妊高征患者血液流变学与脐血流动力学的相关性研究

目的探讨妊高征患者血液流变学与胎儿脐动脉血流阻力指标的相关性和对围产儿结局的影响。方法用粘度仪检测妊高征孕妇全血比粘度高切（ＢＶＨ）、全血比粘度低切（ＢＶＬ）、全血还原比粘度、血浆粘度（ＰＶ）;用离心机检测红细胞压积（ＨＣＴ）;应用彩色多普勒检测胎儿脐动脉血流阻力指标,比较妊高征患者血液流变学各值与胎儿脐动脉血流阻力指标各值相关关系。结果妊高征患者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性;ＨＣＴ、ＢＶＨ、ＢＶＬ、ＰＶ对妊高征的发生、发展及严重程度及脐动脉血流阻力指标有重要影响,导致胎儿胎盘循环障碍,脐动脉血流阻力指标升高。围产儿结局不良发生率,中、重度妊高征高于轻度妊高征（Ｐ＜０．０１）。结论多项指标监测妊高征血液流变学及胎儿脐血流动力学,可提高预测妊高征发生、发展及严重程度和对围产儿预后影响的准确性。

A study on the relationship between hemorheology of pregnant women with pregnancy induced hypertension and hemodynamics of fetal umbilical artery blood flow

Objective To study the correlation between maternal hemorheological changes and resistant parameters of fetal umbilical artery blood flow in pergnant women with pregnancy induced hypertension (PIH). Methods Maternal whole blood viscosity at high and low shear rate (BVH, BVL), reduced whole blood viscosity, plasma viscosity (PV), hematocrit (HCT) and fetal umbilical artery blood flow were examined in cases of PIH. Results The results show a significant positive correlation between maternal hemorheological parameters and resistant parameters of fetal blood flow ( P<0.01, P <0.001). HCT, BVH, BVL, PV played an important role in occurrence, progress and degree of PIH. It can also increase fetal blood flow resistance and cause dysfunction of fetal placental circulation. Thus, there is a higher incidence of poor perinatal outcomes in severe and moderate PIH than that in mild cases ( P <0.01). Conclusion Analysis of these parameters can predict the occurrence and degree of PIH, and perinatal outcomes. There are important practical values in early treatment of PIH and improving fetal well being.