■探讨中晚期胎儿动脉导管(DA)和静脉导管(DV)的分流率及其在评价胎儿生长受限(FGR)中的应用价值。
■在这项回顾性观察研究中,我们回顾了2017年9月10日至2018年11月27日温州医科大学附属第二医院收治的患者的临床资料,最终纳入44例28~31周正常孕妇(正常组)和15例28~31周胎儿生长受限(FGR)孕妇(FGR组).我们测量了DA(QDA)的血流量,肺动脉(QPA),DV(QDV),和脐静脉(QUV)以及DA和DV的分流率(QDA/QPA和QDV/QUV,分别)在所有胎儿中。我们使用正常组均值作为分析的正常参考值比较了组间的均值变量。
■DA分流率与胎龄呈线性正相关(Y=1.455X+2.787;r=0.767,P<0.01),而DV分流率与胎龄呈线性负相关(Y=-2.791X126.885;r=0.761,P<0.01)。正常组胎儿的DA分流率(QDA/QPA)高于FGR组,但两组间差异无统计学意义(P>0.05)。正常组胎儿的DV分流率(QDV/QUV)明显低于FGR组(P<0.05)。FGR组的DV分流率明显高于正常组,在30-30+6周和31-31+6周时差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC曲线)显示分流率越高,FGR胎儿的出生结局越差。
■中期和晚期胎儿的DV分流率可以预测胎儿的出生结局,分流比越高,FGR胎儿的出生结局越差。
UNASSIGNED: To explore the Shunt rate of ductus arteriosus (DA) and ductus venosus (DV) in middle and late fetuses and their application value in the evaluation of fetal growth restriction (FGR).
UNASSIGNED: In this retrospective observational study, we reviewed the clinical data of the patients who admitted to the Second Affiliated Hospital of Wenzhou Medical University from September 10, 2017 to November 27, 2018, and finally included 44 normal women at 28-31 weeks of pregnancy (Normal group) and 15 pregnant women with fetal growth restriction (FGR) within 28-31 weeks of gestation (FGR group). We measured blood flows of the DA (QDA), pulmonary artery (QPA), DV (QDV), and umbilical vein (QUV) and the shunt rates of the DA and DV (QDA/QPA and QDV/QUV, respectively) in all fetuses. We compared the mean variables between groups using the Normal group means as the normal reference values for analysis.
UNASSIGNED: DA shunt rate was linearly and positively correlated with gestational age (Y=1.455X+2.787; r=0.767, P<0.01), while the DV shunt rate was linearly and negatively correlated with gestational age (Y=-2.791X+126.885; r=0.761, P<0.01). The DA shunt rates (QDA/QPA) of fetuses in the normal were higher than those in the FGR groups, but the differences between the two groups were not statistically significant (P > 0.05). The DV shunt rates (QDV/QUV) of fetuses in the normal were significantly lower than those in the FGR groups (P < 0.05). The DV shunt rates in the FGR group were significantly higher than those in the normal group with differences being statistically significant at 30-30+6 and 31-31+6 gestational weeks (P < 0.05) The receiver operating characteristic curve (ROC curve) showed that the higher the shunt rate, the worse the birth outcome of a fetus with FGR.
UNASSIGNED: The DV shunt rate in middle- and late-stage fetuses can predict the fetal birth outcome, and the higher the shunt ratio, the worse the birth outcome of FGR fetuses.