眼动脉多普勒在子痫前期筛查中的应用——当前证据的系统综述。
完整摘要 · 中文译文
子痫前期（PE）累及所有妊娠的2-15%，并且仍然是孕产妇发病和死亡的主要原因。与单胎妊娠相比，多胎妊娠中的发生率约高出三倍。早期识别PE高危女性至关重要；早孕期筛查已成为产前保健的标准组成部分。本系统综述旨在总结关于眼动脉多普勒（OAD）在预测单胎和双胎中PE作用的最新证据。近期研究使得基于母体因素、病史、平均动脉压（MAP）、子宫动脉搏动指数（UtA-PI）和胎盘生长因子（PLGF）的PE预测算法得以开发。在OAD参数中，与血压正常的妊娠相比，随后发生PE的女性中持续观察到PSV2/1比值升高。OAD PSV比值被广泛用作PE的预测工具。相比之下，搏动指数（PI）、阻力指数（RI）和舒张末期流速（EDV）的预测能力有限，对整体模型性能的贡献极小。将OAD参数整合到已建立的多模式筛查模型中可能提高PE的预测准确性。OAD是一种可能具有成本效益、可及且技术上可行的模态，可能有助于风险分层，尤其是在生化检测可及性有限的环境中。然而，需要进一步的大规模前瞻性研究来验证其临床效用、标准化评估方案并确定其Ro 在常规肺栓塞筛查算法中的地位。
完整摘要 · 英文原文
Preeclampsia (PE) complicates 2-15% of all pregnancies and continues to be a leading cause of maternal morbidity and mortality. The incidence is about three times higher in multiple gestations compared to singleton pregnancies. Early identification of women at high risk for PE is crucial; first-trimester screening has become a standard component of prenatal care. This systematic review aims to summarize current evidence on the role of ophthalmic artery Doppler (OAD) in predicting PE among singleton and twins. Recent research has enabled the development of algorithms for PE prediction based on maternal factors, medical history, mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and placental growth factor (PLGF). Within OAD parameters, the elevated PSV2/1 ratio has been consistently observed in women who later developed PE compared with normotensive pregnancies. OAD PSV ratio is widely used as a prediction tool for PE. In contrast, the pulsatility index (PI), resistance index (RI), and end-diastolic velocity (EDV) demonstrated limited predictive ability and contributed minimally to overall model performance. Integration of OAD parameters into established multimodal screening models may improve predictive accuracy for PE. OAD is a potentially cost-effective, accessible, and technically feasible modality that may support risk stratification, particularly in settings with limited access to biochemical testing. However, further large-scale prospective studies are needed to validate its clinical utility, standardize assessment protocols, and determine its role in routine PE screening algorithms.