不同类型重度子痫前期血流动力学改变及与妊娠结局的关系

Hemodynamic Changes in Different Kinds of Severe Preeclampsia and the Relationship of Pregnant Outcomes with Expectant Management

目的探讨重度子痫前期血流动力学改变与期待疗法妊娠结局的关系。方法选取2005年1月-2006年6月住院分娩的重度子痫前期孕妇共217例，按入院孕周分为两组：I组（早发型）发病孕周≤33．6周111例，Ⅱ组（晚发型）为发病孕周≥34周106例。两组入院时均行MP妊娠高血压监测系统测定心输出量、心脏指数、外周阻力、血液粘度及血管顺应性；同时对进行期待疗法的101例早发型重度子痫前期，比较结局良好组（64例）与结局不良组（37例）上述指标的差异。结果I组与Ⅱ组的心输出量、心脏指数、外周阻力、血液粘度及血管顺应性均无统计学差异，I组期待疗法结局良好组和结局不良组心输出量、心脏指数、外周阻力、血液粘度及血管顺应性均无统计学差异。结论不同类型的重度子痫前期存在着相同的血流动力学变化；且血流动力学对预测早发型重度子痫前期期待疗法的妊娠结局意义尚不能肯定。

Objective To investigate the hemodynamic changes in different types severe preeclampsia and the relationship of pregnant outcomes in expectant management.Methods 217 pregnant women who were diagnosed as severe preeclampsia between January 1,2007 and June 30,2008 were included in this study.They were divided into two groups according to the gestation week when admission：group I was defined as the gestation week less than 33.6 week, 111 women;Group Ⅱ was defined as the gestation weeks more than 34 weeks, 106 women.Cardiac output（CO）,cardiac index（CI）,peripheral resistance,blood viscosity,peripheral vascular compliance of the women were detected with the MP monitoring system for patients in group I and group Ⅱ .At the same time,the indexes mentioned above were compared between different pregnant outcomes in group I prescribing expectant manage- ment（101 patients）.Result There were no significant differences in cardiac output, cardiac index,peripheral resistance, blood viscosity,peripheral vascular compliance between the group I and group Ⅱ .The indexes mentioned above with fine pregnant outcomes（64 patients） were almost the same as those with bad pregnant outcomes（37 patients） in group I .Conclusion Different types of severe preeclampsia have the similar hemodynamic changes;Hemody- namic change is not idea to predict the pregnant outcomes in early onset preeclampsia with expectant management.