孕早期子宫动脉超声参数预测模型对子痫前期风险的预测价值

储华; 陆艳; 刘明松

doi:10.16766/j.cnki.issn.1674-4152.003171

孕早期子宫动脉超声参数预测模型对子痫前期风险的预测价值

doi: 10.16766/j.cnki.issn.1674-4152.003171

湖州市妇幼保健院超声科，浙江湖州 313000

基金项目:

浙江省湖州市科学技术局项目 2019GYB15

浙江省医药卫生科技计划项目 2021KY1084

详细信息

通讯作者:
储华，E-mail：chuhua501@163.com

中图分类号: R445.1 R714.24
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出版历程
- 收稿日期: 2023-04-11
- 网络出版日期: 2023-10-19

Predictive value of uterine artery ultrasound parameter prediction model for preeclampsia risk in early pregnancy

Department of Ultrasound, Huzhou Maternal and Child Health Hospital, Huzhou, Zhejiang 313000, China

摘要

摘要: 目的本研究为探明孕11~13周子宫动脉超声参数预测子痫前期的价值，构建了孕11~13周子宫动脉超声参数预测模型，并分析其对子痫前期风险的预测价值。方法纳入2020年5月—2022年5月湖州市妇幼保健院就诊的200例孕早期患者为研究对象，根据患者是否发生子痫前期分为发生组(100例)和未发生组(100例)，从电子病历系统中提取患者孕11~13周子宫动脉超声参数指标，建立基于孕早期子宫动脉超声参数的logistic回归预测模型，并绘制ROC曲线分析其预测子痫前期的敏感度、特异度。结果多因素logistic回归分析结果显示，高体重指数(BMI，OR=1.311，P<0.001)、高胆固醇(OR=1.673，P=0.004)、高子宫动脉搏动指数(UtA-PI，OR=1.327，P<0.001)、高阻力指数(RI，OR=1.846，P=0.036)是子痫前期发生的危险因素；ROC曲线分析显示，该模型预测子痫前期发生风险的AUC为0.762(95% CI：0.696~0.819)，敏感度为81.00%，特异度为63.00%。结论基于孕早期子宫动脉超声参数UtA-PI、RI及高BMI、胆固醇建立的预测模型可用于子痫前期的预测。
- 孕早期 /
- 子宫动脉超声 /
- 子痫前期 /
- 预测模型
Abstract: Objective To explore the value of uterine artery ultrasound parameters in the prediction of preeclampsia at 11-13 weeks of gestation, we constructed a uterine artery ultrasound parameter prediction model at 11-13 weeks of gestation, and analyzed its prediction value for the risk of preeclampsia. Methods A total of 200 patients who visited Huzhou Women's and Children's Health Care Hospital in early pregnancy from May 2020 to May 2022 were included. They were divided into occurred group (100 cases) and not occurred group (100 cases) according to whether they had preeclampsia. The ultrasonic parameters of uterine artery in the 11-13 weeks of pregnancy were extracted from the electronic medical record system, and a logistic regression prediction model based on the ultrasonic parameters of uterine artery in early pregnancy was established. The ROC curve was drawn to analyze its sensitivity and specificity for predicting preeclampsia. Results The multivariate logistic regression analysis showed that high body mass index (BMI, OR=1.311, P<0.001), high cholesterol (OR=1.673, P=0.004), high uterine artery pulsatility index (UtA-PI, OR=1.327, P<0.001) and high resistance index (RI, OR=1.846, P=0.036) were the risk factors for preeclampsia. ROC curve showed that the AUC of the model for predicting the risk of preeclampsia was 0.762 (95% CI: 0.696-0.819), the sensitivity was 81.00%, and the specificity was 63.00%. Conclusion The prediction model based on uterine artery ultrasound parameters UtA-PI, RI, high BMI and cholesterol in early pregnancy can be used for the prediction of preeclampsia.
- Early pregnancy /
- Uterine artery ultrasound /
- Preeclampsia /
- Prediction model

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图 1 孕早期子宫动脉超声参数预测子痫前期发生风险的ROC曲线

Figure 1. ROC curve of ultrasonic parameters of uterine artery in early pregnancy for predicting the risk of preeclampsia

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表 1 2组孕早期患者临床资料比较

Table 1. Comparison of clinical data between two groups in early pregnancy

项目	未发生组 (n=100)	发生组 (n=100)	统计量	P值
年龄(x±s，岁)	27.47±2.89	30.00±4.75	4.550^a	<0.001
BMI(x±s)	26.52±3.31	30.22±4.49	6.633^a	<0.001
孕次[例(%)]			1.228^b	0.268
≤2次	86(86.00)	91(91.00)
≥3次	14(14.00)	6(6.00)
受孕方法[例(%)]			1.802^b	0.179
自然受孕	90(90.00)	95(95.00)
人工受孕	10(10.00)	5(5.00)
收缩压(x±s，mmHg)	120.93±9.77	128.57±18.11	3.713^a	<0.001
舒张压(x±s，mmHg)	72.58±7.82	84.99±14.87	7.387^a	<0.001
PT(x±s，s)	10.48±0.86	10.69±0.83	1.757^a	0.080
胆固醇(x±s，mmol/L)	6.01±0.91	6.57±1.59	3.057^a	0.003
肌酐(x±s，μmmol/L)	48.78±17.71	52.82±15.70	1.707^a	0.089
UtA-PI(x±s)	1.65±0.41	1.79±0.54	2.065^a	0.040
RI(x±s)	0.71±0.17	0.76±0.15	2.205^a	0.029
S/D(x±s)	4.28±1.26	4.59±1.00	1.927^a	0.055
注：^a为t值，^b为χ²值。1 mmHg=0.133 kPa。

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表 2 孕期子痫前期发生风险的多因素logistic分析

Table 2. Multivariate logistic analysis of the risk of preeclampsia during pregnancy

变量	B	SE	Wald χ²	P值	OR值	95% CI
年龄	0.021	0.060	0.122	0.726	1.021	0.909~1.148
BMI	0.270	0.059	20.835	<0.001	1.311	1.167~1.472
收缩压	-0.012	0.018	0.447	0.504	0.988	0.955~1.023
舒张压	0.037	0.026	2.115	0.146	1.038	0.987~1.091
胆固醇	0.514	0.178	8.357	0.004	1.673	1.180~2.371
UtA-PI	0.283	0.070	16.198	<0.001	1.327	1.156~1.522
RI	0.613	0.292	4.410	0.036	1.846	1.342~2.270

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