| 田捧,管秀娟,董孝贞,孟欣雨,张红彬,栗河舟.超声微血管成像联合血管内皮生长因子诊断胎儿生长受限[J].中国医学影像技术,2024,40(1):83~87 |
| 超声微血管成像联合血管内皮生长因子诊断胎儿生长受限 |
| Ultrasound microvascular flow imaging combined with vascular endothelial growth factor for diagnosis of fetal growth restriction |
| 投稿时间：2023-06-14 修订日期：2023-09-18 |
| DOI：10.13929/j.issn.1003-3289.2024.01.016 |
| 中文关键词: 胎儿生长迟缓 胎盘血液循环 血管内皮生长因子类 超声检查 前瞻性研究 |
| 英文关键词:fetal growth retardation placental circulation vascular endothelial growth factors ultrasonography prospective studies |
| 基金项目:2020年河南省医学适宜技术推广项目（SYJS2020080）。 |
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| 中文摘要: |
| 目的 观察超声微血管成像（MV-Flow）联合孕妇血清血管内皮生长因子（VEGF）表达水平诊断胎儿生长受限（FGR）的价值。方法 前瞻性纳入87例胎儿生长受限[FGR组，包括43例孕周<28周（<28周亚组）及44例孕周 ≥ 28周（≥ 28周亚组）] 孕妇及112名正常孕妇[对照组，55名孕周<28周（对照组1）、57名孕周 ≥ 28周（对照组1）]，以MV-Flow技术测量胎盘微血管指数（MVI），于同期检测孕妇血清VEGF表达水平，于分娩后即刻检测胎盘母体面VEGF表达水平；绘制受试者工作特征曲线，评价胎盘MVI、母体血清VEGF及二者联合诊断FGR的价值。结果 FGR组2亚组胎盘MVI、孕妇血清VEGF表达水平及胎盘组织VEGF表达水平均明显低于对照组（P<0.01）。胎盘MVI、母体血清VEGF及二者联合诊断<28周FGR的曲线下面积（AUC）分别为0.981、0.870和0.997，诊断 ≥ 28周FGR的AUC分别为0.991、0.867和0.993。以单一孕妇血清VEGF诊断2亚组FGR的AUC均低于胎盘MVI及其联合孕妇血清VEGF（P均<0.05），而后二者AUC差异均无统计学意义（P均>0.05）。结论 胎盘MVI和孕妇血清VEGF可用于筛查FGR，而前者更具价值。 |
| 英文摘要: |
| Objective To observe the value of ultrasound microvascular flow imaging (MV-Flow) combined with maternal serum vascular endothelial growth factor (VEGF) expression level for diagnosis of fetal growth restriction (FGR). Methods Totally 87 pregnant women with FGR (FGR group, including 43 cases of gestational week<28 weeks [<28 weeks subgroup] and 44 cases of ≥ 28 weeks [ ≥ 28 weeks subgroup]) and 112 normal pregnant women with normal fetuses (normal control group, 55 with gestational week<28 weeks [NC 1 subgroup] and 57 with ≥ 28 weeks [NC 2 subgroup]) were prospectively enrolled. MV-Flow technology was used to measure placental microvascular index (MVI), and the placental microvascular circulation was evaluated. The expression level of maternal serum VEGF was detected simultaneously, also of placental maternal surface immediately after delivery. The receiver operating characteristic curves were drawn to explore the value of placental MVI, maternal serum VEGF and the combination of placental MVI, maternal serum VEGF for diagnosing FGR. Results The levels of placental MVI and maternal serum VEGF in 2 subgroups of FGR group were both lower than those in control group (all P<0.01). Placental VEGF expression level in FGR group was significantly lower than that in control group (P<0.01). The area under the curve (AUC) of placental MVI, maternal serum VEGF and their combination for diagnosing FGR<28 weeks was 0.981, 0.870 and 0.997, respectively, while for diagnosing FGR ≥ 28 weeks was 0.991, 0.867 and 0.993, respectively. AUC of maternal serum VEGF alone for diagnosing in 2 subgroups of FGR were both lower than that of placental MVI and combination of placental MVI and maternal serum VEGF (all P<0.05), while no significant difference of AUC was found between placental MVI and combination of maternal serum VEGF and placental MVI (both P>0.05). Conclusion Both placental MVI and maternal serum VEGF level could be used to screen FGR, and the former was more valuable. |
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