妊娠期高血压疾病患者子宫螺旋动脉特征的超声评估及其与胎盘缺氧损伤的相关性

The ultrasonic evaluation of uterine spiral artery characteristics in patients with gestational hypertension and their correlation with the placental hypoxia injury

目的:探讨妊娠期高血压疾病患者子宫螺旋动脉特征的超声评估及其与胎盘缺氧损伤的相关性。方法:收集2014年12月~2017年2月在本院分娩的妊娠期高血压疾病产妇128例作为妊高症组,同期在本院进行分娩的健康产妇100例作为正常对照组。对比两组产妇产前1周子宫螺旋动脉参数水平,胎盘碾磨液中血管新生指标、氧化应激指标、炎症介质含量的差异。采用Pearson检验评估妊高症产妇子宫螺旋动脉特征与胎盘缺氧损伤的相关关系。结果:妊高症组产妇子宫螺旋动脉RI、PI、S/D的水平高于正常对照组产妇;妊高症组产妇胎盘组织碾磨液中血管新生指标HIF-1α、VEGF、sFlt-1的含量高于正常对照组产妇;抗氧化指标CTA、SOD的含量低于正常对照组产妇,LHP的含量高于正常对照组产妇;炎症介质IL-6、TNF-α、NF-κB、HSP70的含量高于正常对照组产妇。Pearson检验发现,妊高症产妇子宫螺旋动脉RI、PI、S/D水平与胎盘血管新生旺盛程度、氧化应激程度、炎症反应程度均呈正相关。结论:妊高症产妇存在子宫螺旋动脉血流参数异常改变,且其异常程度可客观反映胎盘缺氧损伤程度。

Objective:To investigate the ultrasonic evaluation of uterine spiral artery characteristics in patients with gestational hypertension and their correlation with the placental hypoxia injury.Methods:128 puerperae with gestational hypertension who gave birth in this hospital between December 2014 and February 2017 were collected as gestational hypertension group,and 100 healthy puerperae who gave birth in this hospital during the same period were collected as normal control group.The differences in uterine spiral artery parameter levels as well as the contents of angiogenesis indexes,oxidative stress indexes and inflammatory mediators in the placental grinding fluid were compared between the two groups 1 week before delivery.Pearson test was used to evaluate the correlation between uterine spiral artery characteristics and placental hypoxia injury in patients with gestational hypertension.Results:Uterine spiral artery RI,PI and S/D levels in gestational hypertension group were higher than those in normal control group;angiogenesis indexes HIF-1α,VEGF and sFlt-1 contents in placental grinding fluid of gestational hypertension group were higher than those of normal control group;anti-oxidation indexes CTA and SOD contents were lower than those of control group whereas LHP content was higher than that of normal control group;inflammatory mediators IL-6,TNF-α,NF-κB and HSP70 contents were higher than those of normal control group.Pearson test showed that the uterine spiral artery RI,PI and S/D levels in puerperae with gestational hypertension were positively correlated with the degree of angiogenesis,oxidative stress and inflammatory response in the placenta.Conclusion:There are abnormal changes of uterine spiral artery flow parameters in puerperae with gestational hypertension,and the abnormality can objectively reflect the degree of placental hypoxia injury.