高分辨力超声检测妊高征血管内皮功能的研究

Ultrasonographic detection on vascular endothelial function in patients with hypertention induced by pregnancy

目的 用高分辨力超声检测妊娠高血压综合征 (妊高征 )患者的血管内皮依赖性舒张功能。方法采用ACUSON 12 8XP/10超声诊断系统检测 2 2例妊高征患者、2 0例正常妊娠妇女和 2 0例正常未妊娠妇女肱动脉反应性充血和含服硝酸甘油后内径变化。同时测定血浆纤维连接蛋白 (fibronectin ,Fn)浓度。结果 反应性充血引起肱动脉内径变化率 :正常妊娠组 (14 .9± 6 .0 ) % >正常未妊娠组 (9.7± 2 .9) % >妊高征组 (4.1±1.4) % ,三组比较差异有显著性意义 (P <0 .0 5 )。含服硝酸甘油后肱动脉内径变化率 :正常妊娠组为 (2 0 .0±5 .5 ) % ,正常未妊娠组为 (2 5 .7± 8.4) % ,妊高征组为 (2 0 .4± 6 .9) % ,三组间比较差异无显著性意义 (P >0 .0 5 )。血浆Fn值 :妊高征组高于正常妊娠组 [(413 .8± 177.9)mg/mlvs (2 94.6± 10 9.5 )mg/ml] ,两组之间差异有显著性意义 (P <0 .0 5 )。妊高征患者肱动脉充血反应后血管内径变化百分率与血浆Fn值呈明显负相关(r =-0 .76 ,P <0 .0 1)。结论 妊高征患者存在血管内皮依赖性舒张功能受损 ,超声是无创性检测血管内皮功能的一种可行性方法。

Objective To determine whether the vascular endothelial function in patients with hypertension induced by pregnancy (HIP) was impaired.Methods Twenty-two patients with HIP,20 normotensive pregnant women and 20 age-matched non-pregnant women were studied. The diameter of the brachial arteries were measured at rest during hyperarmia (endothelium-dependent vascular dilatation,EDVD) and after sublingual glyceryl trinitrate( endothelium-independent dilatation).The plasma fibronectin levels were measured in all patients.Results EDVD in patients with HIP was less than that in normotensive pregnant women[( 4.1 ± 1.4 ) % vs ( 14.9 ± 6.0 )%,P< 0.05 ]. In non-pregnant women,EDVD was less than that in normotensive pregnant women [( 9.7 ± 2.9 ) % vs ( 14.9 ± 6.0 ) %,P< 0.05 ]. EDVD in patients with HIP showed significantly correlation to plasma fibronectin levels (r= -0.76 ,P< 0.01 ).Conclusions The endothelial function of the brachial arteries is impaired in patients with HIP.