【摘要】 目的探讨妊娠高血压综合征(PHI)患者胎儿脐动脉(UA)及大脑中动脉(MCA)的血流动力学变化规律,评价彩色多普勒血流显像技术在PIH上的利用价值。方法 应用彩色多普勒血流显像术检测95例正常晚期妊娠和52例PHI患者胎儿UA的搏动指数(PI)、阻力指数(RI)及MCA的搏动指数(PI)、阻力指数(RI),计算MCA—PI/UA—PI、MCA—RI/UA—RI的比值,均取平均值比较。结果PIH组与正常组UA—PI值比较有明显增高(P<0.01),而UA—RI值二组比较差异无显著性(P>0.05);MCA—PI值与MCA—RI值仅在重度PIH组与正常组间比较有显著降低(P<0.01);MCA—PI/UA—PI及MCA—RI/UA—RI的比值与正常组比较均有明显降低(P<0.01);重度PIH组MCA—PI/UA—PI及MCA—RI/UA—RI的比值二者均小于1。预测围产儿结局方面,MCA—PI/UA—PI具有高的敏感性(88.89％)、特异性(97.06％)、阳性预测值(94.12％)及阴性预测值(94.28％),其诊断指数最高为0.86,且与单一血管比较差异有显著性(P<0.01)。结论妊高征患者胎儿的胎盘循环与颅脑循环的血流动力学变化规律不一致,二者结合在预测妊高征病情发展程度和预测围产儿结局方面有重要的临床价值。更多还原

【Abstract】 Objective To study changes on hemodynamics of fetal umbilical artery (UA) and middle cerebral artery (MCA) in pregnancy induced hypertension (PIH), to evaluate the utility of color Doppler blood flow visualize technology in PIH. -Methods Color Doppler blood flow visualize technology was used to detect pulsatility indexes (PI) and resistance indexes (RI) of fetal umbilical artery and middle cerebral artery in 95 normal late pregnancies and 52 PIH cases. The ratios of MCA - PI/UA - PI and MCA - RI/UA - RI were calculated. The mean value of these Doppler indexes were compared. Results UA - PI were significantly higher in PIH groups than that of normal groups ( P < 0.01) . UA - RI showed no significant differences in two groups (P>0.05) . MCA -PI and MCA-RI were significantly lower just in severe PIH groups than that of normal groups (P<0.01) . MCA - PI/UA- PI and MCA- RI/UA- RI ratio were significantly lower in PIH than that of normal groups (P<0.01) .Inse-vere PIH groups, MCA PI/UA PI<1, MCA - RI/UA - RI < 1. For predicting perinatal outcome , MC - PI/UA - PI had the best sensitivity (88.89%), specificity (97.06%), positive predictive value (94.12%) and negative predictive value (94.28%) .The diagnosis index was the best (0.86), and there were significant differences than single vessels.Conclution The regularity of hemodynamic changes from fetal placental circulation was opposite to fetal brain circulation in PIH. Taking both banding together, there were important practical values in the assessment of PIH and perinatal outcome.更多还原