。采用多普勒超声检测两组胎儿UA 和MCA 的RIUA、RIMCA、 血流搏动指数（PI）及收缩期与舒张期比值（S/D），并测量二尖瓣口处A 峰结束至下一个心动周期E 峰开 始的时间间隔（a）和主动脉射血时间（b），得出Tei 指数。绘制ROC 曲线并分析RIUA、RIMCA 联合Tei 指 数对胎儿窘迫的诊断效能。结果 窘迫组RIUA、Tei 指数高于对照组，而RIMCA 低于对照组（P <0.05）。3 者 联合诊断胎儿窘迫的特异性为85.5%，高于三者单独诊断和平行联合诊断的特异性（63.2%、69.7%、65.8% 及 68.4%）（P <0.05），同时约登指数（0.620）和准确性（80.7%）最高。ROC 曲线显示，RIUA、RIMCA 联合Tei 指数系列联合诊断的ROC 曲线下面积高于三者单独诊断及平行联合诊断（P <0.05）。结论 RIUA、RIMCA 联 合Tei 指数可提高胎儿窘迫的诊断效能，在临床诊断中具有重要价值。

Abstract:

Objective To explore the doppler ultrasound detection of fetal umbilical artery (UA), middle cerebral artery (MCA) resistance index (RI) combined with cardiac work index (Tei) to predict the value of fetal distress. Methods From May 2016 to May 2018, 161 cases of pregnant women in our hospital were selected and divided into distress group (85 cases) and control group (76 cases). Fetal doppler ultrasound testing was used to detect RIUA, RIMCA, the blood flow pulsation index (PI) and systolic and diastolic ratio (S/D), and to measure mitral valve inlet end of the peak to the next A cardiac cycle began E peak interval between A and b aortic ejection time, in order to get Tei index. ROC curve was drawn and the diagnostic efficacy of RIUA, RIMCA combined with Tei index in detecting fetal distress by doppler ultrasound was analyzed. Results RIUA and Tei index were higher in the distress group than in the control group (P < 0.05), and RIMCA was lower than in the control group (P < 0.05). The specificity of combined detection was 85.5%, higher than that of separate detection and parallel detection (63.2%, 69.7%, 65.8% and 68.4%) (P < 0.05). ROC curve showed that the area under the ROC curve detected by RIUA, RIMCA combined with Tei index was higher than that detected by separate detection and parallel detection, and the difference was statistically significant (P < 0.05). Conclusions RIUA, RIMCA combined with Tei index can improve the diagnostic efficiency of fetal distress, which is of great value in clinical diagnosis.