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目的通过分析子宫动脉、脐动脉、胎儿大脑中动脉的血流加速时间,结合围产儿预后,探讨加速时间在妊娠期高血压疾病中的应用价值。方法应用彩色多普勒超声技术,对90例妊娠期高血压疾病孕妇和90例同孕周无年龄差别的正常孕妇对照研究,妊娠期高血压疾病孕妇分为妊娠期高血压组、轻度子痫前期组和重度子痫前期组,依次测定子宫动脉、脐动脉、胎儿大脑中动脉的加速时间(acceleration time,AT),妊娠期高血压疾病患者围产儿分为预后不良组和预后良好组,采用方差分析或t检验比较加速时间在各组中的变化。结果正常妊娠子宫动脉、脐动脉和大脑中动脉AT值均随孕周的增加而延长;子宫动脉AT值、脐动脉AT值在轻度子痫前期组和重度子痫前期组均缩短(P<0.01),而大脑中动脉AT值延长(P<0.01);预后不良组与预后良好组比较子宫动脉、脐动脉AT值缩短,大脑中动脉AT值延长,各组间比较差异均有统计学意义。结论妊娠期高血压疾病患者血流加速时间发生明显变化,这种变化与妊高征胎儿的预后密切相关。
Objective To investigate the application value of acceleration time in hypertensive disorder complicating pregnancy by analyzing the acceleration of blood flow in uterine artery, umbilical artery and middle cerebral artery of fetus in combination with the prognosis of perinatal. Methods Color Doppler ultrasound was used to compare 90 pregnant women with gestational hypertension and 90 normal pregnant women with no difference in gestational age. Pregnant women with gestational hypertension were divided into gestational hypertension group, Preeclampsia group and severe preeclampsia group. The acceleration time (AT) of the uterine artery, umbilical artery and fetal middle cerebral artery were measured in turn. The perinatal children with gestational hypertension were divided into poor prognosis group and good prognosis group, An analysis of variance or t-test was used to compare the changes in acceleration time in each group. Results The AT values of uterine arteries, umbilical arteries and middle cerebral arteries of normal pregnant women were both prolonged with the increase of gestational weeks. The values of AT and umbilical arterial AT of uterine arteries were decreased in mild preeclampsia group and severe preeclampsia group (P < 0.01), but the AT value in the middle cerebral artery was prolonged (P <0.01). Compared with the good prognosis group, the AT value of the uterine artery and umbilical artery in the poor prognosis group was shortened and the AT value in the middle cerebral artery was prolonged. There was significant difference among the groups . Conclusions There is a significant change in the acceleration of blood flow in patients with hypertensive disorders during pregnancy, which is closely related to the prognosis of fetus with pregnancy induced hypertension.