Rogov V A, Shilov E M, Sidorova I S, Rogova E F, Makarov I O, Zozulia O V
Ter Arkh. 2002;74(10):52-5.
To study gestational changes in renal and uterine hemodynamics and their relation to systemic and intracardiac hemodynamics in pregnant hypertensive women with chronic glomerulonephritis (CGN).
Echocardiography, ultrasonic dopplerography of renal and uterine arteries were made in 16 pregnant women with CGN and AH syndrome in trimester II-III and 1-3 months after the delivery. Hemodynamic indices in pregnancy were compared to those after the delivery which were considered baseline.
In CGN pregnant women with AH syndrome resistance of renal arteries did not change in pregnancy and were similar postpartum. With advancing pregnancy, the resistance of the uterine arteries diminished. The indices of the resistance in the main trunk of the renal artery correlated with volumetric cardiohemodynamic indices, heart rate and total peripheral resistance in segmental interlobular arteries. No significant correlation were found between uterine, systemic and cardiac hemodynamics though it existed between renal and uterine blood flow.
Pregnancy does not affect vascular resistance of renal arteries in CGN pregnant women with AH syndrome, but contrary to pregnancy with essential hypertension in that with CGN and AH syndrome renal circulation responds to changes in systemic hemodynamics and volumetric indices of cardiohemodynamics. These findigns may reflect disturbances in autoregulation of renal circulation and additional effects on pregnancy outcome in women with CGN and AH syndrome.
研究慢性肾小球肾炎(CGN)合并妊娠高血压综合征孕妇的肾脏及子宫血流动力学的孕期变化及其与全身和心内血流动力学的关系。
对16例妊娠中晚期及产后1 - 3个月的CGN合并妊娠高血压综合征孕妇进行超声心动图检查以及肾脏和子宫动脉的超声多普勒检查。将孕期的血流动力学指标与产后的指标(视为基线)进行比较。
CGN合并妊娠高血压综合征的孕妇,孕期肾动脉阻力无变化,产后相似。随着孕周增加,子宫动脉阻力降低。肾动脉主干阻力指标与分叶间动脉的容量心血流动力学指标、心率及总外周阻力相关。子宫、全身和心脏血流动力学之间未发现显著相关性,尽管肾血流与子宫血流之间存在相关性。
妊娠不影响CGN合并妊娠高血压综合征孕妇的肾动脉血管阻力,但与原发性高血压妊娠不同的是,CGN合并妊娠高血压综合征时肾循环对全身血流动力学变化及心血流动力学容量指标有反应。这些发现可能反映了肾循环自身调节的紊乱以及对CGN合并妊娠高血压综合征孕妇妊娠结局的额外影响。