Hansen W F, Burnham S J, Svendsen T O, Katz V L, Thorp J M, Hansen A R
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA.
J Matern Fetal Med. 1996 Jul-Aug;5(4):194-200. doi: 10.1002/(SICI)1520-6661(199607/08)5:4<194::AID-MFM6>3.0.CO;2-F.
The objective of this study was to evaluate the effect of preeclampsia and its severity on maternal mean middle cerebral artery blood flow velocity (mean MCA-CBFV) using transcranial doppler sonography (TCD), as well as the effect of magnesium on mean MCA-CBFV in preeclampsia. This study used a prospective, comparative design. TCD was used to examine maternal mean MCA-CBFV in both healthy subjects (controls) and preeclamptic subjects (cases). The two groups were similar in age, gestational age, and parity. Healthy subjects were categorized into three groups: Group I, 6-14 weeks, n = 10; Group II, 24-40 weeks, n = 27; Group III, postpartum n = 15, 12-36 h. Serial TCD examinations of the middle cerebral artery were completed in 21 preeclamptic subjects at four different points in time: Time I is an initial measurement before delivery; Time 2 is also before delivery but after magnesium had been administered. Time 3 is postpartum while on magnesium (12-24 h), Time 4 is postpartum off magnesium, (24-48 h). Preeclamptic subjects had significantly increased mean MCA-CBFV when compared to healthy subjects: antepartum (mean 78.2 vs. 55.1 cm/sec, P < 0.0005); postpartum (mean 101.3 vs. 69.8 cm/sec, P < 0.0001). Severe preeclamptics had significantly higher mean MCA-CBFV than mild preeclamptics at each point in time: Time 1: P < 0.016; Time 2: P < 0.040; Time 3: P < 0.002; and Time 4: P < 0.028. These data support the theory that cerebral vasospasm of the smaller diameter vessels is a major component of preeclampsia.
本研究的目的是使用经颅多普勒超声（TCD）评估子痫前期及其严重程度对孕妇大脑中动脉平均血流速度（平均MCA-CBFV）的影响，以及镁对子痫前期患者平均MCA-CBFV的影响。本研究采用前瞻性比较设计。TCD用于检查健康受试者（对照组）和子痫前期受试者（病例组）的孕妇平均MCA-CBFV。两组在年龄、孕周和产次方面相似。健康受试者分为三组：第一组，孕6-14周，n = 10；第二组，孕24-40周，n = 27；第三组，产后12-36小时，n = 15。对21例子痫前期受试者在四个不同时间点进行大脑中动脉的系列TCD检查：时间I为分娩前的初始测量；时间2也在分娩前但在给予镁之后。时间3为产后使用镁时（12-24小时），时间4为产后停用镁时（24-48小时）。与健康受试者相比，子痫前期受试者的平均MCA-CBFV显著增加：产前（平均78.2 vs. 55. I cm/秒，P < 0.0005）；产后（平均101.3 vs. 69.8 cm/秒，P < 0.0001）。在每个时间点，重度子痫前期患者的平均MCA-CBFV均显著高于轻度子痫前期患者：时间1：P < 0.016；时间2：P < 0.040；时间3：P < 0.002；时间4：P < 0.028。这些数据支持以下理论，即小直径血管的脑血管痉挛是子痫前期的主要组成部分。
