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目的 用高分辨力超声检测妊娠高血压综合征 (妊高征 )患者的血管内皮依赖性舒张功能。方法采用ACUSON 12 8XP/10超声诊断系统检测 2 2例妊高征患者、2 0例正常妊娠妇女和 2 0例正常未妊娠妇女肱动脉反应性充血和含服硝酸甘油后内径变化。同时测定血浆纤维连接蛋白 (fibronectin ,Fn)浓度。结果 反应性充血引起肱动脉内径变化率 :正常妊娠组 (14 .9± 6 .0 ) % >正常未妊娠组 (9.7± 2 .9) % >妊高征组 (4.1±1.4) % ,三组比较差异有显著性意义 (P <0 .0 5 )。含服硝酸甘油后肱动脉内径变化率 :正常妊娠组为 (2 0 .0±5 .5 ) % ,正常未妊娠组为 (2 5 .7± 8.4) % ,妊高征组为 (2 0 .4± 6 .9) % ,三组间比较差异无显著性意义 (P >0 .0 5 )。血浆Fn值 :妊高征组高于正常妊娠组 [(413 .8± 177.9)mg/mlvs (2 94.6± 10 9.5 )mg/ml] ,两组之间差异有显著性意义 (P <0 .0 5 )。妊高征患者肱动脉充血反应后血管内径变化百分率与血浆Fn值呈明显负相关(r =-0 .76 ,P <0 .0 1)。结论 妊高征患者存在血管内皮依赖性舒张功能受损 ,超声是无创性检测血管内皮功能的一种可行性方法。
Objective To detect endothelium-dependent vasodilation in patients with pregnancy induced hypertension (PIH) by high resolution ultrasound. Methods The ACUSON 12 8XP / 10 ultrasonic diagnostic system was used to detect the changes of the brachial artery reactive hyperemia and nitroglycerin after treatment in 22 patients with PIH, 20 normal pregnant women and 20 normal pregnant women. Plasma fibronectin (Fn) concentration was measured at the same time. Results The rate of change of internal diameter of brachial artery induced by reactive hyperemia was (9.7 ± 2.9)%> (4.1 ± 1.4)% in normal pregnancy group (4.1 ± 1.4)%, The difference was significant (P <0.05). The rate of change of brachial artery diameter after oral administration of nitroglycerin was (20.0 ± 5. 5)% in normal pregnancy group, (25.7 ± 8.4)% in normal nonpregnant group and (20 .4 ± 6 .9)%, no significant difference between the three groups (P> 0.05). Plasma Fn value: The PIH group was higher than that of the normal pregnancy group [(413.8 ± 177.9) mg / ml vs (94.6 ± 10 9.5) mg / ml], with significant difference between the two groups (P <0. 0 5). The percentage change of vascular diameter after brachial artery hyperemia reaction in PIH was negatively correlated with plasma Fn (r = -0.76, P <0.01). Conclusion There is impaired endothelium-dependent vasodilation in patients with PIH. Ultrasound is a feasible method for non-invasive detection of vascular endothelial function.