多普勒超声参数在预测胎儿宫内发育迟缓的价值研究进展

Research Progress on the Value of Doppler Ultrasound Parameters in Predicting Intrauterine Growth Restriction

摘要: 胎儿宫内发育迟缓(Intrauterine Growth Restriction, IUGR)又称胎儿生长受限(Fetal Growth Restriction, FGR)，作为围产医学领域的重要并发症，IUGR不仅显著增加围产儿窒息、死亡风险，还与儿童期神经发育障碍及成年后代谢综合征高发密切相关。早期精准预测是改善IUGR母儿结局的关键，而多普勒超声凭借其无创、可重复、实时动态的优势，已成为评估胎儿血流动力学状态的核心手段。本文系统梳理近10年国内外相关研究，从胎儿胎盘循环、中枢循环、肾脏循环及母体子宫循环等维度，阐述脐动脉、大脑中动脉、肾动脉、静脉导管及子宫动脉等核心多普勒超声参数的预测价值，分析单一参数与多参数联合应用的效能差异，探讨当前研究存在的问题及未来发展方向，为临床早期识别IUGR提供参考依据。

Abstract: Intrauterine Growth Restriction (IUGR), also known as Fetal Growth Restriction (FGR), is a critical complication in the field of perinatal medicine. IUGR not only significantly increases the risks of perinatal infant asphyxia and mortality but also is closely associated with a higher incidence of childhood neurodevelopmental disorders and adult-onset metabolic syndrome. Early and accurate prediction is the key to improving maternal and fetal outcomes of IUGR, and Doppler ultrasound, with its advantages of being non-invasive, reproducible, and real-time dynamic, has become the core modality for evaluating fetal hemodynamic status. This article systematically reviews relevant domestic and international studies over the past decade, elaborates on the predictive values of core Doppler ultrasound parameters (including those of the umbilical artery, middle cerebral artery, renal artery, ductus venosus, and uterine artery) from the perspectives of fetal-placental circulation, central circulation, renal circulation, and maternal uterine circulation, analyzes the efficacy differences between the application of single parameters and the combined application of multiple parameters, discusses the existing problems in current research and future development directions, and provides a reference basis for the early clinical identification of IUGR.