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目的 探讨药物流产前后子宫血流的变化及药理作用机制。方法 1999年 6月至 2 0 0 2年 2月应用彩色多普勒 (CDFI)对 5 8例药物流产患者子宫动脉和滋养层动脉进行检测 ,比较用药前后子宫动脉和滋养层动脉的血流变化 ,同时比较药物流产组与对照组血清NO-2 /NO-3 水平。结果 服药后比服药前子宫动脉和滋养层动脉的阻力指数 (RI)、收缩期与舒张期血流速度比值 (S/D)增高 ,血流峰值速度 (Vmax)和血流量 (PBF)明显减低 ,差异有显著性意义 (P <0 0 5 ) ;孕妇血清NO-2 /NO-3 水平比非孕妇女显著增高 ,服药后比服药前降低 ,差异有非常显著性意义 (P <0 0 1) ;病理检查显示 :药物流产后的蜕膜和绒毛细胞变性 ,其血管内皮细胞向管腔内突起 ,基底膜中断。结论 应用CDFI监测子宫血流变化与药理作用和病理检查结果相符 ,可作为临床观察药物流产效果的可靠手段。
Objective To investigate the changes of uterine blood flow and pharmacological mechanism before and after medical abortion. Methods The uterine artery and trophoblasts of 58 patients with medical abortion were examined by color Doppler (CDFI) between June 1999 and February 2002. The changes of blood flow in uterine artery and trophoblast artery before and after treatment were compared At the same time, the levels of serum NO-2 / NO-3 in medical abortion group and control group were compared. Results The resistance index (RI), systolic and diastolic blood flow velocity ratio (S / D), blood flow velocity (Vmax) and blood flow (PBF) in the uterine artery and trophoblast artery before treatment were significantly decreased , The difference was significant (P <0.05). The serum level of NO-2 / NO-3 in pregnant women was significantly higher than that in non-pregnant women, and the difference was statistically significant (P <0.01 ); Pathological examination showed: decidual and villus cells after drug abortion degeneration, the vascular endothelial cells protruding into the lumen, the basement membrane interrupted. Conclusion The application of CDFI to monitor changes of uterine blood flow is consistent with the results of pharmacological and pathological examination, which can be used as a reliable method to observe the effect of medical abortion.