妊娠期高血压疾病孕妇血液流变学与胎儿血流动力学的相关性分析

目的分析妊娠期高血压疾病孕妇血液流变学与胎儿血流动力学的相关性。方法检测妊娠高血压疾病孕妇全血及血浆黏度,包括全血比黏度高切（BVH）、全血比黏度低切（BVL）、血浆黏度（PV）、红细胞压积（HCT）;应用彩色多普勒监测胎儿脐动脉（UMA）、大脑中动脉（MCA）血流指标。结果重度妊娠期高血压各值明显大于轻度妊娠期高血压;妊娠期高血压孕妇血液流变学各值与胎儿脐动脉血流阻力指标各值呈正相关,与大脑中动脉血流阻力指标各值呈负相关。当孕妇血液流变学各值增高达到以下指标：BVH≥4.63、BVL≥6.23、PV≥1.68、HCT≥0.36时可预测妊娠高血压的发生;当胎儿UMA血流S/D〉3、PI〉1.7、RI〉0.6时,MCA血流S/D≤4、P I≤1.6、R I≤0.6时,可预测胎儿缺氧。结论妊娠期高血压疾病孕妇血液流变学变化与胎儿血流动力学指标相关性分析,可为预测妊娠期高血压的严重程度提供有益的信息。

Study on the correlation between hemorrheology of pregnant women with HDCP and fetal hemodynamics

Objective To study on the correlation between hemorrheology of pregnant women with hypertensive disorder complicating pregnancy（HDCP）and fetal hemodynamics,and to predict fetal hypoxia and reduce perinatal mortality.Methods Pregnant women with HDCP were detected in whole blood and plasma viscosity,including whole blood viscosity at high shear（BVH）,whole blood viscosity at low shear（BVL）,plasma viscosity（PV）,hematocrit（HCT）,blood flow indicators including umbilical artery（UMA） and middle cerebral artery（MCA） were measured by using color Doppler monitoring.The relationship between（HDCP） and fetal hemodynamic were analyzed.Results Severe gestational hypertension was significantly greater than with mild gestational hypertension.The values between hemorheology of pregnant women with hypertension and the fetal hemodynamics of umbilical artery or the middle cerebral artery showed a negative correlation.When the value of hemorheology of pregnant women increased to achieve the following targets： BVH≥4.63,BVL≥6.23 and PV≥1.68;HCT≥0.36 may predict the occurrence of pregnancy-induced hypertension.When the blood flow of fetal UMA S/D〉3,PI〉1.7,RI〉0.6,MCA blood flow S / D≤4,PI≤1.6 and RI≤0.6 can predict fetal hypoxia.Conclusion It can predict the severity of HDCP by studying on the correlation between hemorrheology of pregnant women with hypertensive disorder complicating pregnancy（HDCP）and fetal hemodynamics,and it could provide reliable information for the clinical treatment of this disease as early as possible to reduce perinatal mortality.