Predictive value of cerebroplacental ratio, cerebro-uterine ratio combined with cystatin C for adverse pregnancy outcomes in preeclampsia fetuses

LU Huan; TIAN Tian; WU Xue-hui; ZHOU Chun-mei; WU Xin-yu; LI Wei

doi:10.11659/jjssx.03E025097

您当前的位置：

首页 >

文章列表页 >

Predictive value of cerebroplacental ratio, cerebro-uterine ratio combined with cystatin C for adverse pregnancy outcomes in preeclampsia fetuses

Clinical Research | 更新时间：2025-09-24

- Predictive value of cerebroplacental ratio, cerebro-uterine ratio combined with cystatin C for adverse pregnancy outcomes in preeclampsia fetuses
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 9, Pages: 827-831(2025)
- 作者机构：
  
  1.成都医学院第二附属医院/核工业四一六医院妇产科，四川成都 610051
  2.四川省医学科学院·四川省人民医院/电子科技大学附属医院妇产科，四川成都 610000
  3.成都医学院第二附属医院/核工业四一六医院超声科，四川成都 610051
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.03E025097
  CLC： R445.1
- Received：17 March 2025，
  
  Published：25 September 2025
- 稿件说明：
移动端阅览
陆欢,田恬,吴雪辉等.脑-胎盘率、脑-子宫率联合胱抑素C对子痫前期不良妊娠结局的预测价值[J].局解手术学杂志,2025,34(09):827-831.

LU Huan,TIAN Tian,WU Xue-hui,et al.Predictive value of cerebroplacental ratio, cerebro-uterine ratio combined with cystatin C for adverse pregnancy outcomes in preeclampsia fetuses[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):827-831.
陆欢,田恬,吴雪辉等.脑-胎盘率、脑-子宫率联合胱抑素C对子痫前期不良妊娠结局的预测价值[J].局解手术学杂志,2025,34(09):827-831. DOI： 10.11659/jjssx.03E025097.

LU Huan,TIAN Tian,WU Xue-hui,et al.Predictive value of cerebroplacental ratio, cerebro-uterine ratio combined with cystatin C for adverse pregnancy outcomes in preeclampsia fetuses[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):827-831. DOI： 10.11659/jjssx.03E025097.

摘要

目的

探讨脑-胎盘率（CPR）、脑-子宫率（CUR）联合胱抑素C（CysC）对子痫前期（PE）患者不良妊娠结局的预测价值。

方法

回顾性分析2019年1月至2024年12月核工业四一六医院妇产科收治的150例PE患者的临床资料，根据妊娠结局将患者分为不良结局组和良好结局组。比较2组患者临床资料、CPR、CUR及CysC水平差异。采用多因素

Logistic

回归分析PE患者不良妊娠结局的独立影响因素；随后通过受试者工作特征（

ROC

）曲线评估各指标对患者不良妊娠结局的预测效能。

结果

不良结局组患者发病孕周、胎儿估测体质量、CUR、CPR均短/小于良好结局组，而体质量指数、CysC水平大/高于良好结局组，差异有统计学意义（

0.05）。多因素

Logistic

回归分析显示，CysC水平升高、CUR及CPR降低是PE患者出现不良妊娠结局的相关影响因素（

0.05）。

ROC

曲线分析显示，CUR、CPR、CysC对PE患者不良妊娠结局均有较好的预测价值，曲线下面积（

AUC

）分别为0.802（95%

：0.729~0.863）、0.834（95%

：0.764~0.890）、0.791（95%

：0.717~0.853）；CUR、CPR、CysC联合预测的

AUC

为0.909（95%

：0.851~0.950），大于三者单独预测（

0.05）。

结论

CUR、CPR、CysC是PE患者不良妊娠结局的影响因素，三者联合检测对于PE患者不良妊娠结局有较好的预测价值。

Abstract

Objective

To investigate the predictive value of cerebroplacental ratio （CPR），cerebro-uterine ratio （CUR） combined with cystatin C （CysC） for adverse pregnancy outcomes in preeclampsia （PE） fetuses.

