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目的 探讨重度妊高征子宫胎盘血流与血浆内皮素 (ET 1)、一氧化氮 (NO)及新生儿体重的关系。方法 选取孕晚期重度妊高征 4 0例 ,于产前采取静脉血分别测定ET 1、NO的含量 ,利用彩色多普勒超声测定子宫胎盘血流动力学变化 ,记录新生儿体重 ,并与正常妊娠组进行比较分析。结果 重度妊高征组ET 1较正常妊娠组明显升高 [(2 87.6 2± 2 8.90 ) μmol/L与 (6 2 .86± 4 .0 3) μmol/L) ],NO明显降低[(5 3.6 1± 2 .6 9) μmol/L与 (170 .6 8± 17.0 6 ) μmol/L];子宫动脉内径较正常孕妇缩小 [(6 .2 2± 0 .6 7)mm与(7.5 8± 0 .96 )mm],子宫 胎盘收缩期与舒张期平均血流速度减慢 ,血流灌注减少 ;新生儿平均体重降低[(2 0 36± 2 .34)g与 (2 5 86± 1.78)g];胎儿宫内发育迟缓 (FGR) 4 2 .5 %。结论 重度妊高征者血清ET 1明显升高 ,NO明显降低 ;子宫胎盘血流受二者调节 ,异常血流导致新生儿体重降低 ,使胎儿宫内发育受限 (FGR)发生率增加。
Objective To investigate the relationship between placental blood flow and plasma endothelin (ET 1), nitric oxide (NO) and neonatal body weight in patients with severe PIH. Methods 40 pregnant women with severe PIH during the third trimester of pregnancy were enrolled in this study. ET 1 and NO levels were measured in prenatal venous blood. The placental hemodynamics were measured by color Doppler sonography. The neonatal weight was recorded and compared with normal Pregnancy group for comparative analysis. Results Compared with the normal pregnancy group, the ET 1 level in severe PIH group was significantly higher than that in the normal pregnancy group [(2 87.6 2 ± 2 8.90) μmol / L vs (62.86 ± 4.30) μmol / L) 5 3.6 1 ± 2.69 μmol / L and 170.68 ± 17.0 6 μmol / L, respectively]. The diameter of uterine artery was smaller than that of normal pregnant women [(6.22 ± 0.67) mm vs. (7.5 8 ± 0.96) mm]. The average blood flow velocity of systolic and diastolic phases in the uterus decreased and the blood perfusion decreased. The mean neonatal weight loss [(2 0 36 ± 2. 34) g and (2 5 86 ± 1.78) g]; intrauterine growth retardation (FGR) 42.5%. Conclusions Serum ET 1 is significantly elevated in patients with severe PIH, and the NO is significantly decreased. The uterine placental blood flow is regulated by both of them. Abnormal blood flow leads to the decrease of neonatal weight and the increased incidence of intrauterine growth restriction (FGR).