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正常妊娠和重度子痫前期的胎儿血液流变学

Fetal hemorheology in normal pregnancy and severe preeclampsia.

作者信息

Heilmann L, Rath W, Pollow K

机构信息

Department Obstetrics Gynecology, Clinica Obstetric Gynecology, City Hospital, Rüsselsheim, Germany.

出版信息

Clin Hemorheol Microcirc. 2005;32(3):183-90.

Abstract

Hemorheological parameters were determined in 45 pairs of mothers with severe preeclampsia and their newborns in comparison with 45 women with uncomplicated pregnancies and their newborns. In both groups we investigated red cell deformability, the plasma viscosity, the red cell aggregation (during stasis and low flow), the macromolecules fibrinogen and factor VIIIR:Ag (VWF), and the blood count parameters hemoglobin, hematocrit, white cells, platelets, reticulocytes, MCV, MCHC. Cholesterol and triglycerides were correlated to the parameter of red cell deformability measured as red cell elongation. We found a significant lower plasma viscosity, red cell aggregation, fibrinogen, cholesterol, triglycerides and VWF in cord blood with a close association between plasma viscosity and fibrinogen (r = 0.56, p = 0.001). The red cell deformability measured as red cell elongation was statistically higher in the cord blood compared to the mothers and associated with a higher MCV. In contrast the MCHC values remained unchanged. Hematocrit and hemoglobin in the cord blood were higher than in the mothers. The incidence of fetal hyperviscosity-polycytemia syndrome in women with severe preeclampsia was between 4.7% and 4.9%. An elevated red cell aggregation was found in 2.8% (stasis) and 4.8% (low flow state), respectively. We conclude that in fetal blood the higher hematocrit and the presence of larger red cells do not cause impaired fetal hemorheology.

摘要

对45对患有重度子痫前期的母亲及其新生儿进行血液流变学参数测定,并与45例无并发症妊娠的妇女及其新生儿进行比较。在两组中,我们研究了红细胞变形性、血浆粘度、红细胞聚集(在血液淤滞和低血流状态下)、大分子纤维蛋白原和因子VIIIR:Ag(血管性血友病因子),以及血细胞计数参数血红蛋白、血细胞比容、白细胞、血小板、网织红细胞、平均红细胞体积、平均红细胞血红蛋白浓度。胆固醇和甘油三酯与以红细胞伸长率衡量的红细胞变形性参数相关。我们发现脐血中的血浆粘度、红细胞聚集、纤维蛋白原、胆固醇、甘油三酯和血管性血友病因子显著降低,且血浆粘度与纤维蛋白原密切相关(r = 0.56,p = 0.001)。以红细胞伸长率衡量的红细胞变形性在脐血中统计学上高于母亲,且与较高的平均红细胞体积相关。相比之下,平均红细胞血红蛋白浓度值保持不变。脐血中的血细胞比容和血红蛋白高于母亲。重度子痫前期妇女中胎儿高粘度-红细胞增多症综合征的发生率在4.7%至4.9%之间。分别在2.8%(血液淤滞)和4.8%(低血流状态)中发现红细胞聚集升高。我们得出结论,在胎儿血液中,较高的血细胞比容和较大红细胞的存在不会导致胎儿血液流变学受损。

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