血管内皮生长因子与总外周血管阻力的关系及其在妊娠期高血压发病中的机制探讨

Relationship between Vascular Endothelial Growth Factor and Total Peripheral Vascular Resistance and Its Morbility Mechanism in Gestational Hypertension

目的分析血管内皮生长因子（VEGF）与总外周血管阻力（TPVR）的关系。方法对正常妊娠孕妇（48例）和妊娠期高血压孕妇（48例）于妊娠20～27^＋6周，28—36^＋6周，≥37周和产后6—8周采用酶联免疫吸附试验动态测量血清VEGF水平，同时采用彩色多普勒超声监测主动脉环内径及血流频谱，计算TPVR，分析VEGF与TPVR的关系。结果随着妊娠的进展，两组孕妇血清VEGF水平持续升高。在妊娠28—36^＋6周和妊娠37周时，两组孕妇血清VEGF水平间差别有统计学意义（P〈0．05），在妊娠28～36^＋6周时两组孕妇TPVR水平间差别有统计学意义（P〈0．05）；产后7周时两组孕妇VEGF水平和TPVR水平间差别均无统计学意义（P〉0．05）。妊娠期高血压病组在妊娠28周后VEGF与TPVR呈正相关（r=0．54，P〈0．05），但这种相关性并不存在于对照组。结论高水平的VEGF可能参与了母体血管内皮细胞损伤，使血管活性物质释放增加，血管收缩和舒张因子失衡，血流动力学紊乱，总外周血管阻力升高，引起高血压。

Objective To analyze plasma vascular endothelial growth factor （VEGF） ＇s relationship with total peripheral vascular resistance （PVR） and to probe the pathogenesis of gestational hypertension by hemodynamics on the hypothesis of vascular endothelial cells dysfunction to find a new way of preveation and treatment. Methods In 48 normal pregnant women and 48 pregnant women with gestational hypertension, we determined dynamically the concentration of plasma VEGF by enzyme linked immunosorbent assay （ELISA）, monitored the internal diameter of aortic ring and bloodstream spectra by Doppler ultrasound, reckoned TPVR and analyzed the relationship between VEGF and TPVR respectively in 20 - 27 ＋ 6 weeks, 28 - 36 ＋ 6 weeks and ≥ 37 weeks in the gestational period, and 6 -8 weeks after parturition. Results There was a positive correlation between vascular endothelial growth factor and total peripheral vascular resistance in the pregnant women with gestational hypertension （ P 〈 0. 05 ）. Conclusion The dysfunction of the hemodynamics increases the levels of total peripheral vascular resistance, thus to induce hypertension.