新利尿合剂对妊娠期高血压疾病患者肾及视网膜血流的影响

Effect of new diuretic mixture on hemodynamics of renal and central retinal artery in patients with hypertensive disorder complicating pregnancy

目的:探讨新利尿合剂(多巴胺、酚妥拉明、速尿)治疗妊娠期高血压疾病的机理。方法:彩色多普勒超声检测24例妊娠期高血压疾病患者静脉滴注新利尿合剂(治疗组)前、后肾动脉及视网膜中央动脉血流动力学的改变,并与同期24例静脉滴注硫酸镁者(对照组)进行比较。结果:治疗组用药前、后比较收缩压和舒张压均降低(P<0.05),肾动脉、视网膜中央动脉血流速度增加(P<0.05,P<0.01),搏动指数、阻力指数降低(P<0.01)。用药后治疗组的收缩压与舒张压较对照组有显著下降(P<0.05),肾动脉血流速度较对照组增加(P<0.05),而搏动指数、阻力指数较对照组降低(P<0.05);视网膜中央动脉血流速度、搏动指数、阻力指数与对照组无统计学差异。结论:新利尿合剂可通过扩张肾、视网膜中央动脉降低外周动脉阻力治疗妊娠期高血压疾病。

Objective： To investigate the mechanism of new diuretic mixture on patients with hypertensive disorder complicating pregnancy. Methods： 24 patients （study group） with hypertensive disorder complicating pregnancy were studied with color Doppler imaging before and after intravenous new diuretic mixture, while other 24 patients （ control group） received intravenous magnesium sulfate. Hemodynamics of renal artery and central retinal artery were measured. Results： New diuretic mixture reduced blood hypertension （P 〈 0. 05） and increased the blood flow velocity of the renal artery and the central retinal artery （P 〈 0. 05 and P 〈 0. 01 ） and reduced pulsatility index （PI） and resistance index （RI） of renal artery and the central retinal artery significantly （P 〈 0. 01 ） . After treatment, compared with control group, blood hypertension were reduced （P 〈 0. 05 ） . The blood flow velocity of the renal artery were increased （ P 〈 0.05 ） . PI and RI of renal artery were reduced （ P 〈 0. 05 ） . Blood flow velocity, PI and RI of the central retinal artery had no change. Conclusion： The mechanism of treatment of new diuretic mixture on patients with hypertensive disorder complicating pregnancy is that it may dilate renal artery and central retinal artery and reduce resistance of peripheral arteries.