妊娠早中晚期相关动脉血流参数及其规律  

Parameter and its regularity of pregnancy woman's related artery in the first,second and third trimester

作　　者：杨怡珂[1] 林建华[1] 林其德[1] 张为远[2] 

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200127 [2]首都医科大学附属北京妇产医院,北京100026

出　　处：《中国实用妇科与产科杂志》2009年第9期677-680,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家十五科技攻关项目(2004BA720A06-01)

摘　　要：目的测定妊娠早、中和晚期正常孕妇子宫动脉、脐动脉及肾动脉血流并寻找其正常规律。方法2005年4月至2006年7月在上海、北京、江苏、四川等11个省市24家医院的3207例正常妊娠妇女应用彩色多普勒超声在孕早、中、晚期连续检测双侧子宫动脉、肾动脉血流动力学参数,并在孕中、晚期检测脐动脉血流动力学参数。结果右侧子宫动脉S/D均数在孕早、中、晚期分别为3.82、2.76、2.24,左侧为3.87、2.86、2.23,双侧子宫动脉之间血流指标无统计学意义(P>0.05),而不同孕期间的各检测指标间差异有统计学意义(在α=0.05水平snk值不同),并且孕22周前血流阻力下降速度明显。脐动脉S/D均数在孕中、晚期分别为3.57、2.51,脐动脉在不同孕期的各检测指标有统计学意义(P<0.01)。左右两侧肾动脉各检测指标之间差异无统计学意义(P>0.05),在相同孕期内,肾动脉主干、肾段动脉和肾皮质动脉三段间RI值逐渐降低,有统计学意义(snk值不同)。结论正常妊娠妇女子宫动脉和脐动脉血流阻力随孕周增加逐渐降低,子宫动脉血流阻力在孕早期下降较明显,而肾动脉血流阻力随孕周增加无改变,但肾动脉血流阻力由外向内逐渐降低;相同孕期左右子宫动脉和左右肾动脉差异无统计学意义;这些规律对部分疾病的预测和治疗有所帮助。Objective To monitor the blood stream of uterine artery, umbilical artery and renal artery with the colored Doppler ultrasound in the first, second and third trimester of pregnancy and to find the regulars of them. Methods In the period between April 2005 to July 2006, 3207 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research project. RI,PI and S/D parameters of two-sided uterine and RI of renal arteries blood stream in the first; second and third trimester and RI,PI and S/D of the umbilical artery blood stream dynamics in the second and third trimester were measured by colored Doppler. Results The mean S/D value of uterine artery were 3. 82, 2.76, 2.24 at the right side, and were 3.87, 2.86, 2.23 at the left in the first, second and third trimester respectively. No statistical difference existed between right and left uterine artery resistance （P〉0.05）, but there were changes among different pregnant periods（the snk were different in the level of α= 0.05 ）. The mean S/D value of umbilical artery in the second and third trimester were 3.57, 2.51 and have significance differences （P 〈0.01 ）. No statistical difference existed between right and left renal artery RI （ P 〉 0.05 ）. In the same stage of pregnant, The mean RI value of the renal artery branch, kidney section artery and kidney cerebral cortex artery were reduced gradually （ the snk were different）. Condusion The resistances of uterine and umbilical artery were decreasing with pregnant progressing, the resistanee of uterine artery was decreasing faster in early stage, there was no visible change in the resistance of renal artery with pregnant progressing, but the renal artery blood stream resistance from outside to inside was gradually reducing. No difference existed between left and right of uterine and umbilieal artery. These rules maybe contributed to predict and cure some diseases.

关 键 词：妊娠 多普勒超声 子宫动脉 脐动脉 肾动脉 

分 类 号：R71[医药卫生—妇产科学]