【摘要】 目的 :探讨一氧化氮 (NO)在胎儿生长受限 (FGR)发生、发展中的作用及L 精氨酸 (L Arg)治疗FGR的效果和作用机制。方法 :选择符合入选条件的FGR患者 6 6例 ,其中L Arg组 30例 ,常规治疗组 36例。正常初产妇 30例为正常组。监测治疗前后胎儿生长发育参数、脐血流参数、孕妇血液流变学参数及孕妇血清NO水平变化 ,脐静脉血清NO水平 ,并比较新生儿出生体重。结果 :治疗后 ,L Arg组与常规治疗组比较 :①L Arg组胎儿双顶径 (BPD)、股骨长 (FL)及腹围(AC)的增长幅度较高 (P均 <0 .0 1) ;②搏动指数 (PI)、阻力指数 (RI)较低 (P <0 .0 1,P <0 .0 5 ) ,快速血流比值 (FBVR)较高 (P <0 .0 1) ;③全血低切粘度 (LBV)值较低 (P <0 .0 5 ) ;④孕妇血清及脐静脉血清NO水平较高 (P均 <0 .0 1) ;⑤新生儿出生体重较高 (P <0 .0 5 )。结论 :NO合成和 (或 )释放减少可能在FGR的发生、发展中起重要作用。L Arg结合常规治疗较单纯常规治疗具有更好的临床疗效更多还原

【Abstract】 Objective:To investigate the relationship between nitric oxide (NO) and fetal growth restriction(FGR), and to assess the effects of L-arginine (L-Arg) in treating FGR.Methods: Sixty six pregnant women with FGR were recruited. Of them, 36 cases(routine therapy group) were given routine therapy, while other 30 cases(L-Arg group) were given L-Arg and routine therapy. Thirty cases with normal pregnancy were served as normal group. Parameters such as fetal growth, umbilical artery flow, maternal hemorheology, serum NO levels of maternal and umbilical blood,newborn birth weight were measured and compared among these three groups. Results:After treatment, as compared with routine therapy group: ①the biparietal diameter(BPD), femoral length(FL) and abdominal circumference(AC) in L-Arg group were significantly increased(P<0.01); ②the values of pulse index(PI) and resistant index(RI) in L-Arg group were significantly lower(P<0.01, P<0.05) , while the fast blood velocity rate(FBVR) was significantly higher(P<0.01); ③The value of blood viscosity at the low shear rate(LBV) in L-Arg group was significantly lower(P<0.05); ④Serum NO levels of maternal and umbilical blood of L-Arg group were significantly higher(P<0.01);⑤The newborn birth weight in L-Arg group was significantly higher(P<0.05).Conclusions:NO deficiency may play an important role in the development of FGR. The curative effect of L-Arg combined with routine therapy is higher than that of routine therapy only.更多还原