初步探讨孕11~13^＋6周子宫螺旋动脉血流动力学参数预测妊娠期糖尿病（GDM）的价值。

前瞻性选取2016年12月至2018年2月在深圳市南山区妇幼保健院产科门诊规律产检的孕妇154例，根据追踪随访结果将其分为正常组138例和GDM组16例。所有孕妇均于孕11~13^＋6周进行超声多普勒检查，测量子宫螺旋动脉血流动力学参数，包括搏动指数（PI）、平均舒张期血流速度（MDV）和时间平均峰值流速（TAPV）。对GDM组与正常组的血流动力学参数进行比较，并绘制ROC曲线，评估子宫螺旋动脉PI预测GDM的效能。

GDM组的子宫螺旋动脉PI值高于正常组（0.87±0.34 vs 0.64±0.18），2组比较差异有统计学意义（t=-4.06，P<0.05）；GDM组的MDV和TAPV比正常组略低，但差异均无统计学意义（P均>0.05）。螺旋动脉PI预测GDM的ROC曲线下面积为0.737（95% CI：0.606~0.867，P<0.05），PI 0.70为最佳界值，其预测GDM的敏感度、特异度分别为93.8%、45.8%。

孕11~13^＋6周出现的子宫螺旋动脉血流动力学改变可能与GDM的发生有关，子宫螺旋动脉PI值对预测GDM具有一定价值。

To study the changes of maternal spiral artery Doppler indices in women with gestational diabetes in the first trimester of pregnancy.

We performed a prospective observational cohort study, involving 154 singleton pregnancies in our obstetric clinic from December 2016 to February 2018. According to the follow-up results, 138 cases were divided into a normal group and 16 cases were divided into a GDM group. All pregnant women were examined by Doppler ultrasonography at 11-13^{+ 6} weeks of gestation to measure the hemodynamic parameters of the uterine spiral artery, including pulsation index (PI), mean diastolic blood flow velocity (MDV), and time-averaged peak flow velocity (TAPV). The hemodynamic parameters of the GDM group and normal group were compared, and ROC curve analysis was performed to evaluate the effect of uterine spiral artery PI in predicting GDM.

PI of the uterine spiral artery in the GDM group was significantly higher than that in the normal group (0.87±0.34 vs 0.64±0.18, t=-4.06, P<0.05), and MDV and TAPV in the GDM group were slightly lower than those in the normal group, without statistical significance. The area under the ROC curve of PI in predicting GDM was 0.737 (95% CI: 0.606~0.867, P<0.05). Using an optimal cutoff of PI of 0.70, the sensitivity and specificity were 93.8% and 45.8%, respectively.

The hemodynamic changes of the uterine spiral arteryat 11-13^{+ 6} weeks of gestation may be related to the occurrence of GDM. The PI of the uterine spiral artery has appreciated value in predicting GDM.