Page 98 - 南京医科大学自然版

南京医科大学学报（自然科学版） 第44卷第8期
·1126 · Journal of Nanjing Medical University（Natural Sciences） 2024年8月

·临床研究·

血栓弹力图联合超声定量参数对胎儿生长受限的诊断效能研究

孙 博 ，周 斌，王冠嘉，吕会娟
*
郑州市妇幼保健院产科，河南 郑州 450000

［摘 要］ 目的：研究血栓弹力图联合超声定量参数对胎儿生长受限（fetal growth restriction，FGR）的诊断效能。方法：收集
2021年7月—2023年5月郑州市妇幼保健院收治的50例FGR孕妇（FGR组），并选取同期同年龄段胎儿发育正常的50例孕妇
作为对照（对照组）。比较两组血栓弹力图指标［最大振幅（maximum amplitude，MA）、α角（Angle）、凝血时间（coagulation time，
K）、凝血反应时间（coagulation response time，R）］、脐动脉与大脑中动脉阻力指数（resistance index，RI）、搏动指数（pulsation
index，PI）、血流收缩末期/舒张末期峰值（end⁃systolic/end⁃diastolic peak value，S/D）、脑胎盘率（cerebroplacental rate，CPR）、体重、腹围，
二元相关分析、偏相关分析研究血栓弹力图、超声定量参数与体重、腹围的关系，受试者工作特征（receiver operating characteristic，
ROC）曲线分析血栓弹力图、超声定量参数及联合诊断 FGR 价值。结果：FGR 组孕中期、孕晚期、分娩前 R、K 均低于对照组，
Angle、MA 高于对照组（P < 0.05）；FGR 组孕中期、孕晚期、分娩前脐动脉 S/D、脐动脉 PI、脐动脉 RI 高于对照组，大脑中动脉
S/D、大脑中动脉PI、大脑中动脉RI、CRP低于对照组（P < 0.05）；FGR组孕中期、孕晚期、分娩前体重、腹围低于对照组（P < 0.05）；
二元相关分析显示，分娩前各血栓弹力图、超声定量参数与体重、腹围相关性更强（P < 0.05）；偏相关分析显示，分娩前R、K、大
脑中动脉RI、CRP与体重、腹围呈正相关，Angle、MA、脐动脉S/D、脐动脉PI、脐动脉RI仍与体重、腹围呈负相关（P < 0.05）；分娩前
血栓弹力图、超声定量参数联合诊断FGR的ROC曲线下面积高于各单一指标（P < 0.05）。结论：FGR孕妇接受血栓弹力图联
合超声定量检测，可有效监测孕产妇在不同时期凝血功能变化和胎儿血流动力学变化，其联合诊断FGR具有较高价值。
［关键词］ 血栓弹力图；超声定量参数；胎儿生长受限；诊断效能
［中图分类号］ R714.5 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）08⁃1126⁃08
doi：10.7655/NYDXBNSN231062

Study on diagnostic efficacy of thromboelastography combined with ultrasonic quantitative
parameters on fetal growth restriction
*
SUN Bo ，ZHOU Bin，WANG Guanjia，LÜ Huijuan
Department of Obsterics，Zhengzhou Maternal and Child Health Hospital，Zhengzhou 450000，China

［Abstract］ Objective：To study the diagnostic efficacy of thromboelastography combined with ultrasound quantitative parameters on
fetal growth restriction（FGR）. Methods：A total of 50 cases of pregnant women with FGR admitted to Zhengzhou Maternal and Child
Health Hospital from July 2021 to May 2023 were collected as the FGR group，and 50 pregnant women with normal fetal development
in the same period and age group were selected as controls（the control group）. The thromboelastogram indicators［maximum amplitude
（MA），Angle，coagulation time（K），coagulation response time（R）］，umbilical and middle cerebral artery resistance index（RI），
pulsation index（PI），end⁃systolic/end⁃diastolic peak value（S/D），cerebroplacental rate（CPR），weight，and abdominal circumference
were compared between the two groups. Binary correlation and partial correlation analyses were performed to explore the correlation of
thromboelastogram and ultrasound quantitative parameters with weight or abdominal circumference. The receiver operating
characteristic（ROC）curve was performed to analyze the diagnostic value of thromboelastogram，ultrasound quantitative parameters，
and the combined diagnosis of FGR. Results：Second⁃trimester，late⁃pregnancy，and before delivery the value of R and K were lower in
the FGR group than in the control group，while the value of Angle and MA were higher（P < 0.05）. The value of Umbilical artery S/D，
umbilical artery PI，and umbilical artery RI in the FGR group were higher than those in the control group during the second⁃trimester，
late⁃pregnancy，and before delivery，while the value of middle cerebral artery S/D，middle cerebral artery PI，middle cerebral artery RI，

［基金项目］ 河南省医学科技攻关计划项目（LHGJ20210784）
∗
通信作者（Corresponding author），E⁃mail：sunbo830808@126.com