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利用眼动脉多普勒血流测量法预测先兆子痫。

Doppler flowmetry of ophthalmic arteries for prediction of pre-eclampsia.

作者信息

Aquino Larissa Oliveira de, Leite Henrique Vítor, Cabral Antônio Carlos Vieira, Brandão Augusto Henriques F

机构信息

Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Department of Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2014 Nov-Dec;60(6):538-41. doi: 10.1590/1806-9282.60.06.011.

Abstract

BACKGROUND

central nervous system (CNS) hyperperfusion is one of the events that constitute the pathophysiological basis for the clinical manifestations and complications of pre-eclampsia (PE). Detecting the increased flow in the CNS through Doppler flowmetry of the ophthalmic artery might precede the clinical onset of PE and could be used as a marker for subsequent development of PE.

OBJECTIVE

to evaluate the ophthalmic artery resistive index (OARI) values in the second trimester of pregnancy for prediction of the clinical manifestations of PE.

OBJECTIVE

to evaluate the ophthalmic artery resistive index (OARI) values in the second trimester of pregnancy for prediction of the clinical manifestations of PE.

METHODS

a total of 73 patients with risk factors for the development of PE were selected from the prenatal service at the HC-UFMG. They were submitted to ophthalmic artery Doppler flowmetry between 24 and 28 weeks of pregnancy and monitored until the end of the pregnancy to verify the occurrence of PE. ROC curves were created to determine the predictive characteristics of the OARI.

RESULTS

fourteen of the patients selected developed PE and 59 remained normotensive until the postpartum period. Patients with subsequent development of PE presented OARI values lower than patients that remained normotensive (0.682 ± 0.028 X 0.700 ± 0.029, p = 0.044). Considering the development of PE as an outcome, the area under the OARI curve was 0.694 (CI 0.543 to 0.845), with no points obtaining good values of sensitivity or specificity.

CONCLUSION

Doppler flowmetry of ophthalmic arteries between 24 and 28 weeks of pregnancy did not present itself as a good exam for predicting PE.

摘要

背景

中枢神经系统(CNS)血流灌注过多是构成先兆子痫(PE)临床表现和并发症病理生理基础的事件之一。通过眼动脉多普勒血流测定法检测中枢神经系统血流增加可能先于PE的临床发作,并可作为PE后续发展的标志物。

目的

评估妊娠中期眼动脉阻力指数(OARI)值以预测PE的临床表现。

方法

从HC-UFMG产前服务中选取73例有PE发生风险因素的患者。她们在妊娠24至28周期间接受眼动脉多普勒血流测定,并监测至妊娠结束以核实PE的发生情况。绘制ROC曲线以确定OARI的预测特征。

结果

所选患者中有14例发生了PE,59例直至产后仍血压正常。随后发生PE的患者的OARI值低于血压正常的患者(0.682±0.028对0.700±0.029,p = 0.044)。将PE的发生作为结果来看,OARI曲线下面积为0.694(95%置信区间0.543至0.845),没有点获得良好的敏感性或特异性值。

结论

妊娠24至28周期间的眼动脉多普勒血流测定并非预测PE的良好检查方法。

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