妊高征患者血管内皮生长因子、脐动脉血流与胎盘病理变化的关系研究

目的分析血管内皮生长因子(VEGF)、脐动脉血流在妊高征疾病中的变化及与胎盘病理变化的相关性。方法对正常妊娠孕妇60例、妊高征孕妇59例,于妊娠24~27+6周、28~36+6周、≥37周采用酶联免疫吸附试验动态测量血清VEGF水平,彩色多普勒超声监测妊娠≥33周孕妇脐动脉血流S/D比值、PI值、R I值,对血VEGF、脐动脉血流与胎盘的病理变化进行相关性研究。结果随着妊娠的进展,2组孕妇血清VEGF水平持续升高,在妊娠28~36+6周和妊娠≥37周时2组血清VEGF水平均有显著性差异(P均<0.05),脐动脉血流S/D、PI、R I值均较对照组显著性增高(P均<0.05),与胎盘病理改变相关(P<0.05),其值越高,胎盘的病理改变越重。结论妊高征患者中血清VEGF、脐动脉血流与胎盘病理改变呈正相关性,可以通过监测VEGF、脐动脉血流来检测胎盘的病理改变,对防治妊高征有一定的临床指导意义。

Study on relationship between changes of vascular endothelial growth factor and umbilical artery blood stream in gestational hypertension patients and placenta pathological change

Objective It is to analyze the changes of vascular endothelial growth factor(VEGF) and umbilical artery blood stream in gestational hypertension and the relationship of above changes with placenta pathological change.Methods The levels of serum VEGF in 60 normal pregnant women and 59 pregnant women with gestational hypertension were surveyed dynamically in 24~27+6 weeks,28~36+6 weeks and ≥37 weeks with enzyme linked inmunosorbent assay.The values of S/D,PI and RI in umbilical artery blood stream of pregnant women in ≥33 weeks were monitored with color Doppler ultrasound.The relationships between the changes of VEGF and umbilical artery blood stream and the pathological change of placenta were studied.Results Along with the progression of pregnancy,the levels of serum VEGF in the two groups both continuously heightened.There were both significant differences on the levels of serum VEGF between the two groups in 28~36+6 weeks and ≥37 weeks(both P<0.05).The values of S/D,PI and RI in umbilical artery blood stream were all significantly higher than that in control group(all P<0.05),which had correlation with placenta pathological change(P<0.05).Higher the values were,severer the placenta pathological change was.Conclusion Serum VEGF and umbilical artery blood stream in the patients with gestational hypertension have positive correlation with placenta pathological change.The pathological change of placenta can be detected through monitoring VEGF and umbilical artery blood stream,which has determinate clinical leading significance on the prevention and cure for gestational hypertension.