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目的对子宫动脉血流动力学变化和血清胎盘生长因子(PLGF)水平对妊娠结局的影响进行评价。方法2004年11月～2006年11月共收集我院180例孕妇资料,孕10～14周时抽取孕妇外周血,ELISA测定PLGF水平;孕20～24周开始,采用多普勒彩超监测两侧子宫动脉的收缩期峰值、舒张期最低流速之比(S/D)、阻力指数(RI)、搏动指数(PI);随访至产后3个月,统计孕妇和新生儿转归。结果发生妊娠期高血压疾病的患者,血清PLGF为(36.2±8.3)pg/ml,明显低于正常组(52.9±9.6)pg/ml(P<0.01)。S/D值、RI、PI、舒张早期切迹等指标差异亦有显著性(P<0.05)。血流指标异常的孕妇,妊娠并发症率和胎儿死亡率显著升高(P<0.05),新生儿结局较差(P<0.05)。结论PLGF表达异常和血流动力学变化,与妊娠期并发症和新生儿不良转归有密切联系。可以作为临床监测指标,以利于及时预防、治疗和改善预后。
Objective To evaluate the effect of changes in uterine artery hemodynamics and serum placental growth factor (PLGF) levels on pregnancy outcomes. Methods A total of 180 pregnant women in our hospital were collected from November 2004 to November 2006. Peripheral blood samples of pregnant women were collected from 10 to 14 weeks of gestation and the level of PLGF was measured by ELISA. From the 20th week to the 24th week of gestation, Doppler ultrasound was used to monitor both sides Uterine artery systolic peak, diastolic minimum velocity ratio (S / D), resistance index (RI), pulsatility index (PI); follow-up to 3 months after delivery, statistical prognosis of pregnant women and newborns. Results Serum PLGF was (36.2 ± 8.3) pg / ml in patients with gestational hypertension, which was significantly lower than that of the normal group (52.9 ± 9.6) pg / ml (P <0.01). S / D values, RI, PI, early diastolic notch and other indicators were also significantly different (P <0.05). Pregnant women with abnormal blood flow index had significantly higher rates of pregnancy complications and fetal mortality (P <0.05), while neonatal outcomes were worse (P <0.05). Conclusions The abnormal expression of PLGF and hemodynamic changes are closely related to the complications of pregnancy and adverse outcome of newborn infants. Can be used as clinical monitoring indicators, in order to facilitate the timely prevention, treatment and improvement of prognosis.