超声评价子痫前期孕妇胎儿心室收缩功能及与胎盘缺氧程度的相关性

摘要

目的:超声评价子痫前期孕妇胎儿心室收缩功能及其与胎盘缺氧程度的相关性.方法:选择2016年3月~2017年6月在我院确诊为子痫前期的45例孕妇作为PE组,同期产检和分娩的60例健康孕妇作为对照组,采用彩色多普勒超声测定胎儿左右心室的心室缩短分数(FS),分娩后采集胎盘并测定缺氧所致氧化应激损伤和细胞凋亡指标.结果:PE组胎儿左心室的FS与对照组比较无显著性差异(P>0.05),右心室的FS显著低于对照组(P<0.05);PE组胎盘组织中丙二醛(M DA)、蛋白质晚期氧化产物(AOPP)、8-羟基脱氧鸟苷(8-OHdG)、Bax、Caspase-9、Caspase-3的含量显著高于对照组(P<0.05),Bcl-2的含量显著低于对照组(P<0.05);胎儿右心室 FS 与胎盘中 MDA、AOPP、8-OHdG、Bax、Caspase-9、Caspase-3含量呈负相关(P<0.05),与胎盘中Bcl-2含量呈正相关(P<0.05).结论:子痫前期孕妇胎儿的右心室收缩功能减弱,超声测定FS能够准确评价胎儿右心室的收缩功能,且与胎盘缺氧所致氧化应激反应、细胞凋亡有关.%Objective:To evaluate fetal ventricular systolic function in preeclampsia and its correlation with placental hypoxia degree.Methods:45 cases of pregnant women diagnosed with preeclampsia in our hospital between March 2016 and June 2017 were selected as PE group,60 cases of health pregnant women receiving prenatal examination and giving birth during the same period were selected as control group.Fetal left and right ventricular fractional shortening(FS)were measured by col-or Doppler ultrasound.Placenta was collected after delivery,and hypoxia-induced oxidative stress and apoptosis indexes were determined.Results:there was no significant difference in fetal left ventricular FS between PE group and control group(P>0.05),and right ventricular FS was significantly lower than that of control group(P<0.05);MDA,AOPP,8-OHdG,Bax, Caspase-9 and Caspase-3 contents in placenta of PE group were significantly higher than those of control group whereas Bcl-2 content was significantly lower than that of control group;fetal right ventricular FS was negatively correlated with MDA, AOPP,8-OHdG,Bax,Caspase-9 and Caspase-3 contents in placenta,and positively correlated with Bcl-2 content in placenta. Conclusion:fetal right ventricular systolic function is weakened in pregnant women with preeclampsia,and FS can be used to e-valuate the systolic function of the right ventricle,and is related to the oxidative stress response and apoptosis caused by pla-cental hypoxia.