佩尔地平治疗妊高征对胎儿的安全性观察

Study of treatment of hypertension during pregnancy with peierdipine

目的 探讨佩尔地平对妊高征患者胎儿的血流动力学和胎盘、脐带血管形态学的影响 .方法 应用彩色多普勒对 A,B,C3组治疗前后分别监测脐动脉 (U A) ,大脑中动脉(MCA)的血流阻力指标 ;对治疗后分娩者取胎盘、脐带作形态学检查 .结果 1各组 UA血流阻力指标比较 :治疗后各组动脉搏动指数 (PI)、动脉阻力指数 (RI)均有下降 ,前后比较差异显著 (P<0 .0 5 ) ;但组间比较无显著性差异 (P>0 .0 5 ) .2各组 MCA血流阻力指标比较 :各组治疗后 PI,RI均有升高 (但其值仍在正常范围 ) ,前后比较差异显著 (P<0 .0 5 ) ;但组间比较无显著性差异 .3各组脐动脉血流速度比值 (S/ D比值 )≤ 3的人数百分率比较 :治疗后 A组 73% ,B组 83% ,C组 88% .各组治疗前后比较差异显著 (P<0 .0 5 ) .组间比较 :C组与 A组比较有高度显著性差异 (P<0 .0 1) .4胎盘、脐带血管病变检出率比较 :治疗后各组血管病变检出率明显降低 ,分别为 A组 6 0 % ,B组 37% ,C组 2 8% .组间比较差异显著 (P<0 .0 5 ) .其中 C组与 A组比较有高度显著性差异 (P<0 .0 1) .结论 佩尔地平治疗妊高征对胎儿宫内缺氧有治疗作用 ,从血流动力学改变上看 。

AIM The effects of Peierdipin on the hemodynamics as well as on the vascular morphology of the placenta and umbilical cord of the fetus of pregnancy-induced hypertension mother. METHODS The changes of the resistance index (RI) of blood flow of umbilical artery (UA) and middle cerebral artery (MCA) before and after treatment in groups A, B, C were monitored with color Doppler's method. The samples of the placenta and umbilical cord were taken from the laborer after treatment for morphological examination. RESULTS ① the comparison of the resistance index of blood flow of UA: The values of pulsative indst (PI) and RI in all groups decreased with notable difference after treatment (P<0.05); but the difference among groups were not so significant (P>0.05). ② the comparison of RI of blood flow of MCA in each group: The PI and RI in all groups increased after treatment (but still within the normal scope), but the difference among groups was not marked. ③ the comparison of the percentage of the cases with S/D<3 in each group: The percentage was 73% in group A, 83% in group B and 88% in group C after treatment (P<0.05). Group C was remarkably different with group A (P<0.01). ④ The comparison of the detectable rate of the vascular pathologic change in placenta and umbilical cord: The rates in all groups decreased after treatment, demonstrating separately as 60% in group A, 37% in group B and 28% in group C. And the difference among groups was also obvious (P<0.05), especially between C and A (P<0.01). CONCLUSION Peierdipin has therapy effects on the intrauterine hypoxia of fetus, and can be considered safe to fetus as far as the changes in hemonamics are concerned.