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| 脐动脉血流S/D值联合孕妇血清CX3CL1 HIF-1α对胎儿窘迫的诊断价值 |
| The diagnostic value of S/D ratio of umbilical artery blood flow combined with maternal serum CX3CL1 and HIF-1α in fetal distress |
| 投稿时间：2023-07-26 |
| DOI：10.3969/j.issn.1000-0399.2024.04.010 |
| 中文关键词: 胎儿窘迫 脐动脉血流S/D值 趋化因子C-X3-C配体1 缺氧诱导因子-1α |
| 英文关键词: Fetal distress S/D ratio of umbilical artery blood flow Chemokine C-X3-C ligand 1 Hypoxia inducible factor-1α |
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| 摘要点击次数: 569 |
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| 中文摘要: |
| 目的 探讨脐动脉血流收缩期末最大血流速度/舒张期末最大血流速度(S/D)、血清趋化因子C-X3-C配体1(CX3CL1)、血清缺氧诱导因子-1α(HIF-1α)对胎儿窘迫(FD)的诊断价值。方法 选取2020年5月至2022年5月在青岛市妇女儿童医院妇产科分娩且出现FD的128例孕妇为研究对象(FD组),根据新生儿Apgar评分将FD孕妇分为轻度窘迫组74例和重度窘迫组54例,另取同期在本院定期产检并分娩的健康且未出现FD的孕妇78例为正常组;超声检测FD孕妇脐动脉血流S/D值;ELISA法检测FD孕妇血清CX3CL1、HIF-1α水平;Pearson法分析FD孕妇血清CX3CL1、HIF-1α水平与脐动脉血流S/D值的相关性;受试者工作特征(ROC)曲线分析血清CX3CL1、HIF-1α水平及脐动脉血流S/D值对胎儿重度窘迫的诊断价值。结果 FD组孕妇脐动脉血流阻力指数(RI)、搏动指数(PI)、S/D值、血清CX3CL1及HIF-1α水平均显著高于正常组(P<0.05),重度窘迫组孕妇RI值、PI值、S/D值、血清CX3CL1及HIF-1α水平均高于轻度窘迫组(P<0.05)。FD组血清CX3CL1、HIF-1α与脐动脉血流S/D值均呈正相关(r=0.531、0.489,P<0.05)。脐动脉血流S/D值、血清CX3CL1、HIF-1α以及3项联合诊断胎儿重度窘迫的AUC分别为0.870、0.802、0.731、0.941,联合诊断的灵敏度为87.04%,特异度为90.54%,3项联合优于脐动脉血流S/D值、血清CX3CL1、HIF-1α各自单独诊断(Z3项联合-S/D=2.775、Z3项联合-CX3CL1=3.998、Z3项联合-HIF-1α=4.925,P均<0.05)。结论 FD孕妇脐动脉血流S/D值、血清CX3CL1、HIF-1α水平均上升,且血清CX3CL1、HIF-1α水平与脐动脉血流S/D值均呈正相关,3项联合对诊断胎儿重度窘迫有更高的价值。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of the maximum systolic/diastolic blood flow velocity (S/D) ratio of the umbilical artery,serum chemokine C-X3-C ligand 1 (CX3CL1),and serum hypoxia inducible factor-1α (HIF-1α) for fetal distress (FD).Methods 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 distress 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 umbilical 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 positively 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,serum 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 sensitivity 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 umbilical artery blood flow,serum CX3CL1 and HIF-1α separately diagnosed (Zcombination-S/D=2.775,Zcombination-CX3CL1=3.998,Zcombination-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 increased,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. |
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