三维超声检测妊娠期高血压疾病和宫内生长受限胎儿的产尿率

摘要

目的 研究妊娠期高血压疾病和宫内生长受限(intrautrine growth restriction,IUGR)胎儿产尿率(urine production rate,UPR)的改变情况.方法 应用三维超声虚拟器官计算机辅助分析(virtual organ computer-aided analysis,VOCAL)技术,测量53例正常单胎妊娠、47例妊娠期高血压疾病及47例IUGR胎儿的膀胱体积并计算各组胎儿UPR,经过Z-score转换消除孕周影响,测得的病例组Z值分别与对照组Z值进行比较.结果 妊娠期高血压组与对照组胎儿UPR之间差异无统计学意义(Z值分别为-0.43±0.30和-0.28±0.48; P＞0.05)；轻度与重度子痫前期组胎儿UPR逐渐减低(Z值分别为-0.65±0.20和-1.09±0.57),与对照组均有显著性差异(均P＜0.01).IUGR组胎儿UPR(Z值为-1.13±0.61)明显低于对照组(P＜0.001).结论 妊娠期高血压疾病和IUGR胎儿有不同程度的UPR减低,认为可能与胎儿慢性宫内缺氧及其程度有关.%Objective To evaluate the changes of fetal urine production rate (UPR) in pregnancy hypertensive disorders and intrautrine growth restriction (IUGR) using virtual organ computer-aided analysis( VOCAL) technique by 3D ultrasonography. Methods Fetal bladder volumn was measured in 53 women with normal singleton pregnancy, 47 cases with pregnancy hypertensive disorders and 47 cases with IUGR using VOCAL technique,and then fetal UPR was calculated in each group. To adjust for gestational age(GA),UPR was transformed to Z-score. Compare the Z-score of the case groups to the control group. Results Fetal UPR between gestational hypertension and the control group had no significant difference (Z-score were -0. 43±0. 30 and -0. 28 ± 0. 48,respectively;P>0. 05);Fetal UPR of mild and severe preeclampsia decreased gradually (Z-score were -0. 65 ±0. 20 and - 1. 09 ± 0. 57, respetively)and they both had significant differences with the control group(P<0. 01). Fetal UPR of the IUGR group(Z-score was - 1. 13 + 0. 61) was significantly lower than that of the control group(P<0. 001). Conclusions Fetal UPR of hypertension disorders in pregnancy and IUGR decreases to different degrees. This may be associated with the severity of chronically intrauterine hypoxia.