妊高征滋养细胞不良浸润螺旋动脉的彩色多普勒超声监测

目的　探讨超声多普勒对妊娠高血压综合征 (妊高征 )滋养细胞不良浸润螺旋动脉的监测。方法　妊高征组和正常妊娠组各 14例 ,采用Sequoia 5 12彩色电脑声像仪 ,探头 4V1,监测子宫动脉及子宫胎盘床中央、周边螺旋动脉PI、RI值 ,同时对其中 10例剖宫产者 (妊高征组 6人 ,正常妊娠组 4人 )术中取胎盘床组织 ,进行螺旋动脉组织学检查。结果　妊高征组子宫动脉的RI、PI值明显高于正常妊娠组 (RI :0 .5 9± 0 .14vs 0 .47± 0 .12 ;PI :0 .95± 0 .2 8vs 0 .6 4± 0 .15 ;P <0 .0 5 ) ;妊高征组螺旋动脉的RI、PI值与正常妊娠组比较 ,无论是子宫胎盘床中央 (RI :0 .37± 0 .0 9vs 0 .2 0± 0 .0 5 ;PI :0 .46± 0 .2 7vs 0 .2 5± 0 .0 5 )还是周边螺旋动脉的RI、PI值 (RI :0 .39± 0 .0 7vs 0 .2 6± 0 .0 7;PI :0 .5 4± 0 .2 6vs 0 .2 8± 0 .0 7)有明显差异 (P <0 .0 0 1)。组织学检查结果显示 ,妊高征组螺旋动脉生理变化不完全 ,同时存在管腔狭窄、平直 ,管壁增厚及急性粥样化等病理改变。结论　彩色多普勒超声监测妊高征子宫动脉、螺旋动脉血流阻力明显高于正常妊娠组 ,与滋养细胞不良浸润螺旋动脉的组织学改变相一致。彩色多普勒对螺旋动脉的血流动力学监测为妊高征滋养细胞不良浸润的研究提供了一种方

Study on Failed Trophoblastic Invasion of the Spiral Arteries in Pregnancy Induced Hypertension by Color Doppler Ultrasonography

Objective To study the ability of color Doppler ultrasound in detecting failed physiologic change of the spiral arteries in patients with pregnancy induced hypertension(PIH). Methods Color Doppler assessment of blood flow in the uteries and spiral arteries in central and peripheral parts of the placental bed in fourteen women with PIH and 14 normotensive controls without any therapy, the pulse index (PI) and resistance index (RI) were compared between the two groups. The histomorphology of 10 cases of placental bed biopsy was analyzed from 6 PIH and 4 normal pregnancies, taken at caesarean section. Results In women with PIH, there was a significantly higher impedance to blood flow in spiral arteries compared with normatensive women ( P <0.001). The histomorphology demonstrated the physiological changes of spiral arteries in PIH were less than those of the control group, and there were pathological changes of spiral arteries in PIH. Conclusion Color Doppler ultrasound can detect failed physiological change of the spiral arteries in PIH, and the results are in concordance with histologic data.