检测胎儿脑及脐动脉血流预测妊高征围产儿结局的临床价值

ACTION OF PREGNANCY HYPERTENSION BY OBSE RVATION OF CEREBRAL AND UMBILICAL ARTERY

目的与方法：应用彩色多普勒超声检测正常妊娠妇女６０例（正常组）、妊高征患者２９例（妊高征组）和妊高征合并胎儿宫内发育迟缓２４例（ＩＵＧＲ组）胎儿大脑中动脉、脐动脉血流速度波形，计算出二血管的阻力指数（ＲＩｍｃａ和ＲＩｕａ），结果：正常妊娠晚期ＲＩｍｃａ／ＲＩｕａ＞１。与正常组比较，重度妊高征时，ＲＩｍｃａ明显下降（Ｐ＜０．０１ＲＩｕａ开高不明显）但ＲＩｍｃａ／ＲＩｕａ≤１，ＩＵＧＲ组ＲＩｍｃａ异常下降，ＲＩｕａ异常升高（Ｐ＜０．０１）；ＲＩｍｃａ／ＲＩｕａ＜１。围产儿结局异常发生情况：正常组５％，重度妊高征５４．５４％（ＩＵＧＲ组５８．３３％、后二组与正常组比较差异极显著（Ｐ＜０．００１）。结论：胎儿脑动脉阻力指数ＲＩｍｃａ的降低，以及与脐动脉阻力指数ＲＩｕＡ的比值ＲＩｍｃａ／ＲＩｕＡ改变，在预测妊高征结局方面有一定的价值，且ＲＩｍｃａ／ＲＩｕＡ比值越低胎儿预后越恶劣。如出现ＲＩｍｃａ异常下降后再上升，则为脑组织不可逆损伤，胎死宫内发生率极高。

Objective and method:To study the significance of blood speed to outcome offetus in women with hypertension pregnancy,60 caser of normal pregnancy as control group,29 case of hypertension of pregnancy observation hypertension of pregnancy.(OHP group),24 cases of hypertension of pregnancy compli cated by gestacive retardaction of intrauterine (IUGR group) were surveyed by colour doppler ultrasound,the speed,the wave form of blood flow,incerebral middle artery (MCA),umbilical artery (UA),were examined,thindexes of resistance in above vasules,(RImcA,RIuA) were assayed.Result: RImcA/RIuA was more than 1 (>1).in control group,but RImcA decreased obviously in severe OHP group RImcA slightly increcsed,RImcA/RIuA≤1,the RImcA fell significantly,RIuA rose strikingly RImcA/RIuA<1 in IUGR,the number of perinatal abnormality of newborn,it was 5.0% in control gronp,54.5% in OHP,58 3% in IUGR,the two later groups nore than control group significantly (P<0.001).Conclusion: Indexes ofresistance of cerebral and umbilical arteria is available to survey fetal development the RImcA/RIuA is more low,the outcome more abnormal.