【摘要】 目的探讨L-精氨酸治疗妊娠期高血压疾病所致胎儿生长受限的效果及其对脐血流参数和一氧化氮(NO)水平的影响。方法妊娠期高血压疾病合并胎儿生长受限妊娠的孕妇68例,其中25例在常规治疗的基础上加用L-精氨酸治疗,监测治疗前后胎儿脐血流参数变化、孕妇外周血和新生儿出生时脐血NO水平。结果L-精氨酸治疗后,胎儿脐血收缩期峰值/舒张期峰值、搏动指数和阻力指数下降(P=0.0000),快速血流比值升高(P=0.0000);L-精氨酸组孕妇血清NO水平明显高于常规治疗组(P=0.0000),但仍低于对照组(P=0.0008);L-精氨酸组新生儿脐血清NO水平高于常规组(P=0.0017),但仍低于对照组(P=0.0000);L-精氨酸组新生儿出生体质量大于常规治疗组(P=0.0068),与对照组相比无统计学差异(P=0.1762)。结论L-精氨酸能显著提高妊娠期高血压疾病合并胎儿生长受限孕妇外周血及脐血中NO水平,改善脐血流,有助于胎儿宫内生长。更多还原

【Abstract】 Objective To investigate the therapeutic effect of L-arginine (L-Arg) administration on fetus growth retardation (FGR) due to pregnancy-induced hypertension and explore its mechanism. Methods Sixty-eight pregnant women with pregnancy-induced hypertension and FGR were enrolled in this study, and 25 of them were given L-Arg in addition to routine therapy. Umbilical artery flow parameters and serum NO concentrations in maternal and umbilical blood were measured, and the therapeutic effects were evaluated according to neonatal birth weight. Results L-Arg therapy markedly decreased the systolic/diastolic value, pulse index and resistant index (P=0.000 0), while increased the fast blood velocity rate(P=0.000 0). NO contents in maternal and umbilical blood were 60.45±22.68 and 28.45±11.35 μmol/L in L-Arg group, respectively, significantly higher than those in routine treatment group (P=0.000 0 and 0.001 7, respectively) but lower than those in the control group (P=0.000 8 and 0.000 0, respectively). The neonatal birth weights were 2.9±0.3 kg in L-Arg group, significantly higher than that in routine treatment group (2.7±0.3 kg, P=0.006 8) and similar with that of the control group (3012.9±295.9 g, P=0.176 2). Conclusion L-Arg promote intrauterine growth of the fetus by increasing NO production and improving the umbilical artery flow in pregnant women with pregnancy-induced hypertension and FGR.更多还原