关键词: 子痫, 颈动脉内膜中膜厚度, 超声检查, 多普勒

Abstract: ABSTRACT:Objective To explore the vascular structure and function in early- and late-onset preeclampsia (PE)at the time of diagnosis.Methods Eighty preeclampsia cases were divided into two groups:40 early (pregnancy< 34 weeks)and 40 late (pregnancy≥ 34 weeks) onset cases according to gestational age at onset,and 80 controls paired by maternal age and gestational age at scan.Carotid intima-media thickness (IMT),distensibility,and circumferential wall stress together with inferior vena cava (IVC)collapsibility were assessed by ultrasound. Results Early-onset preeclampsia was characterized by increased systolic pressure,diastolic pressure and mean arterial pressure,uterine artery pulsatility index,the average rate of cesarean section,systolic and diastolic inner diameter of carotid artery,circumferential stress,the mean carotid artery intima-media thickness, carotid artery intima-media thickness, and fetal cerebroplacental ratio,gestational age at delivery,neonatal birth mass,IVC collapse,collapse index and carotid artery distensibility and umbilical artery blood pH were lower as compared to those of normotensive pregnancies.Late-onset preeclampsia was characterized by significantly increased uterine artery mean pulsatility index,cesarean section rate,systolic pressure,diastolic pressure and mean arterial pressure,systolic and diastolic carotid artery diameter,blood vessel wall circumferential stress and the mean carotid artery intima-media thickness,carotid artery intima-media thickness as compared to those of controls,and fetal cerebroplacental ratio, gestational age at delivery,neonatal birth mass,IVC collapse,collapse index and umbilical artery blood pH were lower there that of control group (all P < 0.05).Conclusion Distinct vascular adaptations in early-and late-onset preeclampsia could reflect different pathophysiologic mechanisms.

Key words: eclampsia, carotid intima-media thickness, ultrasonography, Doppler