正常妊娠孕妇血管内皮功能和僵硬度变化的纵向研究

摘要

目的 探讨正常孕妇的整个孕期至产后血管内皮细胞功能、动脉僵硬度的变化规律及其两者之间的关系.方法 21位正常妊娠和分娩的妇女加入此项研究.作为一个纵向研究,右侧肱动脉的血流介导的血管舒张功能(flow-mediated dilation,FMD)和右侧颈总动脉僵硬度的单点脉搏波传导速度(one-point pulse wave velocity,PWVβ)分别在早孕期、中孕期、晚孕期和产后42 d以后进行检测.结果 正常妊娠妇女依次自早孕期至产后42 d以后四个阶段右侧肱动脉FMD值呈下降趋势,右侧颈总动脉的PWVβ 值呈先升后降的变化趋势,各时期的FMD值和PWVβ 值之间均不存在相关性.结论 正常孕妇肱动脉的FMD值和颈动脉的PWVβ 值均有各自的变化趋势,并且两者联合可以较完整地评估动脉管壁的状况,为进一步研究孕妇的血管异常病变奠定了基础.%Objective To examine the changes of elastic arteries in endothelial function and arterial stiffness and determine the associations between them throughout normal pregnancy.Methods Twenty-one pregnant women were included in this study.Endothelial function was assessed by right brachial artery flow-mediated dilatation (FMD) and arterial stiffness were assessed by right common carotid artery one-point pulse wave velocity (PWVβ) in a longitudinal way during the first,second,and third trimesters of pregnancy,and 6 weeks after delivery.Results In normal pregnancies,FMD decreased from the first trimester to 6 weeks after delivery,and the PWVβ increased at the second trimester,deceased from the third trimester to 6 weeks after delivery.No relation was found between FMD and PWVβ throughout pregnancy and 6 weeks after delivery.Conclusions The FMD of brachial artery and the PWVβ of carotid artery both have their variation tendency in normal pregnancies.The combination of the two parameters will be more effective for the evaluation of the arterial wall.These data provide the foundation for further investigation into them in vascular disorders in pregnancy.