妊娠期高血压疾病患者子宫动脉及胎儿脐动脉的血流动力学观察

Monitoring Gravidity Hypertension Collecting the Patient Womb Arterial and the Embryo Navel Arterial Blood Stream Synthetically Analysis

目的观察妊娠期高血压疾病(HDCP)患者子宫动脉及胎儿脐动脉的血流动力学变化,为降低围生儿不良妊娠结局提供依据。方法应用彩色多普勒检测120例正常晚期妊娠和120例HDCP患者胎儿脐动脉的收缩末期最大血流速度和舒张末期最大血流速度之比(S/D)、搏动指数(PI)、阻力指数(RI)及子宫动脉的S/D、PI、RI、血管直径(D),同时观察胎儿宫内发育情况如双顶径、股骨长度、胎儿体重,并记录新生儿出生体重、Apgar评分及胎儿窘迫、FGR、低体重儿的发生率。结果HDCP组脐动脉S/D、PI、RI值均高于对照组,HDCP组子宫动脉的S/D、PI、RI值也均高于对照组,血管内径则小于对照组,差异有显著统计学意义(P<0.05)。将HDCP患者分为脐动脉S/D≥3和S/D<3两组,比较其妊娠结局,前者Apgar评分<7分、胎儿窘迫、FGR、低体重儿的发生率均高于后者,差异有显著统计学意义(P<0.05)。结论HDCP患者存在子宫-胎盘、胎盘-胎儿循环障碍,子宫动脉及脐动脉阻抗增高、血供不足,这些病理生理变化与不良妊娠结局相关。彩色超声多普勒可以检测HDCP患者子宫动脉、脐动脉血流动力学变化,在预测HDCP病情发展程度和围生儿结局方面有重要的临床价值。

Objective To study changes on hemodynamics of fetal umbilical artery and uterine artery minute, to evaluate the utility of color Doppler blood flow visualize technology in HDCP. Methods Color Doppler blood flow visualize technology was used to defect the systolic/diastolic（S/D） ratio and pulsatility indexes（PI）,and resistance indexs（RI） of fetal umbilical artery and to detect the S/D,PI, RI and artery diameter of utery in 120 nomal late and 120 HDCP cases. Study intrauterine growth of the fetus by measurement of fetal biparietal diameter （BPD）,femur lenth （FL）,embryo＇s weight,the birth weight,Apgar score,and the ratio of fetal distress,fetal growth retardation （FGR）,low weight babies. Results The S/D,PI,RI of fatal umbilical arter in HDCP were higher than thoae of controls. The S/D, PI, RI of uterine artery of controls. Artery diameter was smaller in controls,the difference was signigiant compared with HDCP,S/D≥3 group and S/D〈3 group. Compared the reoutcome of pregnant. The ratio of Apgar score〈7, fetal distress,FGR,low weight babies in S/D〈3 group. The difference was significant （P〈0.05）. Conclusion There was disturbance of uterine-placenta and placenta-fetal circulation. The increase of uterine artery stream and umbilical stream and insufficient blood supply is related to abnomal pregnant color Dopper can defect the hemodynamics of fetal umbilical artery and uterine artery in HDCP. It＇s important to assess HDCP and perinatal outcome.