胚胎停育孕妇妊娠早期子宫动脉、甲状腺上动脉血流参数和血清激素水平测定

Detection of blood flow parameters of uterine and superior thyroid arteries combined with serum hormones during early pregnancy in embryo damage patients

目的:探讨胚胎停育孕妇妊娠早期子宫动脉、甲状腺上动脉的血流参数和血清激素水平的变化。方法:选择经腹部超声诊断胚胎停育孕妇80例作为观察组,孕(7.5±2.4)周,另选择80例正常孕妇作为对照组。比较2组甲状腺上动脉和子宫动脉的血流参数,包括平均血流速度(Vm)、峰值与最小血流速度比值(S/D)、搏动指数(PI)和阻力指数(RI),比较母体血清人绒毛膜促性腺激素β亚基(β-HCG)、性激素六项、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)水平。观察组肌内注射黄体酮(P,40 mg/次,1次/d)和β-HCG(3000 U/次,隔日1次)至孕12周,最终确诊胚胎停育35例,成功妊娠45例,比较胚胎停育与成功妊娠者治疗前后甲状腺上动脉和子宫动脉血流参数以及血清激素水平。结果:观察组甲状腺上动脉和子宫动脉Vm、S/D、PI和RI均小于对照组,血清β-HCG、卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、P、FT3、FT4水平均低于对照组(P<0.05)。观察组成功妊娠孕妇治疗后甲状腺上动脉和子宫动脉Vm、S/D、PI和RI,血清β-HCG、FSH、LH、E2、P、FT3和FT4水平比治疗前增加,且高于胚胎停育孕妇(P<0.05)。结论:胚胎停育孕妇妊娠早期子宫动脉、甲状腺上动脉的血流参数和多项血清激素水平低于正常妊娠孕妇。

Aim:To analyze the blood flow parameters of uterine and superior thyroid arteries combined with serum hormone levels during early pregnancy in embryo damage patients.Methods:A total of 80 pregnant women with embryo damage diagnosed by transabdominal ultrasound were collected as the observation group,whose gestational weeks were(7.5±2.4),and other 80 normal pregnant women as the control group were enrolled.Blood flow parameters of superior thyroid artery and uterine artery including mean blood flow velocity(Vm),ratio of peak to minimum blood flow velocity(S/D),pulsation index(PI)and resistance index(RI)were compared.Serum endocrine hormones including human chorionic gonadotropinβsubunit(β-HCG),six sex hormones,free triiodothyronine(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH)were determined.The observation group got progesterone(P,40 mg,one time per day)andβ-HCG(3000 U,every other day)injected intramuscularly until 12 weeks of gestation.There were 35 cases of embryo damage and 45 cases of successful pregnancy,then the changes of above indicators between cases of embryo damage and successful pregnancy before and after treatment were compared.Results:The values of Vm,S/D,PI and RI in uterine and superior thyroid arteries of observation group were significantly lower than those of control group,and serum levels ofβ-HCG,follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),P,FT3 and FT4 in observation group were also lower than those of control group(P<0.05).The values of Vm,S/D,PI and RI in uterine and superior thyroid arteries,serum levels ofβ-HCG,FSH,LH,E2,P,FT3 and FT4 in women of successful pregnancy in observation group were higher after treatment than before,and more higher than women of embryo damage(P<0.05).Conclusion:The blood flow parameters of uterine and superior thyroid arteries and several hormone levels in pregnant women with embryo damage are lower than normal pregnant women.