Methods

A retrospective analysis was conducted on the clinical data of 150 PE patients admitted to the department of obstetrics and gynecology of Nuclear Industry 416 Hospital from January 2019 to December 2024，and patients were divided into the adverse-outcome group and the favorable-outcome group according to pregnancy outcomes.The clinical data，CPR，CUR and CysC level were compared between the two groups.Multivariate

Logistic

regression was used to analyze the independent influencing factors of adverse pregnancy outcome in PE patients； then，

receiver operating characteristic

（

ROC

） curve analysis was performed to evaluate the predictive efficiency of each index on adverse pregnancy outcome.

Results

The adverse-outcome group had shorter/lower gestational age at diagnosis，estimated fetal body weight，CUR，and CPR，but higher body mass index and CysC level compared to those in the favorable-outcome group，with significant differences （

0.05）.Multivariate

Logistic

regression identified that the elevated CysC level， and decreased CUR and CPR were related influencing factors for adverse pregnancy outcome （

0.05）.

ROC

curve analysis demonstrated that CUR，CPR and CysC had strong predictive value for adverse pregnancy outcome，with the

area under the curve

（

AUC

） of 0.802（95%

： 0.729 to 0.863），0.834 （95%

： 0.764 to 0.890），and 0.791 （95%

： 0.717 to 0.853），respectively； the combined prediction of CUR，CPR and CysC had grater

AUC

of 0.909 （95%

： 0.851 to 0.950） than the individual prediction of the above three indicators（

0.05）.

Conclusion

CUR，CPR and CysC are influencing factors of adverse pregnancy outcome in PE patients，and their combined detection demonstrates good predictive value for adverse pregnancy outcome in PE patients.

关键词

Keywords

references

Dimitriadis E ， Rolnik DL ， Zhou W ， et al . Pre-eclampsia ［J］. Nat Rev Dis Primers ， 2023 ， 9 （ 1 ）： 8 . doi： 10.1038/s41572-023-00417-6 http://dx.doi.org/10.1038/s41572-023-00417-6 .

Umamah F ， Santoso B ， Yunitasari E ， et al . The effectiveness of psycho-educational counseling in pregnant women with preeclampsia： a systematic review ［J］. J Public Health Res ， 2022 ， 11 （ 3 ）： 1194205217 . doi： 10.1177/22799036221104161 http://dx.doi.org/10.1177/22799036221104161 .

马瑞琳，刘雨，徐桂香，等 . 子痫前期大鼠模型子宫动脉、脐动脉、大脑中动脉超声多普勒参数与胎盘血管病理及妊娠结局的关系［J］. 上海交通大学学报（医学版）， 2024 ， 44 （ 5 ）： 543 - 551 . doi： 10.3969/j.issn.1674-8115.2024.05.001 http://dx.doi.org/10.3969/j.issn.1674-8115.2024.05.001 .

Kale RM ， Tirupathi RG ， Sheela SR . Role of ultrasonography and color doppler in the assessment of high-risk pregnancies and their accuracy in predicting fetal outcome ［J］. Cureus ， 2023 ， 15 （ 5 ）： e39017 . doi： 10.7759/cureus.39017 http://dx.doi.org/10.7759/cureus.39017 .

陈欣林，黄慧，陈佩文 . 产科超声多普勒血流评估新进展［J］. 实用妇产科杂志， 2024 ， 40 （ 11 ）： 864 - 866 . doi： 10.3969/j.issn. 1003-6949.2024.11.syfc22202411003 http://dx.doi.org/10.3969/j.issn.1003-6949.2024.11.syfc22202411003 .

Simanaviciute D ， Gudmundsson S . Fetal middle cerebral to uterine artery pulsatility index ratios in normal and pre-eclamptic pregnancies ［J］. Ultrasound Obstet Gynecol ， 2006 ， 28 （ 6 ）： 794 - 801 . doi： 10.1002/uog.3805 http://dx.doi.org/10.1002/uog.3805 .

Orabona R ， Gerosa V ， Gregorini ME ， et al . The prognostic role of various indices and ratios of Doppler velocimetry in patients with pre-eclampsia ［J］. Clin Exp Hypertens ， 2015 ， 37 （ 1 ）： 57 - 62 . doi： 10.3109/10641963.2014.897723 http://dx.doi.org/10.3109/10641963.2014.897723 .

