目的:探讨胎儿肾动脉阻力指标检测对妊娠期糖尿病(GDM)围产儿监测的临床价值.方法:GDM孕妇96例,同期正常孕妇98例为对照组,于妊娠晚期运用彩色多普勒超声检测胎儿肾动脉阻力指数(RI)、搏动指数(PI)及收缩期峰值流速和舒张末期流速的比值(S/D),比较两组肾动脉阻力指标变化及妊娠结局的差异.结果:GDM组胎儿肾动脉RI、PI、及S/D值均高于对照组(P＜0.05); GDM组胎膜早破、早产、巨大儿、围产儿结局不良发生率高于对照组(P＜0.05); GDM组RI≥8.5孕妇组中的早产、胎膜早破、剖宫产、围产儿结局不良发生率高于RI<8.5孕妇组(P＜0.05).结论:妊娠晚期胎儿肾动脉阻力指标监测可评估GDM围产儿预后,肾动脉RI是预测不良妊娠结局的敏感指标,当RI≥8.5时,要警惕胎儿缺氧等不良围产儿结局的发生.%Objective: To explore the clinical value of fetal renal artery resistance index detection perinatal fetal monitoring in gestational diabetes mellitus ( GDM ). Method: 96 pregnant women with GDM and 98 normal pregnant women were enrolled in this study. The fetal artery resistant index( RI ), pulsatility index ( PI ) and peak systolic velocity to end diastolic velocity ratio ( S/D )were detected by color doppler ultra-sonography, then the artery resistant index changes of renal artery and pregnant outcomes in two groups were compared. Result: RI,PI and S/D value of fetal renal artery in the GDM group were higher than those in control group( P<0. 05 ),the premature rupture of membrane , premature delivery, macrosomia, adverse perinatal outcome rate in GDM group were higher than those in control group( P<0. 05 ). In GDM group RI was more than 8. 5 of the group of premature rupture of membrane , premature delivery , cesarean section, adverse perinatal outcome rate were higher than RI less than 8. 5 pregnant women groups( P<0. 05 ). Conclusion: Fetal renal artery resistance index monitoring in the third-trimester can be assessed GDM perinatal infants dead prognosis. Renal artery RI is to predict adverse pregnancy outcome of sensitive index. When RI is more than 8.5, It's alert fetal oxygen and other adverse perinatal infants dead end occurs.
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