子痫前期大鼠模型子宫动脉、脐动脉、大脑中动脉超声多普勒参数与胎盘血管病理及妊娠结局的关系  

Relationship between Doppler ultrasound parameters of uterine artery,umbilical artery,middle cerebral artery and placental vasculopathology and pregnancy outcome in preeclampsia rat model

作　　者：马瑞琳 刘雨 徐桂香 史昊然 崔俭俭 杨泽俊 毛艳 赵茵[1,2] MA Ruilin;LIU Yu;XU Guixiang;SHI Haoran;CUI Jianjian;YANG Zejun;MAO Yan;ZHAO Yin(Obstetrics&Gynecology Department,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Shenzhen Huazhong University of Science and Technology Research Institute,Shenzhen 518063,China)

机构地区：[1]华中科技大学同济医学院附属协和医院妇产科,武汉430022 [2]深圳华中科技大学研究院,深圳518063

出　　处：《上海交通大学学报（医学版）》2024年第5期543-551,共9页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(82171678);深圳自然科学基金(JCYJ20200109140614667)。

摘　　要：目的·通过超声多普勒检测子痫前期(preeclampsia,PE)大鼠模型子宫动脉、脐动脉、大脑中动脉参数,对比胎盘血管病理及妊娠结局,为评估PE动物模型胎盘功能提供有效方法和参考。方法·利用N-硝基-L-精氨酸甲酯(N′-nitro-Larginine-methylesterhydrochloride,L-NAME)和0.9%氯化钠溶液腹腔注射,分别建立PE组(n=8)和正常妊娠(normal pregnancy,NP)组(n=8)的SD大鼠动物模型,检测血压和蛋白尿指标评估模型是否成功建立。在妊娠(gestational day,GD)第19日(GD19)时利用超声多普勒检测PE组和NP组子宫动脉、脐动脉以及胎鼠大脑中动脉相关指标,终止妊娠后通过胎盘血管病理、胎鼠胎盘质量情况评估胎盘功能。结果·PE组大鼠的血压(GD15:P=0.001;GD19:P=0.001)、蛋白尿(GD15:P=0.001;GD19:P=0.001)均高于NP组,其胎鼠脐动脉、子宫动脉的搏动指数(pulsation index,PI)显著高于NP组(均P=0.000),胎鼠大脑中动脉阻力指数(resistance index,RI)显著低于NP组(P=0.000)。胎鼠数量无显著差异,PE组胎盘、胎鼠质量显著低于NP组(P=0.006,P=0.000),胎盘组织血管特异性免疫组化染色提示PE组胎盘微血管迷路密度少于NP组(P=0.001)。通过相关性分析发现胎盘微血管迷路密度、胎鼠质量、胎盘质量与脐动脉RI、子宫动脉PI及RI呈负相关,而与大脑中动脉S/D、PI、RI呈正相关(均P<0.05)。结论·超声多普勒检测L-NAME诱导的PE大鼠模型子宫动脉、脐动脉、大脑中动脉指数相关指标可以良好反映妊娠结局和胎盘血管病理情况,可用于评价PE大鼠模型的胎盘血管灌注情况,具有动物模型研究的实用性和便利性。Objective·To measure the parameters of the uterine artery,umbilical artery and middle cerebral artery in a rat model of preeclampsia(PE)by Doppler ultrasound,and compare the pathological changes in placental blood vessels and pregnancy outcomes,in order to provide an effective method and reference for evaluating placental function in PE animal models.Methods·PE(n=8)and normal pregnancy(NP,n=8)groups in Sprague-Dawley(SD)rat models were established by intraperitoneal injections of N′-nitro-L-arginine methylesterhydrochloride(L-NAME)and 0.9%sodium chloride solution.Blood pressure and proteinuria indexes were detected to evaluate whether the model was successfully established.On gestational day 19(GD19),Doppler ultrasound was utilized to measure the parameters of the uterine artery,umbilical artery and the fetal middle cerebral artery in both the PE and NP groups.After termination of the pregnancies,placental function was evaluated through the pathology of placental blood vessels and the quality of the fetuses and placentas.Results·In the PE group,both blood pressure(GD15:P=0.001;GD19:P=0.001)and proteinuria(GD15:P=0.001;GD19:P=0.001)were significantly higher than those in the NP group.The pulsatility index(PI)of the umbilical artery and uterine artery was notably elevated in the PE group compared to the NP group(both P=0.000).Furthermore,the resistance index(RI)of the fetal middle cerebral artery was significantly lower than that in the PE group(P=0.000).While the number of fetal rats did not differ significantly,the quality of placental and fetal rats was notably lower in the PE group(P=0.006 and P=0.000,respectively).Immunohistochemical staining of placental tissue revealed that the number of placental micro vessel densities in the PE group was less than that in the NP group(P=0.001).Correlation analysis revealed that placental micro vessel density,fetal quality and placental quality were inversely related with the RI of the umbilical artery and the PI and RI of the uterine artery,and positively correlated w

关 键 词：子痫前期 胎盘血管密度 妊娠结局 多普勒超声 

分 类 号：R739.7[医药卫生—肿瘤]