子宫动脉血流多普勒彩超检测及血清PLGF与妊娠期高血压疾病相关性研究

Evaluation of uterine artery flow with color Doppler ultrasound and serum PLGF for prediction of hypertensive disorders in pregnancy

目的:探讨子宫动脉血流指标和血清胎盘生长因子(PLGF)水平与妊娠期高血压疾病(HDP)发生的相关性。方法:2005年3月～2006年11月收集该院孕妇资料,孕10～14周时,抽取孕妇外周血,ELISA测定PLGF水平;孕20～24周开始,采用多普勒彩超监测两侧子宫动脉血流的S/D、RI、PI值。随访至产后3个月,共有200例入选,分为妊娠期高血压疾病组(高血压组)和正常组。结果:高血压组血清PLGF为(36.1±7.9)pg/ml,明显低于正常组(51.6±9.2)pg/ml(P<0.01)。高血压组平均S/D值为2.69±0.33、RI0.58±0.11、PI1.27±0.31,与正常组平均S/D值1.81±0.30、RI0.44±0.09、PI0.82±0.21比较差异显著(P值均<0.05)。各项指标综合评分≥4分时,可获得最好的临床预测效果。结论:PLGF表达异常和多普勒彩超显示子宫血流动力学变化,都与HDP的病理过程有密切联系,可以作为妊娠期间的综合监测指标。

Objective： To determine the correlation between uterine artery hemodynamics or serum PLGF and the onset of hypertensive disorders in pregnancy. Methods： Clinical data of pregnant women were analyzed prospectively during 2005/3 - 2006/11. At 10 - 14 weeks＇gestation, their peripheral blood samples were harvested to measure the PLGF levels with ELISA. Since 20 -24 weeks＇gestation, the S/D ratio, RI, PI in both sides of uterine artery were monitored with color Doppler ultrasound. All of them were followed up till 3 months postpartum and 148 cases were enrolled into hypertensive or normal groups. Results： The mean of serum PLGF in hypertensive group [ （36. 1 ±7.9） pg/ml] was significantly lower than that in normal group [ （51. 6±9. 2） pg/ml] （P 〈0. 01 ） . The S/D ratio, RI, and Pl were 1.81 ±0. 30, RI 0. 44 ±0.09, PI 0. 82 ±0. 21 in normal group; and 2. 69 ±0. 33, RI 0. 58 ±0. 11, PI 1.27 ±0. 31 in hypertensive group, respectively （ P 〈 0.05 ） . The optimal cut - off level of integrated scoring was 4 for appropriate clinical prediction. Conclusion： Abnormal expression of PLGF and changes of uterine artery hemodynamics were both associated with the pathological processes of hypertensive disorders in vreznancv, which can be taken as monitoring, indexes.