增强指数（AIx@75）升高：一种筛查妊娠高血压疾病的有前景的工具。
Increase of augmentation index (AIx@75): a promising tool for screening hypertensive pregnancy disorders.
作者信息
de Oliveira-Gomide Patrícia Myriam Antunes, Palomero Bueno Marta Luisa, Signorelli Mariana de Sena Milagres, Santos Laura Ferreira Moreira Dos, Falcão Junior João Oscar, Rezende Bruno Almeida, Ferreira-Silva Breno Augusto, da Silva Jose Felippe Pinho, Rodrigues-Machado Maria da Glória
机构信息
Faculty of Medical Sciences of Minas Gerais, Alameda Ezequiel Dias, 275, Belo Horizonte, MG, CEP: 30130 -110, Brazil.
Municipal Center for Diagnostic Imaging in Gynecology-Obstetrics of the City of Belo Horizonte, Belo Horizonte, 30210-230, Brazil.
出版信息
BMC Pregnancy Childbirth. 2025 Apr 16;25(1):457. doi: 10.1186/s12884-025-07493-4.
BACKGROUND
Screening tools in the first trimester of pregnancy for hypertensive pregnancy disorders need to be determined.
OBJECTIVES
To compare cardiovascular parameters between pregnant (PG) and non-pregnant women (NPG) and to evaluate the sensitivity and specificity of arterial stiffness indices in screening for hypertensive pregnancy disorders and their possible association with the mean uterine artery pulsatility index (MUA-PI).
METHODS
This study included 77 pregnant women (11-13.6 gestational weeks) and 77 age-matched non-pregnant women. Cardiovascular parameters were non-invasively measured using Mobil- O-Graph, a cuff-based oscillometric device. The Doppler Ultrasonographic was used to evaluate the MUA-PI.
RESULTS
Augmentation index (AIx@75) was significantly higher in PG compared to NPG. ROC curve of AIx@75 showed area under curve (AUC): 0.7303, Sensitivity: 74.03% and Specificity: 64.94% and Cutoff: 22.50%. The systolic volume index was lower and the heart rate was higher in PG compared to NPG. Of the 77 pregnant women, 12 had an unfavorable outcome with hypertensive changes. Central systolic blood pressure (109.1 ± 8.84mmHg) and AIx@75 (31.97 ± 5.47%) were significantly higher in the group of pregnant women with outcome compared to the group without outcome (103.0 ± 8.53mmHg and 26.80 ± 8.71%). ROC curve showed better performance of the AIx@75 [AUC: 0.7179, Sensitivity: 83.33% and Specificity: 60.00%, Cutoff: 27.67%] compared to MUA-PI [AUC: 0.5098, Sensitivity: 8.333% and Specificity 98.44%].
CONCLUSIONS
AIx@75 was significantly higher in PG compared to NPG. We compared the AIx@75 of PG with and without outcomes. ROC curve analysis showed that this index could discriminate between PG with and without an outcome. Differently, the MUA-PI did not differ between PG with and without outcome, suggesting the superiority of AIx@75 in relation to MUA-PI as a method of screening in the first trimester for hypertensive disease of pregnancy. AIx@75 did not assotiate with MUA-PI. Prospective studies will be needed to confirm these findings.
背景
需要确定妊娠早期用于筛查妊娠高血压疾病的工具。
目的
比较孕妇（PG）和非孕妇（NPG）的心血管参数，评估动脉僵硬度指数在筛查妊娠高血压疾病中的敏感性和特异性，以及它们与子宫动脉平均搏动指数（MUA-PI）的可能关联。
方法
本研究纳入了77名孕妇（妊娠11 - 13.6周）和77名年龄匹配的非孕妇。使用基于袖带的示波装置Mobil-O-Graph对心血管参数进行无创测量。采用多普勒超声评估MUA-PI。
结果
与NPG相比，PG的增强指数（AIx@75）显著更高。AIx@75的ROC曲线显示曲线下面积（AUC）为0.7303，敏感性为74.03%，特异性为64.94%，截断值为22.50%。与NPG相比，PG的收缩期容积指数较低，心率较高。在77名孕妇中，12名出现了伴有高血压变化的不良结局。有不良结局的孕妇组的中心收缩压（109.1±8.84mmHg）和AIx@75（31.97±5.47%）显著高于无不良结局的孕妇组（103.0±8.53mmHg和26.80±8.71%）。ROC曲线显示，与MUA-PI相比，AIx@75的表现更好[AUC：0.7179，敏感性：83.33%，特异性：60.00%，截断值：27.67%]，而MUA-PI的AUC为0.5098，敏感性为8.333%，特异性为98.44%。
结论
与NPG相比，PG的AIx@75显著更高。我们比较了有和无不良结局的PG的AIx@75。ROC曲线分析表明，该指数可以区分有无不良结局的PG。不同的是，有无不良结局的PG之间MUA-PI没有差异，这表明在妊娠早期作为妊娠高血压疾病筛查方法时，AIx@75相对于MUA-PI具有优越性。AIx@75与MUA-PI无关联。需要进行前瞻性研究来证实这些发现。
Zotero 插件