重度子痫前期患者颈总动脉结构和功能改变初探  

Structural and functional changes of the common carotid artery in patients with severe preeclampsia

作　　者：赵文[1] 蔡月伟 许建萍[3] Zhao Wen;Cai Yuewei;Xu Jianping(Department of Ultrasonography,Shanxi Provincial People′s Hospital,Taiyuan 030001,China;Department of Critical Care Medicine,First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Ultrasonography,First Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西省人民医院超声科,太原030001 [2]山西医科大学第一医院重症医学科,太原030001 [3]山西医科大学第一医院超声科,太原030001

出　　处：《中华全科医师杂志》2023年第10期1052-1056,共5页Chinese Journal of General Practitioners

摘　　要：目的探讨重度子痫前期(SPE)患者颈总动脉结构和功能的改变情况。方法该研究为横断面研究。选取2019年5月至2021年12月在山西医科大学第一医院住院的SPE患者(SPE组),选取同期年龄、孕周相匹配的健康孕妇作为对照(对照组)。收集入选者的一般临床资料,包括年龄、孕周、病史等。采用彩色多普勒超声测量入选者双侧颈总动脉内膜中层厚度(IMT)、血流动力学参数[收缩期峰值流速(PSV)、舒张末期流速(EDV)、血管阻力指数(RI)和搏动指数(PI)];基于M型超声测得的血管内径及血压值计算颈总动脉弹性参数,包括血管压力-应变弹性系数(Ep)、僵硬度指数(β)及动脉顺应性(AC)。比较两组患者的一般临床资料及超声相关参数,并采用多因素logistic回归模型分析超声参数与SPE的关联。结果SPE组纳入患者56例,年龄(30.2±4.3)岁,对照组纳入31人,年龄(28.6±3.2)岁,两组间年龄差异无统计学意义(P>0.05);两组孕妇的身高、孕周差异均无统计学意义(均P>0.05);与对照组比较,SPE组患者体重较大,收缩压、舒张压较高(均P<0.05)。与对照组比较,SPE组患者的PSV、EDV较低,RI较大(均P<0.05),PI略小,但差异无统计学意义(P>0.05)。SPE组患者颈总动脉IMT较对照组厚(P<0.05)。与对照组比较,SPE组患者Ep、β较大,AC较低(均P<0.05)。多因素logistic回归分析结果显示PSV(OR=0.915,95%CI:0.859~0.974,P=0.005)与SPE呈独立负向关联,IMT(OR=4.012,95%CI:1.150~10.660,P=0.005)、RI(OR=9.279,95%CI:1.781~46.743,P=0.013)、Ep(OR=1.086,95%CI:1.031~1.142,P=0.002)与SPE呈独立正向关联。结论SPE患者颈总动脉结构、血流动力学发生了改变,颈总动脉弹性下降。ObjectiveTo investigate the structural and functional changes of the common carotid artery in patients with severe preeclampsia(SPE).MethodsFifty-six patients with severe preeclampsia(SPE group)admitted in the First Hospital of Shanxi Medical University from May 2019 to December 2021,and 31 normal pregnant women admitted in the same period(control group)were enrolled in the study.All subjects underwent conventional ultrasonography and color Doppler sonography examinations.The QLAB software was used to measure intima-media thickness(IMT)and hemodynamics indexs,including systolic peak velocity(PSV),end diastolic velocity(EDV),vascular resistance index(RI)and vascular pulsation index(PI);the elastic parameters,including stiffness indexβ,the stress and strain modulus of elasticity Ep and compliance(AC).The clinical data and ultrasound parameters were compared between SPE group and control group.Logistic regression was used to analyze the correlation between elastic parameters and SPE.ResultsCompared with the control group,the PSV,EDV were decreased,and RI was increased in the prenatal SPE group(all P<0.05).Compared with the control group,the Ep and stiffness indexβincreased in the SPE group,while AC decreased(all P<0.05).Multivariate logistic regression analysis showed that PSV(OR=0.915,95%CI:0.859-0.974,P=0.005)was negatively correlated with SPE;IMT(OR=4.012,95%CI:1.150-10.660,P=0.005),RI(OR=9.279,95%CI:1.781-46.743,P=0.013),Ep(OR=1.086,95%CI:1.031-1.142,P=0.002)were positively corrected with SPE.ConclusionThe structure and function of the common carotid artery have changed in patients with SPE.

关 键 词：先兆子痫 颈动脉 超声检查 

分 类 号：R714.244[医药卫生—妇产科学]