妊娠期高血压综合征患者产后动脉血管功能的变化

Changes of postpartum arterial vascular function in patients with pregnancy-induced hypertensive syndrome

目的探讨妊娠期高血压综合征患者产后动脉血管功能变化情况。方法选择2016年1月至2017年1月佛山市妇幼保健院就诊的妊娠期高血压综合征产妇150例,将患者分为3组,A组为妊娠高血压产妇50例,B组为轻度子痫前期产妇50例,C组为重度子痫前期产妇50例,并选择同期进行产检的正常产妇50例作为对照(D组)。于产后即时、6周、3个月和6个月分别检测血管弹性指标变化情况[脉搏波传导速度(PWV)、动脉增强压(AP)、等容收缩期到射血期转折点压(PT1)、动脉压增强指数(AIx)以及动脉内膜中膜厚度(IMT)]。结果产后即时A、B、C三组产妇PWV显著高于D组(P均<0.05);产后6周、3个月和6个月A、B、C三组的PWV值均逐渐恢复到正常值,且与D组相比无显著差异(P均>0.05)。A、C组产妇产后即时、产后6周、产后3个月颈总动脉的IMT较B、D组显著增加(P均<0.05);产后即时A、B、C三组产妇PT1、AIx、AP值均高于D组(P均<0.05);产后6周、3个月和6个月A、B、C三组的IMT,PT1、AIx、AP值均逐渐恢复到正常值,且与D组相比,颈总动脉的IMT、PT1、AIx、AP值无统计学差异(P均>0.05)。结论妊娠高血压综合征孕妇产后颈动脉的功能和形态均发生一定程度改变。在产后6个月其颈动脉的功能和形态均恢复到正常水平。

Objective To investigate the changes of postpartum arterial vascular function in patients with pregnancyinduced hypertensive syndrome. Methods A total of 150 delivery women with pregnancy-induced hypertensive syndrome were selected from January 2016 to January 2017 and divided into group A（ pregnancy-induced hypertension）,group B（ parturients with mild preeclampsia） and group C（ parturients with severe preeclampsia）（ n = 50,each）. Fifty normal parturient women were selected as control group（ group D） at the same time. The arterial elasticity indices including pulse wave velocity（ PWV）,arterial pressure enhancement（ AP）,isovolumic systolic ejection period to the turning point of pressure（ PT1）,arterial pressure augmentation index（ AIx） and carotid intima-media thickness（ IMT） were detected respectively in the immediate postpartum period and at 6 weeks,3 months and 6 months after delivery. Results The postpartum PWV values increased significantly in group A,B and C compared with group D（ all P〈0. 05）. PWV gradually restored to normal at 6 weeks,3 months and 6 months after delivery and were similar to that in group D（ all P〈0. 05）. The carotid IMT in the immediate postpartum period,6 weeks and 3 months after delivery in group A and C increased significantly compared with group B and D（ all P〈0. 05）. PTI,AIX,AP values in group A,B and C were significantly higher than those in Group D（ all P〈0. 05）. The carotid IMT,PTI,AIX,AP values in group A,B and C gradually restored to normal at 6 weeks,3 months and 6 months after delivery and were similar to those in control group at 6 months after delivery（ all P〉0. 05）. Conclusions There are some changes in the function and morphology of carotid artery in pregnant women with pregnancy-induced hypertension,with decreasing vascular elasticity. The function and morphology of carotid artery can restore to normal level at 6 months postpartum.