子宫动脉超声多普勒血流监测在妊娠期高血压疾病中的临床价值

Clinical significance of uterine artery Doppler velocimetry in pregnancy-induced hypertension

目的:探讨妊娠期高血压疾病患者子宫动脉血流评分(UAS)与妊娠期高血压疾病患者围产期结果的关系。方法:对190例妊娠期高血压疾病患者(轻度80例,中度74例,重度36例)进行脐动脉和子宫动脉超声多普勒血流检测,并对子宫动脉超声多普勒血流进行评分。结果:子宫动脉血流异常比脐动脉血流异常更为常见(36.3%∶10.2%)(P<0.001);随着病情进展,子宫动脉血流异常明显增多,但仍有68.8%的轻中度和41.7%的重度表现了正常的子宫动脉血流;随着UAS增高,剖宫产率明显增高、出生时孕周明显减低、出生体重显著下降、早产和小于胎龄儿发生率明显增加、转入新生儿监护中心发生率明显增加。结论:UAS是预测妊娠期高血压疾病不良围产期结果的早期且敏感指标;子宫胎盘循环病变可能不是妊娠期高血压疾病的唯一表现和原因。

Objective： To study the relationship between uterine artery score （UAS） and perinatal outcome in women with pregnancy-induced hypertension （PIH）. Methods： Uterine-umbilical artery Doppler veloeimetry was performed in 190 cases of PIH, including 80 cases of mild PIH, 74 moderate PIH, and 36 severe PIH. UAS was used to evaluate the uterine artery blood flow. Resuits： The incidence of abnormal uterine artery blood flow was higher than that of abnormal umbilical artery blood flow （36.3% vs. 10.2%, P 〈 0.05 ） , and increased with the progression of PIH. The uterine artery blood flow was normal in 68.8% of the mild and moderate PIH and 41.7% of the severe PIH. With the increases of UAS, the rates of cesarean section, premature delivery, and admission to neonatal intensive care unit increased, and the gestational age at birth and birth weight decreased. Conclusion： UAS is an early and sensitive indicator to predict the perinatal outcome. Impaired placental circulation may be not the unique finding in PIH.