摘要目的 探讨血浆同型半胱氨酸(Hcy)、脐动脉血流参数与子痫前期(PE)患者病情轻重程度的相关性.方法 选择70名正常晚期妊娠孕妇(对照组)和72例轻度PE(轻度PE组)、66例重度PE患者(重度PE组),分别进行血浆Hcy及脐动脉血流彩色多普勒超声检查,比较3组之间的差异.结果 对照组、轻度PE组、重度PE组的Hcy分别为(8.950±0.585)、(11.116±0.615)、(14.648±0.620)μmol/L,两两比较差异均有统计学意义(P均＜0.05).重度PE组脐动脉血流参数收缩末期最大血流速度与舒张期最大血流速度之比(S/D)为3.43±0.72,显著高于对照组(2.75±0.56)和轻度PE组(2.86±0.82),差异均有统计学意义(P均＜0.05),而对照组与轻度PE组间差异无统计学意义(P＞0.05);轻度PE组、重度PE组阻力指数(RI)分别为0.60±0.05和0.78±0.07,明显高于对照组(0.57±0.06),差异均有统计学意义(P均＜0.05),而轻度PE组与重度PE组之间差异无统计学意义(P＞0.05);轻度PE组、重度PE组搏动指数(PI)分别为1.24±0.21和1.47±0.64,明显高于对照组(0.67±0.35),差异均有统计学意义(P均＜0.05),而轻度PE组与重度PE组之间差异无统计学意义(P＞0.05).轻度PE组血浆Hcy水平与脐动脉血流参数S/D、RI、PI呈正相关(r=0.548,P=0.009;r=0.587,P=0.008;r=0.324,P=0.002);重度PE组血浆Hcy水平与脐动脉血流参数S/D、RI、PI呈正相关(r=0.752,P=0.001;r=0.627,P=0.003;r=0.438,P=0.024).Hcy与PE病情程度呈正相关(r=0.450,P＜0.05),S/D与PE病情严重程度呈正相关(r=0.316,P=0.002);RI、PI与PE病情轻重无相关性(r=0.024,P=0.726;r=0.054,P=0.649).结论 随着PE患者的病情加重,Hcy水平呈升高趋势,在重度患者S/D水平明显升高,降低Hcy、监测S/D为诊治子痫前期,特别是重度子痫前期提供了一种新的思路.

abstractsObjective To analyze the relationship between the levels of plasma total homocysteine (Hcy) and umbilical arterial with color doppler ultrasound with the severity of preeclampsia(PE).Methods A total of 70 cases of the third trimester of normal pregnancy, 72 cases of mild PE, and 66 cases of severe PE were selected.Then plasma Hcy levels and umbilical arterial with color doppler ultrasound were detected.Results Hcy levels were statistically significant difference among the normal control group,mild PE group,and severe PE group((8.950±0.585), (11.116±0.615), (14.648±0.620) μmol/L,P＜0.05).Umbilical artery blood flow parameter S/D values in severe PE group was significantly higher in mild PE group and in contrg.1 group (3.43 ±0.72 vs.2.86 ± 0.82 vs 2.75 ± 0.56, P＜ 0.05), while the control group, mild PE group had no significant difference(P＞0.05).Resistance index(RI) ,Pulsatility index(PI) in mild PE group and severe PE group were significantly higher than control group(0.60±0.05,0.78±0.07 vs.0.57±0.06;1.24±0.21,1.47±0.64 vs.0.67±0.35), and the differences among three groups were significant(P＜0.05), while the mild PE, severe PE group had no significant difference(P＞0.05).Hcy of mild PE group was positively correlated with S/D, RI and PI(r=0.548,P=0.009;r=0.587,P=0.008;r=0.324,P=0.02).Hcy of severe PE group was positively correlated with S/D,RI and PI(r=0.752,P=0.001;r=0.627,P=0.003;r =0.438,P=0.024).Hcy and the severity of PE was positively correlated (r =0.450, P ＜ 0.05), S/D and the severity of PE was positively correlated(r=0.316, P =0.002).RI, PI and the severity of PE was no correlation (r =0.024, P =0.726;r =0.054,P =0.649).Conclusion The levels of Hcy and S/D were related to the severity of PE.To reduce Hcy,and monitor S/D were new ways for the diagnosis and treatment of pre-eclampsia.