关键词: 子宫动脉, 超声心动图, 子痫前期, 阻力指数, 搏动指数, 预测

Abstract:

Objective　To explore the predictive value of uterine artery blood flow parameters combined with echocardiography for early-onset preeclampsia (PE). Methods　A retrospective study was conducted to collect the data of 90 patients with early-onset PE admitted to Shangluo Central Hospital from June 2022 to August 2024. The patients were included in a case group [age 21-45 (30.21±4.17) years]. In addition, the data of 90 healthy pregnant women who received regular prenatal examination in the hospital during the same period were collected according to the ratio of 1:1 and included in a control group [age 20-45 (29.32±4.45) years]. The uterine artery blood flow parameters [resistance index (RI), pulsatility index (PI), and systolic phase/diastolic phase (S/D)] and echocardiographic parameters [left ventricular ejection fraction (LVEF), fractional shortening (FS), cardiac index (CI), and early diastolic flow velocity/late diastolic flow velocity (E/A)] were collected and compared between the two groups at 14-20 weeks of gestation. The measurement data were of the normal distribution, and the independent sample t test was used to test the differences between the groups. The Mann-Whitney U test was used to test the difference between the groups. The χ² test was used to test the differences between the groups. The receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to evaluate the predictive value of uterine artery blood flow parameters combined with echocardiography for early onset PE. Results　The RI, PI, and S/D in the case group were all higher than those in the control group (0.84±0.25 vs. 0.68±0.13, 1.08±0.29 vs. 0.86±0.17, and 2.60±0.58 vs. 2.12±0.25), and the LVEF, E/A values were lower [(61.58±5.74)% vs. (66.44±6.02)%, and 0.93±0.22 vs. 1.17±0.36], with statistical differences (all P<0.05). The ROC showed that the combined prediction of AUC for early-onset PE by logistic regression probability models of RI, PI, S/D, LVEF, E/A alone and several at 14-20 weeks of pregnancy was greater than 0.7 (95%CI 0.914-0.975 for joint prediction), which had certain predictive value, and the joint prediction value was higher than those of RI, PI, S/D, LVEF, and E/A alone (P<0.05). Conclusion　Uterine artery blood flow parameters (RI, PI, and S/D) and echocardiographic parameters (LVEF and E/A) have certain predictive value for early-onset PE, and the combined predictive value is higher.

Key words: Uterine artery, Echocardiography, Preeclampsia, Resistance index, Pulsatility index, Prediction