Department of Anaesthesia, The Royal Women's Hospital Parkville and Department of Pharmacology, The University of Melbourne, Victoria, Australia.
Anaesthesia. 2012 Oct;67(10):1105-18. doi: 10.1111/j.1365-2044.2012.07193.x. Epub 2012 Jun 26.
This study aimed to compare the haemodynamics in healthy pregnant women with the haemodynamics in women with untreated pre-eclampsia, to determine the cardiovascular reason for hypertension in pre-eclampsia. 40 women with untreated pre-eclampsia, 40 matched healthy pregnant women and 20 non-pregnant women were studied using transthoracic echocardiography. Untreated pre-eclampsia demonstrated (mean (SD), healthy non-pregnant vs healthy pregnant vs untreated pre-eclampsia) increased cardiac output (3400 (752) vs 4109 (595) vs 4789 (1416) ml.min(-1), p=0.002), increased stroke volume (53 (10) vs 53 (8) vs 59 (13) ml, p=0.04), increased fractional shortening (35 (5) vs 35 (7) vs 41 (8) %, p=0.006), increased fractional area change (57 (7) vs 57 (9) vs 65 (9)%, p=0.002) and increased systemic vascular resistance (2116 (457) vs 1613 (315) vs 2016 (625) dyne.s.cm(-5), p=0.001). Mitral E/septal e' was higher (6.0 (1.1) vs 6.7 (1.3) vs 10.4 (2.4), p=0.002) and left atrial size increased (3.2 (0.3) vs 3.8 (0.4) vs 4.0 (0.4) cm, p=0.002). Hypertension in untreated pre-eclampsia is due to increased cardiac output and mild vasoconstriction, with increased inotropy and reduced diastolic function.
本研究旨在比较未治疗的子痫前期孕妇与健康孕妇的血液动力学，以确定子痫前期高血压的心血管原因。使用经胸超声心动图研究了 40 名未治疗的子痫前期妇女、40 名匹配的健康孕妇和 20 名非孕妇。未治疗的子痫前期表现出（平均值（标准差），健康非孕妇与健康孕妇与未治疗的子痫前期）增加的心输出量（3400（752）与 4109（595）与 4789（1416）ml.min(-1)，p=0.002），增加的每搏量（53（10）与 53（8）与 59（13）ml，p=0.04），增加的分数缩短（35（5）与 35（7）与 41（8）％，p=0.006），增加的分数面积变化（57（7）与 57（9）与 65（9）％，p=0.002）和增加的全身血管阻力（2116（457）与 1613（315）与 2016（625）dyne.s.cm(-5)，p=0.001）。二尖瓣 E/间隔 e'更高（6.0（1.1）与 6.7（1.3）与 10.4（2.4），p=0.002），左心房增大（3.2（0.3）与 3.8（0.4）与 4.0（0.4）cm，p=0.002）。未治疗的子痫前期的高血压是由于心输出量增加和轻度血管收缩，以及收缩力增加和舒张功能降低所致。
