Girsen Anna, Mäkikallio Kaarin, Hiilesmaa Vilho, Hämäläinen Esa, Teramo Kari, Räsänen Juha
Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland.
Am J Obstet Gynecol. 2007 May;196(5):467.e1-6. doi: 10.1016/j.ajog.2006.12.032.
We hypothesized that in growth restricted fetuses, erythropoietin (EPO) secretion is increased in proportion to the severity of cardiovascular compromise.
Thirty-eight growth restricted fetuses underwent Doppler ultrasonography of cardiovascular hemodynamics. An umbilical artery (UA) blood sample was taken at delivery for EPO analysis. Group 1 fetuses (n=9) had normal UA and ductus venosus (DV) velocimetries. Group 2 fetuses (n=18) showed an abnormal UA and a normal DV velocimetry. Group 3 fetuses (n=11) had abnormal UA and DV velocimetries. Normal EPO values were determined in 19 uncomplicated pregnancies (control group).
In group 3, EPO levels were higher (P<.05) than in groups 1 and 2. All fetuses in group 3 had EPO concentrations above the 90th percentile EPO value in the control group. The corresponding incidences were 44% and 50% in groups 1 and 2. Fetuses with retrograde aortic isthmus net blood flow had greater (P<.001) EPO levels than fetuses with antegrade net blood flow. Descending aorta, UA, DV and left hepatic vein pulsatility index values correlated significantly with EPO concentrations.
In fetal growth restriction, serum EPO concentration is increased in proportion to the severity of fetal cardiovascular compromise. Furthermore, in fetuses with retrograde aortic isthmus net blood flow, EPO levels are increased.
我们假设在生长受限胎儿中，促红细胞生成素（EPO）的分泌与心血管功能损害的严重程度成比例增加。
38例生长受限胎儿接受了心血管血流动力学的多普勒超声检查。分娩时采集脐动脉（UA）血样进行EPO分析。第1组胎儿（n = 9）UA和静脉导管（DV）血流速度正常。第2组胎儿（n = 18）UA血流异常而DV血流速度正常。第3组胎儿（n = 11）UA和DV血流速度均异常。测定了19例无并发症妊娠（对照组）的正常EPO值。
第3组的EPO水平高于第1组和第2组（P <.05）。第3组所有胎儿的EPO浓度均高于对照组第90百分位数的EPO值。第1组和第2组的相应发生率分别为44% 和50%。主动脉峡部逆向净血流的胎儿比正向净血流的胎儿EPO水平更高（P <.001）。降主动脉、UA、DV和左肝静脉搏动指数值与EPO浓度显著相关。
在胎儿生长受限中，血清EPO浓度与胎儿心血管功能损害的严重程度成比例增加。此外，主动脉峡部逆向净血流的胎儿EPO水平升高。
