硫酸镁对子痫前期孕妇及胎儿动脉血流的影响

Effect of magnesium sulfate on arterial blood flow in preeclampsia pregnant woman and fetuses

目的探讨重度子痫前期(SPE)孕妇及胎儿的动脉血流变化情况及硫酸镁对其的影响。方法选择2013年1月至2015年1月该院收治的SPE孕妇174例作为观察组,正常孕妇174例作为对照组,观察组孕妇给予硫酸镁治疗2d,观察硫酸镁治疗前后孕妇大脑中动脉、子宫动脉、子宫螺旋动脉、脐动脉、胎儿大脑中动脉血流及孕妇血压、头晕眼花症状、无负荷试验(NST)的变化。结果观察组治疗前、后与对照组孕妇和胎儿大脑中动脉阻力指数(RI)值、搏动指数(PI)值、收缩期峰值流速/舒张末期流速(S/D)值比较,差异均无统计学意义(P>0.05)。观察组治疗前子宫动脉和子宫螺旋动脉RI值、PI值、S/D值明显高于对照组(P<0.05);治疗后子宫动脉RI值、PI值、S/D值明显低于治疗前(P<0.05)。观察组治疗前脐动脉RI值、PI值、S/D值均高于对照组(P<0.05);治疗后脐动脉PI值、S/D值较治疗前降低,但差异无统计学意义(P>0.05)。治疗后,观察组收缩压、舒张压、平均动脉压与治疗前比较均有所降低,头晕眼花比例较治疗前降低,但差异均无统计学意义(P>0.05),而NST无反应的发生率均明显低于治疗前(P<0.05)。结论硫酸镁治疗能够明显改善SPE患者子宫动脉、子宫螺旋动脉的血流情况,能够改善胎儿宫内储备情况。

Objective To investigate the changes of arterial blood flow in pregnant women with severe preeclampsia（SPE） and fetuses and the effect of magnesium sulfate on it. Methods One hundred and seventy-four SPE pregnant women in our hospital from January 2013 to January 2015 were selected as the observation group and 174 normal pregnant women as the control group. The observation group was given the magnesium sulfate treatment for 2 d. The arterial blood flow changes of middle cerebral artery,uterine artery, uterine spiral artery, umbilical artery, fetal middle cerebral artery before and after treatment in the observation group were observed. And maternal blood pressure,dizziness symptoms, no load test（NST） changes were also observed. Results The RI,PI and S/D values of pregnant women and fetal middle cerebral artery before and after treatment had no statistical differences between the control group and observation group（P〈0.05）. The RI,PI and S/D values of uterine artery and uterine spiral artery before treatment in the observation group were significantly higher than those in the control group（P〈0.05）;the RI, PI and S/D values of uterine artery and uterine spiral artery after treatment in the observation group were significantly lower than those before treatment（P〈0.05）. The umbilical artery RI,PI and S/D values before treatment in the observation group were higher than those in the control group（P〈0.05） ;the PI and S/D values after treatment were lower than those before treatment,but difference was statistically signifieant（P〈0.05）. The systolic pressure,diastolic pressure and mean arterial blood pressure after treatment in the observation group were decreased compared with treatment, and the proportion of dizziness was decreased compared with before treatment, but the difference was not statistically significant（P〈 0.05）, while the incidence rate of NST no response was significantly lower than that before treatment（P〈0.05）. Conclusion The magnesium sulfate therapy can significantly improve the blood flow situation of uterine artery and uterine spiral artery in the patients with SPE and can improve fetal intrauterine reserve.