妊娠期高血压疾病患者孕中期血管内皮功能变化

目的探讨妊娠期高血压疾病患者在孕中期临床发病前的血管内皮功能的变化。方法对340例孕中期孕妇用超声行肱动脉血流介导的舒张功能（FMD）,血清内皮素（ET）、一氧化氮（NO）测定,并根据其随访的妊娠结局分为妊娠期高血压疾病组（妊高征组）和正常组,比较两组的FMD,ET,NO结果。结果 340例中有41例孕晚期发生妊娠期高血压疾病（妊高征组）,而其余299例未发生妊娠期高血压疾病（正常组）。孕中期妊高征组FMD、血清NO显著低于正常组,而血清ET显著高于正常组,差异均有显著性（P〈0.05）。在妊高征组内,重度子痫前期组FMD、血清NO显著低于轻度子痫前期组,而血清ET显著高于轻度子痫前期,差异有显著性（P〈0.05）。结论孕中期妊娠期高血压疾病潜在患者虽然血压正常,但已存在血管内皮损伤,可被超声、实验室等检出。

The varies of the endothelial function in the second trimester in patients with hypertensive disorders complicating pregnancy in the third trimester

Objective:To expore the varies of the endothelial fuction in the second trimester in patients who suffered from hypertensive disorders complicating pregnancy(HDCP) in the third trimester.Methods:Flow-mediated dilation(FMD) of brachial artery by ultrasonography,Serum concentrations of endothelin(ET) and nitric oxide(NO) were detected for 340 pregnancy women in the second trimester respectively,and then they were followed up till puerperium and be devided into hypertensive and normal group.Results:41 cases were suffered from HDCP out of 340 cases.The FMD and NO in hypertensive group was significantly lower than that in normal group,the ET in hypertensive group was significantly higher than that in normal group(P<0.05);Among the hypertensive group,the FMD and NO in the severe preeclampsia group was significantly lower than that in mild preeclampsia group(P<0.05),the serum level of ET was on the contrary however.Conclusions:Although the blood pressure of second trimester was normal in patients who suffered from HDCP in late pregnancy,the vascular endothelial function maybe had impaired and can be detected by ultrasonography and labortary test.