Eser A ， Zulfıkaroglu E ， Eserdag S ， et al . Predictive value of middle cerebral artery to uterine artery pulsatility index ratio in preeclampsia ［J］. Arch Gynecol Obstet ， 2011 ， 284 （ 2 ）： 307 - 311 . doi： 10.1007/s00404-010-1660-5 http://dx.doi.org/10.1007/s00404-010-1660-5 .

Agaoglu Z ， Tanacan A ， Ipek G ， et al . The role of the cerebro-placental-uterine ratio in predicting composite adverse perinatal outcomes in patients with pregnancy-induced hypertension ［J］. Pregnancy Hypertens ， 2024 ， 37 ： 101148 . doi： 10.1016/j.preghy.2024.101148 http://dx.doi.org/10.1016/j.preghy.2024.101148 .

Khalil A ， Morales-Roselló J ， Townsend R ， et al . Value of third-trimester cerebroplacental ratio and uterine artery Doppler indices as predictors of stillbirth and perinatal loss ［J］. Ultrasound Obstet Gynecol ， 2016 ， 47 （ 1 ）： 74 - 80 . doi： 10.1002/uog.15729 http://dx.doi.org/10.1002/uog.15729 .

Yuan X ， Han X ， Jia C ， et al . Association of maternal serum uric acid and cystatin C levels in late pregnancy with adverse birth outcomes： an observational cohort study in China ［J］. Int J Womens Health ， 2022 ， 14 ： 213 - 223 . doi： 10.2147/IJWH.S350847 http://dx.doi.org/10.2147/IJWH.S350847 .

中华医学会妇产科学分会妊娠期高血压疾病组 . 妊娠期高血压疾病诊治指南（2020）［J］. 中华妇产科杂志， 2020 ， 55 （ 4 ）： 227 - 238 . doi： 10.3760/cma.j.cn112141-20200114-00039 http://dx.doi.org/10.3760/cma.j.cn112141-20200114-00039 .

Zhou P ， Sun Y ， Tan Y ， et al . Fetal and neonatal middle cerebral artery hemodynamic changes and significance under ultrasound detection in hypertensive disorder complicating pregnancy patients with different severities ［J］. Comput Math Methods Med ， 2022 ， 2022 ： 6110228 . doi： 10.1155/2022/6110228 http://dx.doi.org/10.1155/2022/6110228 .

Arbeille P ， Roncin A ， Berson M ， et al . Exploration of the fetal cerebral blood flow by duplex Doppler--linear array system in normal and pathological pregnancies ［J］. Ultrasound Med Biol ， 1987 ， 13 （ 6 ）： 329 - 337 . doi： 10.1016/0301-5629（87）90166-9 http://dx.doi.org/10.1016/0301-5629（87）90166-9 .

Vollgraff HC ， De Boer MA ， Heymans MW ， et al . Prognostic accuracy of cerebroplacental ratio and middle cerebral artery Doppler for adverse perinatal outcome： systematic review and meta-analysis ［J］. Ultrasound Obstet Gynecol ， 2018 ， 51 （ 3 ）： 313 - 322 . doi： 10.1002/uog.18809 http://dx.doi.org/10.1002/uog.18809 .

Zhou S ， Guo H ， Feng D ， et al . Middle cerebral artery-to-uterine artery pulsatility index ratio and cerebroplacental ratio independently predict adverse perinatal outcomes in pregnancies at term ［J］. Ultrasound Med Biol ， 2021 ， 47 （ 10 ）： 2903 - 2909 . doi： 10.1016/j.ultrasmedbio.2021.06.015 http://dx.doi.org/10.1016/j.ultrasmedbio.2021.06.015 .

陆欢 . 彩超监测子痫前期胎儿血流动力学的应用价值及不良结局影响因素分析［D］. 成都：成都医学院， 2020 . doi： 10.27843/d.cnki.gcdyy.2020.000092 http://dx.doi.org/10.27843/d.cnki.gcdyy.2020.000092 .

