妊娠期妇女肾血流动力学特征  

Characteristics of renal artery blood flow during normal pregnancy

作　　者：孙丽洲[1] 潘义[1] 姜海风[1] 

机构地区：[1]南京医科大学第一附属医院妇产科,210029

出　　处：《江苏医药》2007年第11期1087-1089,共3页Jiangsu Medical Journal

基　　金：国家十五科技攻关项目(2004BA720A06-01)

摘　　要：目的研究妊娠期肾血流动力学的改变。方法随机对160例正常妊娠妇女以彩色多普勒超声监测孕10～14周（孕早期）、20～24周（孕中期）、30～34周（孕晚期）肾动脉血流的峰值流速/舒张末期流速比（S/D）、搏动指数（PI）和阻力指数（RI）,同时测定血浆内皮素,所得结果与50例年龄相仿非妊娠妇女测定值比较。结果正常妊娠组孕晚期血内皮素水平明显高于孕早期、孕中期和非妊娠组（P〈0.05）。正常妊娠组孕中期肾主动脉血流的S/D和RI以及肾段动脉的S/D、PI和RI均显著高于非妊娠组（P〈0.05或P〈0.01）。与孕早期比较,孕中期肾主动脉血流的PI和肾段动脉血流的S/D、PI和RI均明显升高（P〈0.05）。孕晚期肾段动脉的血流动力学参数均高于孕中期（P〈0.05）。结论随着妊娠进展,孕中期血流动力学发生显著改变,反映了妊娠期肾血循环的变化,以此可以早期发现妊娠期病理改变,以便早期采取措施预防妊娠并发症的发生。Objective To study the characteristics of renal artery blood flow during normal pregnancy. Methods One hundred and sixty normal pregnant women and 50 non-pregnant women as the controls were seleeeted in this study. The renal duplex parameters（S/D, PI and RI） of the main and segmental renal artery were monitored with color Dopplar ultrasound from the 10th to 14th gestational week（early stage , E） ,20th to 24th gestational week（mlddle stage, M） and 30th to 34th gestational week （later stage, L）respectively, and the same measurements were also performed in the controls. Plasma endothelin （ET-1）level was detected with ELISA in the same pregnant stages. Results ET-1 was significantly higher in normal pregnant women at L than that at E and M, and in nonpregnant control subjects（P〈0. 05）. The values of S/D and PI from the renal main artery and S/ D,PI and RI from the renal segmental arteries were all significantly higher in pregnant women at M than those in the controls （P〈0. 05 or P〈0.01）. Conclusion The greatest increase in renal blood flow may be seen at M of pregnancy, reflecting the changes of renal blood circulation. Early detection of pathological changes in renal blood flow is helpful to take some measures for preventing pregnant complication.

关 键 词：妊娠 肾 肾血流 内皮素 

分 类 号：R71[医药卫生—妇产科学]