妊高征血液流变学与胎儿脑血流动力学相关性研究

本研究运用彩色多普勒超声，监测妊高征胎儿大脑中动脉（ＭＣＡ）血流的平均血流速度（Ｖｍ）和血流阻力指标，（Ｓ／Ｄ、ＰＩ、ＲＩ）并探讨它们与孕妇血液流变学各值的相关性，流变学包括：全血比粘度高切（ＢＶＨ）、全血比粘度度低切（ＢＶＬ）、血浆粘度（ＰＶ）、红细胞压积（ＨＣＴ）。结果：妊高征孕妇血液流变学各值与胎儿ＭＣＡ血流Ｖｍ及血流阻力指标各值呈正相关，阐明了妊高征血液流变学各值升高导致胎儿缺氧时，胎儿ＭＣＡ血流Ｖｍ加快、阻力指标各值降低。当血液流变学各值大于临界值或胎儿ＭＣＡ血流阻力指标低于临界值时，预测胎儿缺氧严重，应及时积极治疗，降低围产儿死亡率，保障母婴健康。

A Study of the Relationship between Hemoheology of Pregnancy Induced Hypertensive and Fetal Cerebral Hemodynamics

Exact prediction of fetal intrauterine hypoxia is an important event to improve perinatological quality.In this research,color Doppler ultrasonography was used to study 107 fetus cerebral hemodynamics.The mean velocity(Vm)and resistive indexes(S/D,PI,RI)of fetal middle cerebral artery(MCA)were evaluated.Comparing with hemoheological indexes of the fetal mothers(BVH,BVL,PV and HCT),it discovered that mothers with PIH have increased hemoheological indexes,and hypoxia occurs in their fetuses.As a result,Vm of fetal MCA increases and resistive indexes decreases.There is a significant correlation between fetal resistive index and mother hemoheological indexes.Abnormal changes of these two groups of indexes beyond certain critical values indicate severe fetal hypoxia and some kinds of treatments should be considered.Combined monitoring of the above indexes may supply more accurate prediction of fetal intrauterine hypoxia.