重度子痫前期患者分娩前后血管内皮功能的超声研究

Ultrasound study on vascular endothelial function in patients with severe preeclampsia before and after parturition

目的研究重度子痫前期患者分娩前及分娩后不同时间肱动脉血流介导的内皮依赖性血管舒张功能（FMD）。方法对49例重度子痫前期患者（研究组）分娩前（孕28-40周）、分娩后1、6、24周行高频彩色多普勒超声检测右侧肱动脉FMD,对照组为60例健康生育期妇女。测量静息状态下右侧肱动脉内径（D1）、血流量（Q1）以及反应性充血后内径（D2）、血流量（Q2）;计算血管内径变化率（△D%）、血流量变化率（△Q%）。结果研究组分娩前、分娩后不同时间（1、6、24周）的△D%和△Q%均低于对照组（P〈0.001）。研究组内分娩前、分娩后不同时间（1、6、24周）的△D%及△Q%比较,差异无统计学意义（P〉0.05）。结论重度子痫前期患者分娩前存在血流介导的FMD受损并持续至分娩后,且至分娩后24周时尚无明显恢复和改善。

Aim To study the flow mediated dilation（ FMD） of brachial artery at different time points before and after parturition in patients with severe preeclampsia. Methods 49 cases of severe preeclampsia（ study group）were examined by high-frequency color Doppler ultrasonography before parturition（ 28-40 weeks of pregnancy）,and 1,6,24 weeks after parturition,and the right brachial artery FMD was detected. 60 cases of healthy childbearing women was as the control group. The internal diameter（ D1） and blood flow（ Q1） of right brachial artery,and the internal diameter（ D2） and blood flow（ Q2） after reactive hyperemia were measured at resting state. The vessel diameter change rate（ △D%） and the blood flow change rate（ △Q%） were calculated. Results Before parturition,and at different time points（ 1,6,24 weeks） after parturition,the △D% and △Q% of the study group were lower than those of the control group（ P〈0.001）. There were no significant differences in △D% and △Q% inside the study group before parturition,and at different time points after parturition（ 1,6,24 weeks）（ P〉 0. 05）. Conclusion Patients with severe preeclampsia have FMD damage before parturition and continue to post parturition,and there is no obvious recovery and improvement for the 24 weeks after parturition.