妊娠期高血压患者子宫动脉及胎儿脐动脉血流动力学研究

Study on uterine artery and fetal umbilical artery hemodynamics in patients with HDP

目的:探讨妊娠期高血压疾病(HDP)患者子宫动脉及胎儿脐动脉血流动力学变化。方法:选取2015年7月~2016年7月我院孕检的HDP患者80例为观察组,另选取同期孕检健康孕妇80例为对照组,2组孕妇均于妊娠30~40周行序贯性彩色多普勒超声检查,使用二维超声诊断仪测定子宫动脉和脐动脉,记录搏动指数(PI)、阻力指数(RI)、收缩压最大血流速度与舒张末期最大血流速度比值(S/D),并测定胎儿双顶径、头围、股骨长度及腹围;采用酶联免疫分析法测定血清8-异前列腺素F2α(8-isoPGF2α),免疫比浊法测定血清胱抑素C(Cys C)、C反应蛋白(CRP)。结果:观察组子宫动脉PI、RI、S/D值明显高于对照组(P<0.05);观察组脐动脉PI、RI、S/D值明显高于对照组(P<0.05);观察组胎儿双顶径、头围、股骨长度及腹围明显小于对照组(P<0.05);观察组8-iso-PGF2α、Cys C、CRP水平明显高于对照组(P<0.05)。结论:HDP患者子宫动脉及脐动脉血流阻力明显升高,严重影响胎盘血流灌注及胎儿的生长发育,而彩色多谱勒超声可为胎儿宫内窘迫提供无创性诊断。

Objective：To explore the uterine artery and fetal umbilical artery hemodynamic change in patients with HDP.Methods：A total of 80 patients with HDP who came to our hospital from July,2015 to July,2016 for pregnancy examination were included in the study and served as the observation group,while 80 healthy pregnant women who came for pregnancy examination in the same period were served as the control group.The pregnant women in the two groups were performed with sequential color Doppler ultrasound at gestation 30-40 weeks.The two-dimensional ultrasound apparatus was used to detect the uterine artery and umbilical artery.PI,RI,and S/D were recorded.The fetal BPD,head girth,femur length,and abdominal girth were measured.ELISA was used to detect 8-iso-PGF2α.The immunoturbidimetry was used to detect Cys-C and CRP.Results：The uterine artery PI,RI,and S/D in the observation group were significantly higher than those in the control group（P〈0.05）.The umbilical artery PI,RI,and S/D in the observation group were significantly higher than those in the control group（P〈0.05）.The fetal BPD,head girth,femur length,and abdominal girth in the observation group were significantly less than those in the control group（P〈0.05）.8-iso-PGF2α,Cys C,and CRP levels in the observation group were significantly higher than those in the control group（P〈0.05）.Conclusions：The uterine artery and umbilical artery blood flow resistance in patients with HDP are significantly elevated,which can severely affect the placental blood perfusion and fetal growth and development,while the color Doppler ultrasound can provide a non-invasive diagnosis for fetal distress in uterus.