子痫前期子宫螺旋动脉血流与孕妇血清血管内皮生长因子表达相关研究

Correlation between hemodynamics of uterine spiral artery and expression of serum vascular endothelial growth factor in pregnant women

目的应用彩色多普勒超声技术检测子宫螺旋动脉,与孕妇血清血管内皮生长因子(VEGF)检测相结合,分析子痫前期子宫螺旋动脉血流动力学参数改变和其病情严重程度的关系。方法对30例子痫前期孕妇及38名健康孕妇,在未经任何药物治疗前,应用彩色多普勒超声技术检测子宫螺旋动脉,并对结果进行记录和比较。用酶联免疫吸附试验(ELISA)法测定血清VEGF含量。结果①子宫螺旋动脉血流动力学参数子痫前期组较对照组搏动指数(PI)值、阻力指数(RI)值、收缩期峰值流速与舒张末期血流速度之比值(S/D)增高,差异有统计学意义(P<0.01)。子痫前期重度组与轻度组比较各血流动力学参数值均增高,差异有统计学意义(P<0.01)。②血清VEGF含量子痫前期组较对照组降低,差异有统计学意义(P<0.01),子痫前期重度组低于轻度组,差异有统计学意义(P<0.01)。③子痫前期血清VEGF水平分别与子宫螺旋动脉血流动力学参数PI(r=-0.79,P<0.01)、RI(r=-0.78,P<0.01)、S/D(r=-0.83,P<0.01)呈显著负相关。结论①彩色多普勒超声技术检测子宫螺旋动脉血流可以预测子痫前期严重程度。②子痫前期孕妇血清VEGF表达与子宫螺旋动脉血流动力学参数之间呈显著负相关。

Objective To analyze the correlation between altered hemodynamics of uterine spiral artery and severity of pre-eclampsia during pregnancy by color Doppler ultrasound detection of uterine spiral artery and test of serum vascular endothelial growth factor （VEGF）. Methods Before pharmacotherapy, the uterine spiral artery was measured with color Doppler ultrasound in 30 cases of pre-eclampsia complicating pregnancy and 38 cases of normal pregnancy. The results were recorded and compared between the two groups. ELISA was used for detecting serum VEGF in all subjects. Results ① Of the uterine spiral artery hemodynamic parameters, PI, RI and S/D were higher in pre-eclampsia group than in normal group （P〈0.01）. These hemodynamic parameters were higher in patients with severe pre-eclampsia than in mild cases （P〈0.01）. ② The contents of serum VEGF was lower in pre-eclampsia group than in normal group, and in severe pre-eclampsia group than in mild cases （P〈0.01）. ③ Serum VEGF level was negatively correlated with parameters of uterine spiral artery hemodynamics [PI （r=-0.79, P〈0.01）, RI （r=-0.78, P〈0.01） and S/D（r=-0.83, P〈0.01）] in pre-eclamptic pregnancy （P〈0.01）. Conclusion ① Color Doppler ultrasound detection of uterine spiral artery flow may be useful to predict severity of pre-eclampsia during pregnancy. ② Expression of serum VEGF appeared to be negatively correlated with hemodynamics of uterine spiral artery in pre-eclamptic pregnancy.