检测血流加速时间在妊娠期高血压中的应用

目的通过分析子宫动脉、脐动脉、胎儿大脑中动脉的血流加速时间，结合围产儿预后，探讨加速时间在妊娠期高血压疾病中的应用价值。方法应用彩色多普勒超声技术，对90例妊娠期高血压疾病孕妇和90例同孕周无年龄差别的正常孕妇对照研究，妊娠期高血压疾病孕妇分为妊娠期高血压组、轻度子痫前期组和重度子痫前期组。依次测定子宫动脉、脐动脉、胎儿大脑中动脉的加速时间（acceleration time，AT），妊娠期高血压疾病患者围产儿分为预后不良组和预后良好组，采用方差分析或t检验比较加速时间在各组中的变化。结果正常妊娠子宫动脉、脐动脉和大脑中动脉AT值均随孕周的增加而延长；子宫动脉AT值、脐动脉AT值在轻度子痫前期组和重度子痫前期组均缩短（P〈0．01），而大脑中动脉AT值延长（P〈0．01）；预后不良组与预后良好组比较子宫动脉、脐动脉AT值缩短，大脑中动脉AT值延长，各组间比较差异均有统计学意义。结论妊娠期高血压疾病患者血流加速时间发生明显变化，这种变化与妊高征胎儿的预后密切相关。

Application of doppler blood flow acceleration time in assessment of hypertensive disorders complicating pregnancy

Objective ] By analyzing the changes of blood acceleration time （AT） in uterine, umbilical and fetal brain arteries of patients with hypertensive disorders complicating pregnancy（HDCP）, and combining with the prognosis of the perinatal infants, application of AT in PIH has been discussed. Methods ] With the color doppler ultrasound technology, 90 cases of HDCP women were studied and compared with another 90 well pregnant women with the same gestational weeks and ages. The HDCP women were grouped into pregnancy hypertension group, mild preeclampsia group and severe preeclampsia group.and in turn, their AT values of uterine, umbilical and Middle cerebral arteries （MCA） were determined. The fetal prognosis of the HDCP women is again divided into poor and good groups, respectively. The AT changes of the pregnant women were checked and compared each other carefully through t test method, and the effect of abnormal AT on perinatal prognosis were investigated with a logistic regression analysis. Results ] For normal pregnancy, the AT values of the gravid uterus, umbilical and middle cerebral arteries tend to increase with the increase of the gestational weeks. In contrast, the AT values of uterine and umbilical arteries become smaller （P〈0.001）, while the fetal brain artery AT extended （P〈0.001） in the mild and severe preeclampsias. Compared with the group of good prognosis, the AT of uterine and umbilical arteries of the poor prognosis are also shortened, while that of middle cerebral extended. Our conclusions have statistical significance and may be used as a guide in practice. Conclusion ] The blood AT values of HDCP women were found to be changed obviously and these changes are closely related to the perinatal prognosis of the HDCP women.