子痫前期孕妇视网膜中央动脉血流参数监测的价值

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目的探讨子痫前期孕妇视网膜中央动脉与胎儿大脑中动脉血流参数改变的关联度及对妊娠结局的影响。方法 32例子痫前期孕妇,其中轻型18例设为轻型子痫前期组,重型14例设为重型子痫前期组,另21例无合并症单胎孕妇设为对照组。采用彩色超声检测三组孕妇视网膜中央动脉和胎儿大脑中动脉血流频谱,分析二者血流参数及与围生期结局的关系。结果 (1)视网膜中央动脉:对照组、轻型子痫前期组、重型子痫前期组搏动指数(PI)、血流阻力(RI)数值依次增高,其中PI尤为敏感,而血流速度变化不明显。(2)胎儿大脑中动脉血流:PI、RI改变在三组中数值依次递减。(3)孕妇视网膜中央动脉和胎儿大脑中动脉舒张期血流消失及反向异常频谱仅出现于重度子痫前期组。视网膜中央动脉PI值升高和舒张期血流消失及反向异常频谱出现对围生期结局有明显影响。结论视网膜中央动脉和胎儿大脑中动脉血流参数值与妊娠期高血压疾病有明显关联,舒张期血流消失及反向异常频谱均可出现于重度子痫前期病例中,对围生期结局有影响,可作为预测严重不良围生期结局的监测指标。 Objective To investigate the correlation between the changes of blood flow parameters in the middle cerebral artery and the central retinal artery in pregnant women with preeclampsia and its effect on pregnancy outcome. Methods Thirty - two pregnant women with preeclampsia were included in this study. Eighteen patients with mild preeclampsia were classified as mild preeclampsia, 14 patients with severe preeclampsia, and 21 pregnant women without congenital complications as controls. Three groups of pregnant women with central retinal artery and fetal middle cerebral artery blood flow spectrum were detected by color sonography. The relationship between blood flow parameters and perinatal outcome was analyzed. Results (1) The central retinal artery: The pulsatility index (PI) and flow resistance (RI) in the control group, mild preeclampsia group and severe preeclampsia group were higher than those in the control group, PI was more sensitive and the blood velocity did not change significantly . (2) Fetal middle cerebral artery blood flow: PI, RI changes in the three groups in decreasing values. (3) The disappearance of diastolic blood flow in the central retinal artery and fetal middle cerebral artery of pregnant women and the abnormal frequency spectrum only appeared in severe preeclampsia group. Central retinal artery PI value and diastolic blood flow disappears and the reverse frequency spectrum of the perinatal outcome has a significant effect. Conclusions There is a clear correlation between blood flow parameters of central retinal artery and fetal middle cerebral artery and hypertensive disorder complicating pregnancy. Diastolic blood flow disappears and reverse abnormal frequency spectrum can occur in severe preeclampsia patients. Perinatal outcome has Impact, can be used as a predictor of serious adverse perinatal outcome monitoring indicators.
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