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[妊娠期中心血流动力学和外周循环的变化]

[Changes in central hemodynamics and peripheral circulation in pregnancy].

作者信息

Heilmann L, Lohr D, Hintereicher M, von Tempelhoff G F, Ose C

机构信息

Abt. Gynäkologie und Geburtshilfe, Stadtkrankenhaus Rüsselsheim.

出版信息

Geburtshilfe Frauenheilkd. 1993 Jul;53(7):472-8. doi: 10.1055/s-2007-1022916.

Abstract

Systemic blood pressure, stroke volume, systolic time intervals (measured via impedance cardiography), rheological properties of blood (hematocrit, plasma viscosity and erythrocyte aggregation) and peripheral flow conditions (measured via occlusive impedance plethysmography) were assessed longitudinally in 21 nonpregnant women and in 49 patients from 5th to 41st week of gestation and 4 to 9 days postpartum. Measurements were taken in the left lateral position. The data showed, that dz/dt, stroke volume and cardiac index rose until the 30th week of gestation and decreased throughout the rest of pregnancy. The same changes were observed in the data on diastolic pressure and Heather Index. Peripheral resistance fell during the first trimester and then increased notably throughout the following time of pregnancy. The systolic time intervals become longer in the last trimester of pregnancy, but were characterised by a markedly shortened left ventricular ejection time (LVET). The reduction of stroke volume in the last trimester is due to diminished venous return or venous outflow by obstruction of the inferior vena cava or by abnormalities in the left ventricular function and/or impaired rheological properties of the blood.

摘要

对21名未怀孕女性以及49名妊娠第5周至第41周和产后4至9天的患者纵向评估了全身血压、心搏量、收缩期时间间期(通过阻抗心动图测量)、血液流变学特性(血细胞比容、血浆粘度和红细胞聚集)以及外周血流状况(通过闭塞性阻抗体积描记法测量)。测量在左侧卧位进行。数据显示,dz/dt、心搏量和心脏指数在妊娠第30周前上升,在妊娠其余时间下降。舒张压和希瑟指数的数据也观察到同样的变化。外周阻力在孕早期下降,然后在随后的妊娠期间显著增加。妊娠晚期收缩期时间间期变长,但特征是左心室射血时间(LVET)明显缩短。妊娠晚期心搏量的减少是由于下腔静脉阻塞导致静脉回流或静脉流出减少,或左心室功能异常和/或血液流变学特性受损。

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