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目的：探讨一氧化氮（ＮＯ）在妊高征发病及在子宫－胎盘－胎儿循环阻力中的调节作用和对胎儿生长发育的影响。方法：采用Ｇｒｅｉｓｓ法测定了４３例妊高征患者（妊高征组）分娩前后外周血及脐血血清ＮＯ的含量，以２５例正常晚孕妇（正常晚孕组）及１８例健康未孕妇（未孕组）作对照。应用彩色多普勒超声检测了部分病例子宫动脉及脐动脉血流阻力指标Ｓ／Ｄ值，并观察了部分病例胎盘绒毛血管的超微结构变化。结果：妊高征组产前外周血及脐血ＮＯ含量均低于正常晚孕组（Ｐ＜０．０１）。脐血ＮＯ含量高于母血（Ｐ＜０．０１）。妊高征组外周血及脐血血清ＮＯ含量均与脐动脉Ｓ／Ｄ值呈负相关（ｒ分别为－０．５２，Ｐ＜０．０５及－０．５８，Ｐ＜０．０１）。中、重度患者的胎盘绒毛血管均有不同程度的病变。结论：ＮＯ的合成减少可能是妊高征发病中的一个重要环节，妊高征患者ＮＯ合成减少与胎盘循环阻力增高及绒毛血管的超微结构改变可能互相影响、互为因果。
Objective: To investigate the effect of nitric oxide (NO) on the pathogenesis of PIH and the regulation of uterine-placenta-fetal circulation resistance and its effect on fetal growth and development. Methods: The contents of NO in peripheral blood and umbilical cord serum of 43 patients with PIH (pregnancy induced hypertension group) before and after delivery were measured by Greiss method. Twenty-five normal pregnant women (normal pregnancy group) and 18 healthy pregnant women Not pregnant group) as a control. The color Doppler ultrasound was used to detect the S / D of blood flow resistance indexes of uterine arteries and umbilical arteries in some cases. The ultrastructural changes of placental villi in some cases were observed. Results: The prenatal peripheral blood and umbilical blood NO levels in PIH group were lower than those in normal pregnancy group (P <0.01). Umbilical blood NO levels were higher than maternal blood (P <0.01). The serum NO levels in peripheral blood and umbilical cord blood of PIH group were negatively correlated with S / D values of umbilical artery (r = -0.52, P <0.05 and -0.58, respectively, P <0.01). In severe patients with placental villi vessels have varying degrees of disease. CONCLUSIONS: The decreased synthesis of NO may be an important link in the pathogenesis of PIH. The decrease of NO synthesis and the increase of placental circulation resistance and the ultrastructure of villus may play an important role in the pathogenesis of PIH.