肝素对胎儿生长受限脐血流的影响

南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (04): 423-425.

肝素对胎儿生长受限脐血流的影响

余艳红¹, 沈立勇¹, 王志坚¹, 张宇², 苏桂栋¹

1. 第一军医大学南方医院妇产科, 广东, 广州, 510515;
2. 解放军第536医院, 青海, 西宁, 810007

出版日期:2004-04-20 发布日期:2004-04-20
基金资助:
收稿日期:2003-11-8。
基金项目:广东省重大社会问题联合攻关课题(ZKB04701S)
作者简介:余艳红(1962-),女,教授、主任医师,主要研究方向为围产医学,以第一负责人身份承担多项国家、省部级科研课题,电话:020-61641907,E-mail:youthkitty@yahoo.com

Effect of heparin on umbilical blood flow in patients with fetal growth retardation

YU Yan-hong¹, SHEN Li-yong¹, WANG Zhi-jian¹, ZHANG Yu², SU Gui-dong¹

1. 第一军医大学南方医院妇产科, 广东, 广州, 510515;
2. 解放军第536医院, 青海, 西宁, 810007

Online:2004-04-20 Published:2004-04-20

摘要/Abstract

摘要： 目的探讨肝素对胎儿生长受限(FGR)脐血流的影响,提供肝素治疗效果评价的依据。方法将103例FGR患者随机分为3组,在基础治疗的基础上,分别采用低分子右旋糖苷加丹参(对照组)、标准肝素(标准肝素组)及低分子肝素(低分子肝素组)治疗。于治疗前及终止妊娠前用彩色多普勒超声监测各组胎儿脐血流收缩期最大血流速度/舒张期末血流速度的比值(S/D)、阻力指数(RI)、搏动指数(PI),新生儿出生时进行Apgar评分、测量体质量及胎龄。结果 (1)随着孕周的增加,脐血流有降低的趋势,治疗后两肝素组脐血流S/D比值、PI、RI显著低于对照组(P<0.05)。(2)两肝素组新生儿1 min Apgar评分、体质量显著高于对照组,胎龄显著延长(P<0.05)。(3)两肝素组之间上述各指标无显著差异(P>0.05)。结论肝素可显著改善脐血流,降低S/D 比值、PI、RI,促进胎儿生长发育,使新生儿体质量增加,延长胎龄,提高新生儿1 min Apgar评分,且肝素对母、儿都是安全的。脐血流阻力指标可作为FGR治疗效果观察指标。

Abstract: Objective To investigate the effect of heparin on umbilical blood flow in pregnant women with fetal growth retardation (FGR). Methods A total of 103 FGR women wre randomized into control group (n=37), standard heparin group (n=35) and low-molecular-weight heparin group (n=31). Low-molecular-weight dextran was given in the control group, and the other two groups received agents for intervention as indicated. The umbilical blood flow, 1-minute Apgar score, body weight and gestational age of the neonates were measured and compared between the 3 groups. Results As the gestational age increases, the systolic/diastolic (S/D) ratio, pulsatility index (PI) and resistance index (RI) were significantly lowered in the two heparin groups in comparison with those in the control group (P<0.05). One-minute Apgar score and body weight of the neonates were significantly greater in the two heparin groups (P<0.05), and the gestational age was also significantly longer (P<0.05). No statistical differences in the indices measured were noted between the two heparin groups (P>0.05). Conclusions Heparin, which is safe for both the mothers and their fetuses, might improve fetal growth and development, increase neonate body weight, prolong the gestational age and raise the one-minute Apgar score.

中图分类号:

R722.6

余艳红¹, 沈立勇¹, 王志坚¹, 张宇², 苏桂栋¹. 肝素对胎儿生长受限脐血流的影响[J]. 南方医科大学学报, 2004, 24(04): 423-425.

YU Yan-hong¹, SHEN Li-yong¹, WANG Zhi-jian¹, ZHANG Yu², SU Gui-dong¹. Effect of heparin on umbilical blood flow in patients with fetal growth retardation[J]. Journal of Southern Medical University, 2004, 24(04): 423-425.

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