母体缺氧诱导因子-1α水平及胎盘血流变化与胎儿生长受限的相关性  

Correlation of maternal hypoxia inducible factor-1α level,placental blood flow and fetal growth restriction

作　　者：蒋玲玲[1] 陈丽平[1] 鲁晓燕[1] 刘颖蕾[1] 单峰[1] 曹杨 刘曼华[1] J IANG Lingling;CHEN Liping;LU Xiaoyan;LIU Yinglei;SHAN Feng;CAO Yang;LIU Manhua(Department of Obstetrics and Gynecology,Nantong First People＇s Hospital,Nantong,Jiangsu 226001,China)

机构地区：[1]江苏省南通市第一人民医院妇产科,226001

出　　处：《检验医学与临床》2018年第12期1707-1710,1715,共5页Laboratory Medicine and Clinic

基　　金：江苏省南通市卫生和计划生育委员会青年医学人才科研基金资助项目(WQ2016029)

摘　　要：目的研究母体缺氧诱导因子-1α(HIF-1α)水平和胎盘血流量与胎儿生长受限(FGR)发生和发展的相关性。方法以2014年10月至2017年10月于该院就诊的60例FGR患者作为研究组,另取同期就诊的60例健康孕妇作为对照组,检测两组研究对象孕20、24、28、32、36周和分娩前母体静脉血及分娩时胎儿脐静脉血中HIF-1α水平,监测各时间节点胎盘血流搏动指数(PI)、血流阻力指数(RI)和脐动脉收缩期峰值与舒张末期流速比值(S/D)的动态变化,分析胎儿分娩后母体胎盘组织HIF-1α表达水平,统计孕妇妊娠不良事件发生情况。结果研究组孕妇孕20、24、28、32、36周和分娩前血清HIF-1α水平均明显高于对照组,差异均有统计学意义(P<0.05);且研究组孕妇分娩后胎盘组织切片染色HIF-1α表达水平光密度值明显高于对照组,胎儿脐静脉血HIF-1α水平明显高于对照组,差异均有统计学意义(P<0.05);两组孕妇胎盘动脉血流PI、RI和S/D均随孕周增加而呈逐渐减小趋势,且研究组孕妇孕20、24、28、32、36周和分娩前母体胎盘动脉血流PI、RI和S/D均明显高于对照组,差异均有统计学意义(P<0.05);孕妇静脉血HIF-1α水平、胎儿脐静脉血HIF-1α水平、分娩后母体胎盘组织HIF-1α水平,胎盘血流PI、RI和S/D均与FGR呈正相关(P<0.05);研究组孕妇妊娠不良反应事件总体发生率明显高于对照组,差异有统计学意义(P<0.05)。结论孕妇HIF-1α水平升高及胎盘血流PI、RI和S/D升高会增加孕妇妊娠并发症和妊娠不良事件发生率。Objective To investigate the correlation between maternal hypoxia inducible factor-1α（HIF-1α）level and placental blood flow level and the occurrence and development of fetal growth restriction（FGR）.Methods A total of 60 cases of FGR treated from October 2014 to October 2017 in the hospital were taken as the study group,and 60 cases of normal pregnant women during the same period were taken as control group.The levels of HIF-1αin the fetal umbilical vein blood of two groups of subjects at 20,24,28,32,36 weeks,pre labor and delivery were detected.The dynamic changes in the ratio of the pulsatile index（PI）,the blood flow resistance index（RI）,the peak systolic peak of the umbilical artery and the end end velocity of the umbilical artery（S/D）were monitored.The expression level of HIF-1αin maternal placenta after fetal birth was calculated,and the incidence of adverse pregnancy events was recorded.Results Serum HIF-1αlevels of the study group were significantly higher than those in the control group at 20,24,28,32,36 weeks and before delivery,and the difference was statistically significant（P〈0.05）;the HIF-1αexpression level of the placental tissue section of the study group was significantly higher than that of the control group,the HIF-1αlevel of fetal umbilical vein blood was significantly higher than that of the control group,and the difference was statistically significant（P〈0.05）;the blood flow PI,RI and S/D of the two groups of pregnant women gradually decreased with the increase of gestational age,and the maternal placental arterial blood flow PI,RI and S/D were significantly higher than those in the control group at 20,24,28,32,36,and before delivery,and the difference was statistically significant（P〈0.05）;HIF-1αlevel of venous blood,HIF-1αlevel of fetal umbilical vein,HIF-1αlevel of placental tissue in maternal body after delivery,PI,RI and S/D of placental blood flow were positively correlated with FGR（P〈0.05）;the overall incidence of adverse events in pr

关 键 词：缺氧诱导因子-1Α 胎盘血流 胎儿生长受限 

分 类 号：R714.51[医药卫生—妇产科学]