蒙玉民，廖贵，唐泉，等 . 血清胱抑素C在不同疾病中的应用研究进展［J］. 广西医学， 2023 ， 45 （ 23 ）： 2905 - 2909 . doi： 10.11675/j.issn.0253-4304.2023.23.18 http://dx.doi.org/10.11675/j.issn.0253-4304.2023.23.18 .

Li YT ， Liu CH ， Wang PH . Serum cystatin C or cystatin C-based glomerular filtration rate may be a better choice in estimating renal function in women with preeclampsia ［J］. Taiwan J Obstet Gynecol ， 2021 ， 60 （ 5 ）： 801 - 802 . doi： 10.1016/j.tjog.2021.07.002 http://dx.doi.org/10.1016/j.tjog.2021.07.002 .

Taşkömür AT ， Erten Ö . The role of cystatin C，neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in the evaluation of kidney function in women with preeclampsia ［J］. Taiwan J Obstet Gynecol ， 2021 ， 60 （ 4 ）： 615 - 620 . doi： 10.1016/j.tjog.2021.05.007 http://dx.doi.org/10.1016/j.tjog.2021.05.007 .

陈倩，周瑞娴，郭海香，等 . 胱抑素C、尿白蛋白-肌酐比值与妊娠期高血压疾病肾损伤的相关性研究［J］. 中国计划生育和妇产科， 2022 ， 14 （ 7 ）： 89 - 92 . doi： 10.3969/j.issn.1674-4020.2022.07.21 http://dx.doi.org/10.3969/j.issn.1674-4020.2022.07.21 .

Jin Y ， Chen Y ， Li X ， et al . Enhanced detection of cystatin C for predicting adverse outcomes in gestational diabetes mellitus using a point-of-care immunosensor ［J］. Bioelectrochemistry ， 2025 ， 163 ： 108907 . doi： 10.1016/j.bioelechem.2025.108907 http://dx.doi.org/10.1016/j.bioelechem.2025.108907 .

俞佳丽，朱鸣萍，赵文龙，等 . 早发子痫前期患者血浆胎盘生长因子和胱抑素C水平与妊娠结局的关系［J］. 中国妇幼保健， 2021 ， 36 （ 8 ）： 1714 - 1716 . doi： 10.19829/j.zgfybj.issn.1001-4411.2021.08.003 http://dx.doi.org/10.19829/j.zgfybj.issn.1001-4411.2021.08.003 .

褚慧娟 . 子痫前期孕妇血清铁蛋白、胱抑素C水平与妊娠结局的相关性分析［J］. 临床研究， 2022 ， 30 （ 10 ）： 99 - 103 . doi： 10.12385/j.issn.2096-1278（2022）10-0099-05 http://dx.doi.org/10.12385/j.issn.2096-1278（2022）10-0099-05 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Expression of miR-574 in placental tissue of preeclampsia and its significance in the pathogenesis of preeclampsia

Effect of ureteral wall thickness at the site of ureteral stones on the clinical efficacy of ureteroscopic lithotripsy

Effects of miR-375 knockdown on the proliferation and apoptosis of trophoblast cells in a preeclampsia model and its mechanism

Multimodal MRI manifestations and correlation between lipoprotein-associated phospholipase A2,cystatin C and short-term prognosis in acute cerebral infarction

Etiology and pregnancy outcome of pregnant women with pulmonary hypertension

Related Author

GUO Yan-ling

ZHU Yan-ju

YANG Ying

CHEN Lyu-yang

PU Wei

JI Jian

WU Zhi-da

WANG Ya-fei

Related Institution

Department of Obstetrics，Chengde Maternal and Child Health Care Hospital/Chengde Children's Hospital

Department of Obstetrics，Affiliated Hospital of Chengde Medical University

Department of Urology，the Third People's Hospital of Yunnan Province/the Second Affiliated Hospital of Dali University

Department of Obstetrics， Maternity & Child Care Center of Qinhuangdao

Second Clinical College of North Sichuan Medical College/Department of Neurology，Nanchong Central Hospital/Nanchong Hospital，Beijing Anzhen Hospital， Capital Medical University，Nanchong Sichuan

⁰